Common anti-nausea drug could help COVID-19 patients, study suggests

AdventHealth and BERG, an artificial-intelligence powered biotechnology company, recently discussed the findings of a study that shows ondansetron, a long-approved drug to treat nausea, is associated with lower COVID-19 deaths, particularly for ventilated patients.

The study, which is the first to use AI to report disease outcomes in COVID-19 patients, used a supercomputer to comb through nearly 280,000 electronic health records to find more than 16,000 COVID-19 patients seen in 2020 at hospitals in AdventHealth’s Central Florida Division. The analysis searched for drugs, co-morbidities and other factors such as lab results that associated with death from the virus. Researchers identified ondansetron as the only medication associated with decreased mortality in this cohort.

“Oftentimes, in science and medicine, we don’t know what we don’t know,” Dr. Steven Smith, chief scientific officer and senior vice president of the AdventHealth Research Institute, told the Orlando Sentinel. “The big-brain computer program [can] look at really large datasets in a way the human mind can never really wrap their heads around.”

One theory behind the finding is that SARS-CoV-2 might have an indirect effect on specialized cells in the gastrointestinal tract, which can trigger the release of neuroactive agents such as the emesis inducing serotonin. Ondansetron, known by the brand name Zofran, is a selective serotonin receptor antagonist and could modulate this effect, as well as turning down an overactive immune system which is known to occur in some patients with severe covid-19.

But, as the Sentinel reported, physicians aren't recommending people take the drug for this purpose.

“We’re not recommending ondansetron,” Smith told the newspaper. “But rather, this is a step in the scientific process, and making sure that we have the most effective and safe medications for our patients.”

So far there have been no controlled trials examining the effect of ondansetron in COVID-19 patients and the study’s authors suggested such investigations move forward as a result of the study. The study is gaining attention as a preprint and has been submitted for publication.

In addition, the study corroborated findings in other studies that remdesivir, the first approved drug for COVID-19 treatment, does not have a clear effect on reducing mortality.

And the analysis validated a previous finding that a drug to treat rheumatoid arthritis also is associated with lower COVID-19 mortality for mechanically ventilated patients.

The study is part of a larger partnership with BERG and among the growing portfolio of research and laboratory work underway at AdventHealth.