London researchers to test promising coronavirus treatment

A new drug for preventing lung damage and blood clots in people with coronavirus (Covid-19) is set to be trialled in UK hospitals with support from researchers at our British Heart Foundation Centre of Research Excellence at Imperial College London. 

The researchers say the drug, a molecule known as TRV027, could put a brake on many of the dangerous processes which occur in Covid-19, such as lung damage and blood clots. The cell pathways targeted by the drug are thought to be major drivers of severe illness in Covid-19. 

The pilot trial will involve 60 patients with confirmed or suspected Covid-19, and will follow patients for eight days during the critical period where some patients’ symptoms worsen significantly requiring treatment in ICU and sometimes ventilation. 

Covid-19 affects blood vessels

The molecule - developed by the drug company Trevena – aims to restore the balance between two hormones, angiotensin II and angiotensin 1-7, which control blood pressure and affect blood vessels.

Usually, this balance is maintained by ACE-2, which sits on cell surfaces and is also the ‘entry point’ for SARS—CoV-2, the coronavirus which causes Covid-19. 

In Covid-19, it is thought the balance tips towards too much angiotensin II which makes the blood become more sticky, leading to clots throughout the body, and in particular the lungs. TRV027 is thought to have a dual action by both blocking angiotensin II activity and also mimicking angiotensin(1-7) activity which opposes angiotensin II. 

Restores the balance

By restoring the balance the researchers say TRV027 could dampen the virus’s ability to cause damage. The drug has been tested as a treatment for heart failure and was shown to be safe. 

Dr Kat Pollock, Senior Clinical Research Fellow in Vaccinology and Honorary Consultant at Imperial College London who is jointly leading the study said: 

 “We need to move away from thinking of Covid-19 as solely a respiratory illness – it also has devastating effects on the rest of the body including the blood vessels and heart. When this infection was first described, we were surprised to learn that people with heart and circulatory diseases appeared to be at risk. 

“Our study will play an important role in understanding the mechanisms which make Covid-19 dangerous and offers a potential treatment.”

In the trial, half of the patients will be given TRV027, and half the patients will be given placebo along with the usual care. 

The researchers will observe the patient condition and track the levels of important markers in the blood which indicate the severity of illness, in particular markers of abnormal clotting which they anticipate will be lower in the group receiving TRV027. 

If the findings are promising, the team aim to secure funding for a larger clinical trial to determine whether it made a meaningful difference to patient’s health. 

The researchers hope the study will answer many pressing questions about the link between severe Covid-19, blood pressure, and the ACE-2 pathway.   

Treatment hope

Dr David Owen, Senior Clinical Research Fellow and Clinical Pharmacologist at Imperial College London who is jointly leading the study said:

“This virus poses a huge challenge for researchers because so much about it is unknown. In order to fight it, we need a team effort. This project has brought together pathologists, virologists, pharmacologists and researchers who usually focus on heart and circulatory diseases.  Drawing on this range of expertise will give us the best chance of finding a desperately needed treatment for Covid-19.” 

Our Medical Director, Professor Sir Nilesh Samani commented on the research:

“Without an effective vaccine for Covid-19, we urgently need to find new treatments which can reduce the damage caused by this virus.” 

 “People with heart and circulatory diseases are at greater risk of experiencing a more severe illness, and it’s vital we find out why and tackle this increased risk. As part of the BHF’s contribution to the fight against Covid-19 we have given the green light for researchers at our Centres of Research Excellence to mobilise behind research that could lead to improved treatments for people suffering from the virus.”

Find out how BHF scientists are joining the fight against Covid-19