Changing COVID-19 strategy could buy time

Australian pharmacologist Emeritus Professor Richard Head has called for a new approach to treating COVID-19. In a journal commentary published with colleagues from the University of Newcastle, the University of South Australia professor says scientists should be focusing on repurposing existing proven drugs to block the acute inflammatory responses to the virus in seriously ill patients.

The commentary, published in Pharmacology Research & Perspectives, calls for an “urgent, coordinated international approach” led by a taskforce of industry and peak research bodies to save time and minimise duplication.

“We should be treating the host — not necessarily the virus — in the first instance, and buying ourselves time to identify, manufacture and employ drugs and vaccines which target the spread of the virus throughout the body,” Professor Head said.

“By clinically evaluating existing drugs, the goal is to mitigate the life-threatening inflammatory respiratory processes that are a key factor in COVID-19,” he explained.

“This deadly and astonishing virus can destroy cells on a grotesque scale, piercing an enzyme called ACE2 to gain entry via the lung and dysregulating normal cell functions.”

ACE2 is the host receptor that provides the entry point for the coronavirus to hook into and infect a wide range of human cells. It is critical to regulating inflammation in many of the body’s organs.

By invading and damaging the enzyme, the SARS-CoV-2 virus disrupts ACE2’s normal regulatory function, sending the immune system off balance and driving severe inflammation.

“We can’t restore broken ACE2, so we need to block and dampen the inflammatory response and take control of what happens when these enzymes are disabled.”

Professor Head said that although eliminating the virus is the ideal goal, a new approach is needed immediately to tackle acute cases, which would also take the pressure off health resources and buy valuable time to find a vaccine and antivirals.

“Inevitably, the world needs a solution that can be effective in the absence of a vaccine and antivirals, as social isolation eases and the economy starts to reopen. Realistically, a vaccine may never be developed exactly as planned, or potentially take a year, or years, to be rolled out globally,” he said.

Co-author and Chair of Clinical Pharmacology at the University of Newcastle Professor Jennifer Martin said Australia has enjoyed “a fine record in research and prevention of disease”.

“Urgent attention now needs to be given to coordinating a clinical evaluation of existing pharmaceuticals to buy time in this pandemic,” she said.

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