S1P1 receptor agonists for “cytokine storm.” Might be a viable option to reduce ARDS and need for ventilator. Two existing MS drugs might be worth trying: Gilenya (fingolimod) and just-approved Zeposia (Ozanimod), which may have better safety profile. New trial starting in China with fingolimod. It’s immunomodulator, not immunosuppressor, so reduced risk of secondary infection, but still a risk. However, if the alternative is ventilator with 86% mortality, I might prefer to risk it and fight secondary infection. The drugs are not cheap, but would likely only need few days treatment. Perhaps your friend in NO might want to consider this (PS, some older anecdotal evidence from Ebola front suggests that statins and ARBs (preferably in combo) have shown efficacy)
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