Journal
OPEN FORUM INFECTIOUS DISEASES
Volume 9, Issue 8, Pages -Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ofid/ofac381
Keywords
acute respiratory distress syndrome; COVID-19; clinical trial; host-directed therapy; sepsis
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Host-directed therapeutics targeting immune dysregulation are considered the most promising approach to address acute lung injury/ARDS related to COVID-19. Immune-based biomarkers can improve patient stratification and inform clinical decision-making.
Host-directed therapeutics targeting immune dysregulation are considered the most promising approach to address the unmet clinical need for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). To better understand the current clinical study landscape and gaps in treating hospitalized patients with severe or critical COVID-19, we identified COVID-19 trials developing host-directed therapies registered at ClinicalTrials.gov and discussed the factors contributing to the success vs failure of these studies. We have learned, instead of the one-size-fits-all approach, future clinical trials evaluating a targeted immunomodulatory agent in heterogeneous patients with ALI/ARDS due to COVID-19 or other infectious diseases can use immune-based biomarkers in addition to clinical and demographic characteristics to improve patient stratification and inform clinical decision-making. Identifying distinct patient subgroups based on immune profiles across the disease trajectory, regardless of the causative pathogen, may accelerate evaluating host-directed therapeutics in trials of ALI/ARDS and related conditions (eg, sepsis).
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