COVID-19 and AKI
The outbreak of coronavirus disease 2019 (COVID-19) has rapidly evolved into a global pandemic. Most patients with COVID-19 have mild symptoms, but about 5% develop severe symptoms which can include acute respiratory distress syndrome, septic shock, and multiple organ failure and can lead to death in 20-50% of the severe cases.
Kidney involvement in COVID-19 is frequent, with clinical presentation ranging from mild proteinuria to progressive acute kidney injury (AKI) necessitating renal replacement therapy including dialysis, as the illness develops and afterwards as patient recovers from COVID-19. An expanding literature base shows that kidney disease plays a central role in the cycle of multi-organ failure in advanced disease stages, ultimately leading to death. The incidence of AKI in severe COVID-19 ranges between publications from 30-80%. AKI is considered a marker of disease severity and negative prognostic factor for survival.
Despite the fact that a handful of drugs have received conditional approval in some countries or show promising clinical results, mortality remains high and more specific treatment options for the critically ill COVID-19 patients are required. recAP’s potent inhibition processes of acute inflammation and coagulation by dephosphorylating extracellular ATP/ADP are considered to be highly relevant to the respiratory failure and other organ failures described for COVID-19 patients admitted to the ICU.
AM-Pharma included an exploratory cohort to its Phase III REVIVAL pivotal study, to test recombinant alkaline phosphatase in up to 100 COVID-19 patients admitted to the ICU with respiratory issues and AKI to prevent worsening of the disease and to enhance the chance for patients to recover with adequate organ function.
Severe COVD-19 patients often present acute inflammation, organ failure with variable rates of Acute Kidney Injury (AKI) and thrombosis; up to 90% of the patients that received mechanical ventilation also suffered from AKI, as reported in the US recently.6
Further information about this study can be found at NCT04411472 (REVIVAL).