For many, COVID-19, no matter its severity, comes around just once, with symptoms clearing up within 2-6 weeks of infection. For others—including those only mildly sick with COVID-19—the initial illness is often just the beginning of a lengthy series of complications. Originally discarded by the medical community, doctors currently recognize what is frequently called "Long COVID Syndrome" (LCS) with increasing regularity. Now, thanks to a drug first developed to neutralize autoantibodies in autoimmune heart failure, a new treatment for LCS may be on the horizon, with a clinical trial set to get underway in Germany.
In a rather roundabout way, the drug, called BC 007, first impacted LCS in July 2021 when a patient with glaucoma who also happened to have LCS realized that his Long COVID symptoms disappeared after just one treatment of the BC 007 drug. Under the direction of experts at the University of Erlangen-Nuremberg, doctors at the Department of Ophthalmology as well as two separate Departments of Medicine (Gastroenterology, Pneumology and Endocrinology; and Rheumatology and Immunology) were already aware that patients who had recovered from COVID-19 had extremely limited blood flow to the eyes, lasting several months after the infection. The researchers speculated that the changes to the blood flow affected not just the eyes but the entire body.
The team from the Department of Ophthalmology with patient Oliver G. in front of the Department of Neurology at Universitätsklinikum Erlangen: Jakob Hoffmanns, Franzi Reith, Oliver G., PD Dr. Dr. Bettina Hohberger and Prof. Dr. Christian Mardin (from left to right). Photo: Franziska Männel/Universitätsklinikum Erlangen
After Taking BC 007, Long COVID Disappeared Overnight
The discovery came to light when an established 59-year old patient with glaucoma in the Erlangen glaucoma registry reported his ongoing and debilitating symptoms after surviving COVID-19—loss of taste, extreme concentration disruptions, and fatigue severely restricted him in his professional and private life. Concerned, the doctors at the eye clinic wanted to help him. In an individual attempt at healing him with BC 007, the patient stayed for three days at the University Clinic Erlangen, where he received an infusion of the drug. Describing the process, the medical team reported:
"There was an improvement within a few hours. When he was discharged, our patient felt much more relaxed than before the administration and his autoantibody values confirmed this impression. The difficulty concentrating also disappeared, the performance of the 59-year-old increased again and the sense of taste returned. Overall, the blood flow to the capillaries, which we can measure on the eye, has improved significantly."
Indeed, the autoantibodies in question quickly diminished after the treatment and stayed that way for the next month. Notably, the improvements appeared to last for at least several months after the treatment. Berlin Cure's expert team, including lead researcher Dr. Gerd Wallukat, believes the drug is "soaking up autoantibodies interfering with the microcirculation." Led by ophthalmologist Dr. Bettina Hohberger, researchers have determined that blood flows to the eyes in COVID-19 and Long COVID are diminished even in patients without any visual problems. They've even been able to identify the most impacted microvascular layer in the retina that's been affected. They reported:
"These results argue for a critical impairment of retinal microcirculation after COVID-19 infection, accented in the ICP, yet affecting additional adjacent microvascular layers after even worse COVID-19 infections."
Citing sepsis as a possible model, the experts agree with their peers that SARS-CoV-2's entry via the ACE-2 receptor into the endothelial cell walls causes the problem. They state that as the virus penetrates the cells, it sparks a hypercoagulation response which produces microclots. They also hypothesized that the capillary damage they observed in the eyes actually reflected a massive disruption of the small blood vessels across the body. The team commented, "We hypothesize that the severity of capillary impairment after COVID-19 infection is mapped on retinal microcirculation."
Screenshot / healthrising.org. Just as antibodies can block the coronavirus from entering a cell, autoantibodies can block the receptor that opens the blood vessels from functioning properly.
Other Patients Have Success with BC 007
Following the clinic's successful treatment of its first patient, at least two more individuals with LCS have received the 75-minute infusion of BC 007. All patients were monitored in the hospital for three days following the treatment, and all have reported rapid positive results. One of the patients, a cross country skier and former iron man participant, was in "superb shape before getting the whole, dreary Long-COVID package." Describing his dire health months after being infected with COVID-19, he commented:
"I was completely disoriented and unfocused, I was just trying my best to survive from one day to the next. I was a shadow of my former self, a zombie. I barely recognized myself.
I was no longer able to follow conversations. I couldn't draft a presentation or carry out negotiations, and my colleagues had to help me with everything. At home, tackling the smallest chores became a major challenge, and for a while, I even needed at-home help. Reading, pottering around in the garden, or taking my dog for a walk was basically all I could cope with. As if that wasn't enough, I was plagued by financial worries, panic attacks, and what I call emotional incontinence. I was completely incapable of keeping my emotions in check."
The doctors reported that just one week after receiving BC 007, his physical strength, cognitive abilities, and emotional balance returned. After just one day, the patient noted that his brain fog lifted, and his muscles stopped twitching as much. On day two, his tremor disappeared. Grateful his employer "didn't give up on him" after a forced 15-month break, he stated, "My physical, cognitive and mental abilities have all returned. I have stopped lounging around incapable of doing anything else, I can think clearly again, I am emotionally stable and able to feel happy again."
Is BC 007 a Cure for Long COVID?
According to Berlin Cure, "It can be shown in all of the mentioned diseases that autoantibodies bind to and stimulate certain cell surface receptors and imitate a non-existing chronic physiological stimulus with undesirable, pathologic and deleterious effects on the concerned organ (heart, nerve system, lung, eyes, kidney, etc.)." The company clarifies that BC 007 is the only known compound "capable of neutralizing functionally active but pathological autoantibodies directed against G protein-coupled receptors." In patients with Long COVID, Berlin Cure declares that "neutralizing the autoantibodies [which may explain why some people develop Long COVID] by BC 007 in compassionate use treatments could bring them to a state that could almost be described as a cure."
Before discovering the drug's promising success in treating LCS, in June 2020, BC 007 was discussed as a potential early treatment for COVID-19. The drug is highly water-soluble, making it a potential therapeutic application as a nasal spray to fight against COVID-19. In a June 24, 2020, article on BC 007, the AP expanded on potential uses for the drug, noting that it is "a fully synthetic substance and can be produced quickly and in large quantities, is very stable in storage and has extremely few side effects. It does not trigger any immunological counteractions in the body." The article added, "Some of the targeted sequences possessed by COVID-19 are not unique and are seen in other viruses of this family. BC 007 could therefore not only inhibit COVID-19, but also other viruses."
A double-blind, randomized clinical trial to confirm the Long COVID findings obtained with the initial patients is set to begin in 2022. Individuals with Long Covid who are interested in the trial can contact Erlangen University Hospital at firstname.lastname@example.org.