New COVID-19 Drug Shows Promise: Faster Recovery?

observational-study PMID: 36549549

Quick Summary: A new drug called upamostat, which works by blocking a specific enzyme, showed promising results in a small study for people with early COVID-19. It seemed to speed up recovery and reduce the need for hospitalization.

What The Research Found

This study looked at upamostat, a drug that targets a protein called a serine protease. In people with COVID-19, upamostat appeared to:

Speed up recovery: People taking upamostat recovered from severe symptoms faster than those taking a placebo (a "dummy" pill).

Reduce severe symptoms: Fewer people taking upamostat developed new, serious symptoms.

Lower hospitalization rates: No one taking upamostat needed to go to the hospital for worsening COVID-19, compared to some people in the placebo group.

Study Details

Who was studied: 61 adults with COVID-19 who had symptoms for less than 5 days.

How long: Participants took the drug or placebo for 14 days and were monitored for several weeks.

What they took: Participants were randomly assigned to take either:

A placebo (a "dummy" pill)
Upamostat 200 mg daily
Upamostat 400 mg daily

What This Means For You

If you get COVID-19, this research suggests that upamostat might help you:

Feel better sooner.

Avoid getting sicker.

Potentially avoid hospitalization.

Important: This was a small study, and upamostat is not yet widely available. Talk to your doctor about the best treatments for you.

Study Limitations

Small Study: The study only included a small number of people, so the results might not apply to everyone.

Self-Reporting: Participants reported their own symptoms, which can sometimes be inaccurate.

More Research Needed: We need larger studies to confirm these findings and understand the long-term effects of upamostat.

Not a Supplement: Upamostat is a drug, not a supplement. It requires a prescription and medical supervision.

Key Findings

Upamostat, a serine protease inhibitor, demonstrated tolerability and efficacy in shortening recovery time, reducing new severe symptoms, and lowering hospitalization rates in outpatients with symptomatic COVID-19. Patients receiving 400 mg daily showed the fastest median recovery time (3 days vs. 8 days for placebo). New severe symptoms occurred in 20% of placebo recipients versus 2.4% in combined upamostat groups (P=0.036), and 15% of placebo patients were hospitalized compared to 0% in upamostat groups (P=0.03). D-dimer levels, a coagulation marker, decreased by 38% (200 mg) and 48% (400 mg) versus placebo.

Study Design

This was a randomized, placebo-controlled pilot trial (not observational, per the study title) conducted in 2023. Sixty-one adults with SARS-CoV-2 infection and ≥2 moderate-severe symptoms (e.g., fever, dyspnea) within 5 days of onset were enrolled. Participants were randomized to oral upamostat 200 mg, 400 mg, or placebo daily for 14 days. Symptom tracking occurred daily for 28 days, then thrice weekly for 4 weeks, with periodic lab/physical assessments.

Dosage & Administration

Upamostat was administered orally at 200 mg or 400 mg daily for 14 days. Placebo was matched in appearance and schedule. Dosing began within 5 days of symptom onset.

Results & Efficacy

Recovery Time: Median sustained recovery from severe symptoms was 8 days (placebo), 4 days (200 mg), and 3 days (400 mg).
New Severe Symptoms: Developed in 20% (placebo) vs. 2.4% (combined upamostat groups) (P=0.036).
Hospitalization: 15% of placebo patients (3/20) were hospitalized vs. 0% in upamostat groups (P=0.03).
D-dimer Levels: Placebo group showed no change; upamostat reduced levels by 38% (200 mg) and 48% (400 mg).
Safety: Only one adverse event (mild skin rash, 400 mg group) reported; no discontinuations due to side effects.

Limitations

The study was a small pilot trial (n=61), limiting statistical power. Symptom data relied on self-reporting, introducing potential bias. Demographics (e.g., age, comorbidities) were not detailed, reducing generalizability. No long-term follow-up was conducted, and the mechanism linking protease inhibition to reduced hospitalization remains unclear. Larger, phase III trials are needed to confirm findings and assess mortality/complication risks.

Clinical Relevance

For outpatient COVID-19 management, upamostat (particularly 400 mg daily) may reduce symptom severity progression and hospitalization risk. Its impact on D-dimer suggests anticoagulant activity, which could mitigate hypercoagulability in severe cases. However, as a pilot study, results should be interpreted cautiously. Supplement users should note that protease inhibitors like upamostat are pharmaceutical agents, not dietary supplements, and require medical supervision. These findings support further investigation into host-directed therapies for early-stage viral infections.

Note: The study was misclassified as observational in the user input but is a randomized controlled trial per its title and methodology.