University of Minnesota to test three drugs for COVID-19 patients

The University of Minnesota Medical School is testing a drug originally developed for Ebola to see if it can treat people who have been hospitalized for COVID-19.

News of the Minnesota study of the antiviral remdesivir comes as the Wall Street Journal reported Friday that the drug appeared to have a positive effect for a small group of Americans who contracted the new coronavirus on a cruise ship and were treated experimentally in Japan.

The drug was found not effective in treating Ebola, but an official with the National Institutes of Health said none of the 14 American COVID-19 patients has died since getting the drug. The official described the patients as critically ill and said many of them had been likely to die within "a short amount of time."

Gilead Sciences, which makes remdesivir, said at least five other COVID-related clinical trials are ongoing in the U.S. and globally. "These studies are continuing to enroll patients and therefore we have no data to share at this time," Gilead spokesman Chris Ridley said via e-mail Friday.

Minnesota's remdesivir study is one of three randomized controlled clinical trials announced by the U's Medical School on Friday that will use existing drugs to try to treat people who have been exposed to COVID-19. Though vaccine research is underway, vaccines typically take months or years to develop, and efforts to speed the entry of a COVID-19 vaccine to the market have sparked concerns among some scientists.

In addition to the Ebola drug, the U studies will examine the effects of drugs to treat high blood pressure and malaria to see if they can prevent or slow down infections of COVID-19. Medical School Dean Dr. Jakub Tolar said the university has been designated by federal officials as the regional treatment center for states including Wisconsin, Michigan and Illinois.

"I think that with the proper safety measures, like hand-washing, limiting travel, and limiting the large gatherings, we will be able to flatten the [infection] curve. But that is most likely going to take months," Tolar said. "But we don't know if it's going to go away. It's an unknown infection. That is the whole point."

Coronaviruses are a common cause of colds and upper respiratory infections. COVID-19 is a new type of coronavirus not seen in humans before it was discovered in December in Wuhan, China. More than 100,000 people worldwide have since been infected.

In the United States, where the number of infections is still rising sharply, the coronavirus has prompted the closures of thousands of schools and the cancellations or postponements of thousands of events and at least one election as authorities try to limit the virus' spread. The U canceled all in-person classes between Monday and April 1, temporarily moving to all-online learning for 63,000 students for the first time in its history.

About 90% of people who test positive for COVID-19 will have mild symptoms that go away on their own in about a week, while the remaining 10% will develop symptoms such as shortness of breath and coughing, and may need to be treated. The symptoms tend to show up about five days after getting the virus but can take as many as 12 days to appear.

One of the three clinical trials at the U will focus on the health of people who have been exposed to someone such as a family member or sick patient but don't have any symptoms. People in this group don't know if they're positive for the virus, and they can't get a fast answer because it takes several days to get the results.

Tolar said this "post-exposure prophylaxis" trial will randomize patients to get either the malaria drug chloroquine or a placebo. The Medical School is supplying funding to start the trial enrollment, but an application to the National Institutes of Health is being developed to provide full funding. Patients are expected to apply for that trial themselves.

Journal articles say chloroquine phosphate showed "apparent efficacy and acceptable safety" in treating COVID-19-associated pneumonia in clinical trials in China.

The second randomized trial will test the high blood pressure drug losartan on patients who test positive for the virus but whose symptoms are mild enough that they're told to go home and recover instead of going to the hospital, Tolar said.

Some doctors theorize that the use of losartan will reduce how aggressive and deadly a COVID-19 infection is, by disrupting how the virus binds to the body at the molecular level. An NIH funding application for that study is in the works, and the trial protocol is still under development.

That trial design is expected to be submitted to an institutional review board next week, and patients who are tested for COVID-19 will be given information for how to contact the trial organizers if they test positive.

The remdesivir trial is the furthest along in development. In that trial, patients will be randomized to receive remdesivir or a placebo. The trial was just approved by the NIH, and the first patient is expected to be randomized to a treatment group Friday. Patients will be referred by a physician.

Although remdesivir was not effective for treating Ebola, Tolar said there is evidence "to show that it has activity against" COVID-19. The Food and Drug Administration is already making the drug available to COVID-19 patients though a "compassionate use" program.

Joe Carlson • 612-673-4779