Researchers have determined that a cheap and widely available blood-thinning drug can be used to treat COVID-19 patients by improving their breathing.
The research findings, published today in the British Journal of Clinical Pharmacology and co-authored by scientists from the Australian National University and King's College in London, are based on a clinical trial that used heparin to treat 98 patients diagnosed with COVID-19.
The trial found that breathing and oxygen levels improved in 70 per cent of the patients after they inhaled a course of heparin, and their symptoms improved.
"What we found was that this drug also works against COVID-19 by stopping the virus from entering the cells in the lungs," study co-author Professor Frank van Haren from the ANU said.
The drug is now being rolled out to patients in hospital in 13 different countries, as part of a controlled trial.
In Australia, as hospitals report record-breaking numbers of COVID-19 patients and some states and territories postpone elective surgeries, major hospitals in Sydney and Melbourne will be involved.
Heparin could fill 'urgent need' for COVID-19 treatment
Professor Van Haren, who is also ICU Director at Sydney's St George hospital, said the study's findings were "promising" and could mean fewer people with COVID-19 end up in the intensive care unit (ICU).
"I don't think any drug is going to be the answer, like the magic bullet," Professor Van Haren said.
"There is still an urgent need for an effective treatment of COVID-19 and the early results of our trials show inhaled heparin is safe and effective."
Heparin has long been used as a blood-thinner to treat diseases of the heart, lungs and certain blood vessels, and has typically been administered intravenously.
But researchers have developed a way for heparin to be inhaled using a nebuliser.
It also acts as an anticoagulant, giving it the added benefit of preventing blood clots — a known lung complication for people with the virus.
Study co-author Professor Clive Page, from King's College London, said heparin had anti-viral and anti-inflammatory properties which stopped the virus from infecting cells — essentially, stopping patients from getting sick.
"Inhaled heparin has antiviral properties which work by binding to the spike proteins the coronavirus uses to enter the cells of the body," Professor Page said.
A 'breakthrough' for low-income countries
As a relatively cheap drug that is already in use in hospitals, the study's authors believe heparin could be introduced with relative ease, unlike other recently approved drugs that need to go through the manufacturing process.
"This drug is already available in hospitals all over the world and it is a very inexpensive drug," Professor Van Haren said.
"Some of the treatments that have been developed for COVID are very expensive, only people in Australia in the US in Europe can afford these treatments.
Thanks to the drug's availability, it could also help ease some of the pressure in ICUs, which have been inundated by COVID-19 patients across Australia due to the Omicron spread.
In Canberra, 63 people were in hospital with the virus on Tuesday — the highest number of the pandemic — including six people in intensive care and two on a ventilator.
In New South Wales, 25 people died with COVID-19 in the last 24-hour reporting period, and Victoria has activated an emergency Code Brown alert.
Professor Van Haren said he had seen first-hand the impact of COVID-19 on patients and staff, and was conscious of how overwhelmed hospitals were becoming by those suffering more severe symptoms of the virus.
"All staff are under a lot of pressure, it's been pretty tough," he said.
"I think for everyone, for everyone in the community as well, but especially I think for for the intensive care staff and ED staff, ambulance staff, everyone is feeling it."
Heparin has 'real prospects' as a treatment
Associate Professor Vito Ferro from the School of Chemistry and Molecular Biosciences at the University of Queensland was not involved in the study, but said the results of the trial looked promising.
He said while heparin had been identified as a potential treatment for COVID-19 early in the pandemic, it was only now that the scientific community was starting to see proof of its efficacy.
"It's been well known that heparin has antiviral activity, it's been known for decades, but it hasn't really been used," Professor Ferro said.
He said one issue with the drug had been the potential for bleeding if it was administered intravenously.
But in finding a way to administer it with a nebuliser, the research team has eradicated that possible side effect, he said.
"They have provided positive initial results and impetus for further clinical studies in order to get approval for more widespread use," he said.
If the randomised trial is successful, heparin could be in use in hospitals in just a few months' time.
