COVID-19: disease pathways and gene expression changes predict methylprednisolone can improve out- come in severe cases
Current management efforts of COVID-19 include: early diagnosis, use of antivirals, and immune modulation. After the initial viral phase of the illness, identification of the patients developing cytokine storm syndrome is critical.1, 2 Treatment of hyper- inflammation in these patients using existing, approved therapies with proven safety profiles could address the immediate need to reduce the rising mortality.3 The identification of existing drugs that could modulate the immune response is an immediate need. Here we show that an analysis of the changes in the gene expression, path- ways and putative mechanisms between SARS-CoV2, influenza A, and respiratory syncytial virus can be used to identify FDA-approved drugs that could be repurposed to help COVID-19 patients with severe symptoms related to hyper-inflammation. An important finding is that drugs in the same class may not achieve similar effects. An independent clinical study evaluated 213 subjects, 81 (38%) and 132 (62%) in pre-and post-methylprednisolone groups, respectively. Thirty-day all-cause mortality occurred at a significantly lower rate in the post-methylprednisolone group compared to pre-methylprednisolone group (29.6% vs. 16.6%, p=0.027). Clinical results con- firmed the in silico prediction that methylprednisolone could improve outcomes in severe cases of COVID-19. These findings are important for any future pandemic regardless of the virus.
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Posted 15 May, 2020
COVID-19: disease pathways and gene expression changes predict methylprednisolone can improve out- come in severe cases
Posted 15 May, 2020
Current management efforts of COVID-19 include: early diagnosis, use of antivirals, and immune modulation. After the initial viral phase of the illness, identification of the patients developing cytokine storm syndrome is critical.1, 2 Treatment of hyper- inflammation in these patients using existing, approved therapies with proven safety profiles could address the immediate need to reduce the rising mortality.3 The identification of existing drugs that could modulate the immune response is an immediate need. Here we show that an analysis of the changes in the gene expression, path- ways and putative mechanisms between SARS-CoV2, influenza A, and respiratory syncytial virus can be used to identify FDA-approved drugs that could be repurposed to help COVID-19 patients with severe symptoms related to hyper-inflammation. An important finding is that drugs in the same class may not achieve similar effects. An independent clinical study evaluated 213 subjects, 81 (38%) and 132 (62%) in pre-and post-methylprednisolone groups, respectively. Thirty-day all-cause mortality occurred at a significantly lower rate in the post-methylprednisolone group compared to pre-methylprednisolone group (29.6% vs. 16.6%, p=0.027). Clinical results con- firmed the in silico prediction that methylprednisolone could improve outcomes in severe cases of COVID-19. These findings are important for any future pandemic regardless of the virus.
Figure 1
Figure 2
Figure 3
Figure 4