Colorado family of doctors hopeful blood clot research will help near-death COVID-19 patients

Coronavirus

DENVER (KDVR) — A family of medical professionals is hopeful its research into anti-blood clotting medication could help in the fight against COVID-19.

“We’re approaching this with optimism that it’s going to work,” said Dr. Hunter Moore, a transplant surgery fellow at the University of Colorado Denver.

Moore is a co-author on a medical research article published last week in the Journal of Trauma and Acute Care Surgery, a publication that is edited by his father, world-renowned trauma surgeon Dr. Gene Moore. 

Gene Moore, his other son, Dr. Peter Moore, and his brother, Dr. Frederick Moore, are also co-authors on the study along with a group of others from Beth Israel Deaconess Medical Center at Harvard Medical School and at the Massachusetts Institute of Technology.

“Extraordinary times may call for extraordinary measures. If an observational trial of this treatment in the first series of patients is effective and safe, the approach could be readily broadened,” the paper said.  “This would have multiple patient-related and public health benefits including…earlier weaning from the ventilator to free up more ventilators for other patients in need.”

“All of us are very concerned having seen what’s happened in Italy, in China, and now it’s happening in New York City. It almost seems like there’s this impending healthcare crisis that we’re trying our best to prepare for but we’ve never seen before,” said Peter Moore, a pulmonary sciences and critical care medicine fellow at the University of Colorado and National Jewish Hospital. 

Next week, he will be on the front lines, treating COVID19 patients at UC Health’s Intensive Care Unit.

The men are researching a drug, alteplase or tPA (tissue plasminogen activator), used to treat heart attacks and strokes and whether its ability to dissolve blood clots might be effective for COVID-19 patients who cannot breathe properly.

“The underlying problem we are trying to address is the blood clots that form in the small vessels – the blood vessels- that provide oxygen to the lung and the air spaces within the lung that brings oxygen through the air and exchanges it into the blood,” said Gene Moore, a trauma surgeon for whom the hospital trauma wing at Denver Health is named. 

“These small blood clots…are blocking the ability to take oxygen from the air and transmit it into the body, so we are proposing a potential treatment approach to eliminate these clots,” he said.

Hunter Moore said the drug’s purpose is to break down the clots.

“When you break down the clots, it should improve the amount of blood that goes into the lung that has the ability to get the oxygen from when you breathe in, and so that improves the ability for the lungs to put oxygen into your blood and then reduce your need for using a ventilator,” he said.

He said there have been smaller studies on animals and humans who had “really bad pulmonary failure” for whom death was imminent.  

“This was used as a salvage therapy,” said Moore of a 2001 study that involved 20 patients. “Of these 20 patients that were given this clot-breaking medication, 80 percent of them had improvement in their oxygenation and the expected mortality rate of 100 percent was reduced to 70 percent.”

“There are abundant animal experiments that suggest our therapy is effective, (but) we have no idea until its tested as to whether it – No. 1, is effective or – No. 2, has dangerous side effects,” said Gene Moore. “All we can do is try to balance the risk versus the benefit and pick out a population in which we believe that balance is appropriate.”

Peter Moore said he imagines this treatment could be used in COVID-19 patients who have severe lung failure who would not survive if they were not breathing on a ventilator and do not have access to a ventilator.

“And that patient population, by giving them this medication, we’d hope that the amount of oxygen transferred from the lungs to the blood vessels would be improved by breaking up these clots could allow them to survive without a ventilator,” he said.

He also said if this treatment speeds up recovery of lung injuries, it could reduce the amount of time someone is on a ventilator and free up the machine for other sick patients.

“If these clots are really driving this process of advanced lung failure, I’m pretty encouraged that it will work,” said Hunter Moore.

The doctors have proposed testing this on patients  – with proper consent – who would otherwise die.

Gene Moore said people from around the world have asked for information about the therapy protocol.  

“This protocol, at this very moment, is being used in New York City,” he said.  

They said treatment has also begun with their research counterparts in Boston.

“We hope to be able to use this in Colorado once we get through some of the regulatory red tape,” said Peter Moore.

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