URGENT National Security Message to The President of the United States: Deploy the Drug CYCLOSPORINE Against COVID-19 Disease.
Dear Mr. President,
I write to you in your capacity as our chief executive and in defense of the United States of America.
I also write as an American physician, a cellular immunologist, and a single father to six bright children.
I write this urgent national security message to you for the record — and I hope not just for our nation’s history to reflect on, but for your office to act on.
Here, I will inform you that United States Rep. Brian Fitzpatrick, who is co-chair of the US House of Representatives’ COVID-19 task force, is also fully in process with my urgent message here and is actively participating in moving this effort forth.
As you know almost all hospitals across the nation are being hit with a Tsunami of COVID-19 patients, many deteriorating or in critical condition. It is becoming increasingly evident that these patients are suffering from a “Cytokine Storm” like clinical phenomenon, reminiscent of that seen in the disease entities we know as “Macrophage Activation Syndrome”(MAC) and HLH.
More specifically, it is already becoming clear that a major component of COVID-19 critical illness is a pathogenic T-cell HYPERIMMUNE process. This HYPERIMMUNITY is very likely to be COVID-19’s “kill mechanism”.
Therefore, in the setting of the large scale catastrophe underway across the United States, it would be a CRITICAL ERROR to leave the most classical and effective clinical pharmacological agent that is available for control of “Cytokine Storm” in our arsenal entirely ignored.
Here, I am informing you that it is well-established that the drug CYCLOSPORINE is a central dampner of T-cell (and macrophage) activation — and that, in the case of MAS and HLH syndromes, it has often been observed that this drug acts like an “on-off switch” for the “Cytokine Storm”.
It is my singular and respectful professional recommendation to your administration, for the record, that United States immediately begin treating symptomatic hospital inpatients with COVID-19, starting at the pre-ICU disease stage, using CYCLOSPORINE starting at 2.5–5mg/kg/day in two divided doses. This patient population has typically had at least one week or more to brew a protective immune response, which then evolves into the deadly hyperimmune stage requiring hospitalization.
At the pre-ICU stage, it is highly likely that interrupting the patient’s HYPERIMMUNE state using CYCLOSPORINE will dampen this response by targeting the highly specific Calcineurin pathway CYCLOSPORINE interrupts — and which both the adaptive and innate immune systems use to become hyperactive, as it does in MAS and HLH, as well as, COVID-19 critical illness.
Mr. President, the major advantage of CYCLOSPORINE is its known safety profile, especially when used transiently, and the fact that a vast clinical experience exists for its use. Additionally, because it is a widely available and classically known immune dampener — it is scalable to large numbers of patients across the nation.
Finally, I am informing you that in previous studies, CYCLOSPORINE has been shown to specifically inhibit replication of the Coronavirus family. This feature of CYCLOSPORINE’s effect on COVID-19 will also likely be critically important.
I write this national security message to you here for the record and in defense of the United States of America — our children’s home. And in sincere hopes that it find its way to your desk intact.
Yours in citizenship and service to the United States,
Hooman Noorchashm MD, PhD
Noorchashm@gmail.com.
