Dornase Alfa for ARDS in Patients With Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2)
Status:
Completed
Trial end date:
2020-12-31
Target enrollment:
Participant gender:
Summary
This study is designed to evaluate a potential mechanism by which a hyperactive immune
response may contribute to death from SARS-CoV-2; by an excessive neutrophil-mediated
deposition of cell-free DNA in neutrophil extracellular traps (NET). Excessive amounts of
NETs can increase rigidity of mucus, clog airways, and be agents for the development of acute
respiratory distress (Narasaraju et al., Am J Pathol. 2011). Many aspects of this pathway
have been observed in severe SARS-CoV-2 (Zhang et al., Respiratory research. 2020). Dornase
alfa (DNAse I; Pulmozyme (Genentech) is a nebulized drug that works by degrading cell-free
DNA and thus promoting airway clearance and recovery. The investigators hypothesize that by
thinning mucus and degrading these NETs further lung damage may be prevented and a reduction
in time to recovery may occur. The two aims of the study are to see if inhaled/nebulized
dornase alfa will improve clinical outcome measures in SARS-CoV-2 related acute respiratory
distress syndrome (ARDS) and to see if dornase alfa reduces the amount of bronchoalveolar
lavage and blood markers of NET activity.
The study will recruit patients who are on mechanical ventilation for respiratory failure
related to SARS-CoV-2 positive infection and have ARDS based upon Berlin criteria.
The investigators aim to recruit 10-20 patients for this study.