Not a vaccine but not an antivirus, the alternative treatment for Covid-19 (not spiritual)
Covid-19 is known for its diverse and sometimes confusing symptoms. However, many of the patients die from one same reason — their own immune response. This is called cytokine storm, which is caused when the immune system is not able to stop itself and immune cells spread beyond the infected body parts. It triggers blood-pressure loss and multiple organ failure. In other words, if we save patients from cytokine storms, the patients will have more chances to stand up and fight back the virus.
Despite the importance of preventing cytokine storms, so far we have only one drug that has been proven to be a life-saving drug. The low-dose steroid treatment dexamethasone is the drug. Dexamethasone was confirmed to reduce the risk of death from 40% to 28% for patients on ventilators. This was a breakthrough to fight against the virus, but there are other ways to raise the odds for survival.
Cytokines are a broad category of small proteins, so why not filter them out from the blood of suffering patients ? This is the idea. One of the leading companies is CytoSorbents Corporation from New Jersey. On April 10, 2020, FDA granted an Emergency Use Authorization to the extracorporeal cytokine adsorber product. It is already approved in the European Union with distribution in 58 countries. According to the website of CytoSorbents Corporation, so far CytoSorb therapy has been provided to 750 critically ill patients with Covid-19 in various centers in Italy, China and Germany. The biocompatible, highly porous polymer beads remove toxic substances including pro-inflammatory cytokines directly from the patient’s blood.
There are other companies that develop similar blood purification devices. Terumo BCT and Marker Therapeutics AG develop their own extracorporeal blood purification devices and FDA issued an Emergency Use Authorization on April 9, 2020. On June 2, they announced the first Covid-19 patient was treated by removing an overload of inflammatory cytokines. Terumo BCT is a Colorado-based medical company focused on devices for blood and cell innovations. Marker Therapeutics AG is a swiss-based diagnostics and therapeutics company. The device mechanism is similar. The adsorption cartridge reduces inflammatory cytokines when the patient’s blood and the plasma passes through the cartridge. The treated plasma is recombined with the rest of the blood and returned to the patient.
Illinois-based medical company, Baxter International Inc. received an Emergency Use Authorization on April 23, 2020 for their Oxiris filter set to treat Covid-19 patients admitted in ICU. They also focus on AKI (Acute Kidney Injury) triggered by Covid-19, which is a condition where the kidneys suddenly stop working. It sometimes occurs with cytokine storms. Baxter International Inc. adds 15 to 30% of patients with severe Covid-19 symptoms develop AKI and 67% of severely ill Covid-19 patients present additional organ dysfunction syndromes associated with cytokine storm. While the patient’s blood passes through their Oxiris filter, cytokines, endotoxin, fluid and uremic toxins are removed before returning to the patient’s body.
If we see vaccines as the front guard, blood purifier can be seen as the last savior of Covid-19 patients. At the same time, it seems to bring less severe clinical risk as medical staff can interrupt it in the process in case a problem occurs. According to California-based think tank, Milken Institute, only 10 device approaches are developed while over 165 vaccines are studied. Considering the potential risk and technical feasibility, more device treatments can possibly be looked into.
