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The doping drug EPO seems to ease severe corona cases. This is what researchers at the Max Planck Institute for Experimental Medicine in Göttingen, Germany, have now discovered. The drug that was originally intended as a cure for anemia might also be able to protect patients from neurological side effects once the SARS Cov-2 virus attacks the brain. The initial case studies were already very positive. The researchers are now starting a randomized clinical trial to systematically investigate the effects of EPO treatment in COVID-19 patients.

A patient with serious symptoms of COVID-19 was admitted to an Iranian hospital at the end of March. As he also had bad blood values, the doctors prescribed EPO in his case too. Another indication that EPO plays a protective role in COVID-19 comes from South America. There, serious diseases are rarer in high altitude areas than in the low-lying regions. Possibly because people living at higher altitudes produce more EPO themselves. In other words, they have more red blood cells and are better adapted to oxygen deficiencies. Could EPO have contributed to the rapid healing of the Iranian patient? And also explain the variances in the frequency of the disease in South America?

Milder disease progression thanks to EPO?

Hannelore Ehrenreich believes that this might indeed be possible. The scientist at the Max Planck Institute of Experimental Medicine suspects a correlation between the administration of EPO and a mild progression of the disease. “We have found, for example, that dialysis patients tolerate COVID-19 remarkably well. It is precisely these patients who regularly receive erythropoietin (EPO) as part of their dialysis treatment,” says Ehrenreich. EPO is released in our bodies as a natural reaction to reduced oxygen levels. The molecule stimulates the formation of red blood cells and thus improves the oxygen supply to the brain and muscles. Athletes who use synthetically produced EPO as a doping drug also benefit from this effect. However, EPO not only stimulates the blood cells but also a lot of other tissues in the body.

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EPO improves breathing in cases of oxygen deficiency.

Ehrenreich and her colleagues have now summarized the studies on the effects of EPO that are already available. Including animal studies suggesting that EPO acts on the sections of the brain stem and spinal cord that regulate respiration. This improves respiration whenever there is a lack of oxygen. EPO also has an anti-inflammatory effect on immune cells, which may help to reduce the often exaggerated immune response occurring in COVID-19 patients. EPO can also protect against neurological symptoms and side effects of the disease, such as headaches, dizziness, loss of taste and smell, and epileptic seizures.

The protective effects of EPO have been demonstrated both in animals and in a large number of studies on people who have various brain disorders. However, pharmaceutical companies have only limited interest in funding any further required studies on approved active substances such as erythropoietin, (of which the patent protection has since expired). “COVID-19 can have such serious consequences for health that we need to examine all evidence of the protective effect that EPO might have. After all, there is currently no vaccine or drug available at present. This is why we are in the process of preparing a clinical trial with people to examine the effect EPO has on COVID-19; a so-called proof-of-concept study,” Ehrenreich explains. In this clinical trial, critically ill Covid-19 patients will be given additional amounts of EPO.

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About the author

Author profile picture Arnoud Cornelissen has for many years been writing about science and technology in, among others, various Dutch newspapers.