ASCOT is currently trialing the use of three different treatment approaches, called ‘domains’. These are:
- Antiviral drugs – to stop the virus from multiplying
- Antibodies – to fight the virus
- Hyperimmunoglobulin (India only, not currently active)
- Anticoagulants – blood thinning drugs to reduce the risk of clots
- Low Molecular Weight Heparin
Antiviral Drug – to stop the virus from multiplying
Nafamostat is an agent which may block the entry of SARS-CoV-2 (the virus that causes COVID-19) into human cells. Laboratory studies have shown that nafamostat has a strong effect against SARS-CoV-2. It also has blood thinning properties which may help against the clots in the lungs seen in COVIC-19. Nafamostat has been safely used in humans for other conditions such as pancreatitis (an inflamed pancreas).
Antibodies– to fight the virus
Individuals who recover from COVID-19 develop natural defenses to the disease in their blood (called antibodies). Antibodies are found in the part of the blood called plasma. Plasma collected from individuals who have recovered from COVID-19 (called convalescent plasma) will contain antibodies directed against the virus that causes COVID-19.
Hyperimmune globulin is a product that is made from convalescent plasma. It consists of a concentrated immune globulin, which is a protein used by the immune system to identify and neutralize foreign bacteria and viruses.
This domain treatment is not currently active.
Anticoagulants – to reduce the risk of clots
Currently, all patients who are admitted to hospital with pneumonia, including COVID-19 receive a blood-thinning medication to prevent the development of blood clots in veins and in the lungs. The usual care is to give a low dose (prophylactic dose) of the anticoagulant medication to prevent these blood clots. However, there is a high risk of blood clots amongst COVID-19 patients, and therefore, giving a higher dose of a blood-thinning medication may reduce the risk of clots.
This study will be evaluating different doses of an anticoagulant called low molecular weight heparin.