This common high blood pressure drug may help prevent COVID-19 complication

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In a new study, researchers have identified a drug treatment that may reduce the risk of death from the most serious complication of COVID-19, also known as SARS-CoV-2 infection.

They found prazosin, a U.S. Food and Drug Administration-approved alpha blocker that relaxes blood vessels, may specifically target an extreme inflammatory process called cytokine storm syndrome (CSS) that mainly affects older adults with underlying health conditions.

CSS is associated with disease severity and increased risk of death in COVID-19 infection.

Using it to address COVID-19-related hyper-inflammation of the lungs and other organs has the potential to reduce deaths in the most vulnerable populations.

The research was conducted by a team in the Ludwig Center at the Johns Hopkins Kimmel Cancer Center.

The team cautions that although they believe if given early enough after viral exposure, the drug could prevent some deaths, it would not work in patients with advanced stages of the disease.

They also emphasize that controlled clinical trials for this novel use of prazosin are needed before it can be safely recommended.

In the paper, the team described how they have been working in collaboration to identify chemical ways of safely blocking the actions of catecholamines and cytokine responses.

Together, catecholamines and cytokines enhance the inflammatory process that leads to severe COVID-19 symptoms.

In mouse models of CSS, they found that prazosin—commonly used to treat blood pressure, prostate gland enlargement and other conditions—blocked catecholamines (hormones released by the adrenal glands when the body is under stress), reduced cytokine levels, and increased survival after exposure to agents that trigger cytokine storm responses similar to those observed in COVID-19.

Drugs that target CSS have been found to reduce the risk of death from other viral illnesses by up to 55%, according to preliminary results from a retrospective clinical study.

Prazosin is taken by mouth, costs less than $25 per month in the United States, and has been safely taken by millions of people over the last two decades.

This should enable highly expedited clinical trials in people early after exposure to the SARS-CoV-2 virus, say the researchers.

The lead author of the study is Chetan Bettegowda, M.D., Ph.D., the Jennison and Novak Families Professor of Neurosurgery.

The study is published in the Journal of Clinical Investigation.

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