Widely Used Beta-Blocker Costing Only USD 2 Proves Beneficial When Administered to COVID-19 Patients

The most severe form of COVID-19 is severe respiratory failure, which requires intubation and is associated with a high mortality rate. Pulmonary infection with the SARS-CoV2 virus can progress to acute respiratory distress syndrome (ARDS), in which inflammation and neutrophil hyperactivation play a central role. There is currently a lack of therapies for ARDS associated with COVID-19.

The research team recently discovered that metoprolol, a well-established beta-blocker, has a highly selective effect on hyperactivated neutrophils during situations of acute stress such as a myocardial infarction. Given the central role played by neutrophils in ARDS, the team postulated that metoprolol might be an effective treatment for patients with severe COVID-19. In a randomized clinical trial, the research team examined the effect of intravenous metoprolol administration on lung inflammation and respiratory function in severe COVID-19 patients intubated after developing ARDS.

Describing the study, Dr. Borja Ibáñez who led the study, explained that that the team “randomized 20 intubated COVID-19 patients to receive intravenous metoprolol (15 mg per day over 3 days) or to a control group that did not receive metoprolol. We analyzed the inflammatory infiltrate in bronchoalveolar fluid before and after treatment and also monitored clinical progression parameters such as oxygenation and days on mechanical ventilation.”

Co-author Eduardo Oliver, a Ramón y Cajal fellow at the CNIC, affirmed that the intravenous metroprolol treatment “significantly reduced neutrophil infiltration of the lungs and improved oxygenation.” Intensive care specialist Arnoldo Santos, who coordinated the ICU part of the study, indicated that the team saw “a clear trend among the metoprolol-treated patients to require fewer days on mechanical ventilation and therefore a shorter stay in the ICU.”

Dr. Ibáñez added that “while we need to be cautious with these results of a pilot trial, we have observed that metoprolol treatment in this clinical setting is safe, is associated with a very significant reduction in lung infiltration, and appears to lead to very rapid improvements in patient oxygenation.”

The researchers therefore propose intravenous metoprolol as a “promising intervention that could improve the prognosis of severely ill COVID-19 patients.” They also emphasize that metoprolol is a safe and cheap drug (daily treatment cost below USD 2) that is readily available.

Related Links:
Spanish National Centre for Cardiovascular Research