Erythropoietin as candidate for supportive treatment of seve
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In light of the present therapeutic situation in COVID-19, any measure to improve course and outcome of seriously affected individuals is of utmost importance. Erythropoietin is a hypoxia-inducible growth factor, named after its original discovery in hematopoiesis.

Over the last 30 years, it became more and more clear that EPO is expressed in many organs and tissues of the body, where it exerts multiple functions in the sense of a pleiotropic tissue-protective cytokine. EPO has not only successfully been used to treat or prevent anemia but also for various other conditions, ranging from brain to different other organ diseases, in both human trials and numerous animal studies.

Overall, in critically ill patients, EPO was safe and probably efficient, as summarized in recent meta-analyses This article recaps here evidence that supports the use of human recombinant erythropoietin (EPO) for ameliorating course and outcome of seriously ill COVID-19 patients. This brief expert review grounds on available subject-relevant literature searched until May 14, 2020, including Medline, Google Scholar, and preprint servers. It delineates in brief sections, each introduced by a summary of respective COVID-19 references, how EPO may target a number of the gravest sequelae of these patients.

EPO is expected to:
-- Improve respiration at several levels including lung, brainstem, spinal cord and respiratory muscles
-- Counteract overshooting inflammation caused by cytokine storm/ inflammasome
-- Act neuroprotective and neuroregenerative in brain and peripheral nervous system.

Based on this accumulating experimental and clinical evidence, it finally provides the research design for a double-blind placebo-controlled randomized clinical trial including severely affected patients, which is planned to start shortly.

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