On Mar. 20, 2020, Cardax released a white paper outlining the potential role of astaxanthin in the treatment of coronavirus disease and is seeking strategic collaborations to further develop astaxanthin for COVID-19. The paper was entitled “Astaxanthin: A safe, natural, and multi-faceted anti-inflammatory for maintaining lung health and possibly minimizing SARS-CoV-2 effects”.

This association between infection and progression of disease with inflammation suggests a strategy that would partner anti-infective agents, such as anti-virals and vaccines, with anti-inflammatory agents. An anti-inflammatory agent would be expected to mitigate symptoms including fever, pain, and swelling. Furthermore, an anti-inflammatory regimen initiated at a relatively early stage in disease progression might be expected to stem the immune over-response and to slow or even prevent progression of symptoms leading to lung injury and ARDS. Importantly, an appropriate anti-inflammatory intervention should not result in abnormal immune suppression but should target healthy immune homeostasis.

An anti-inflammatory treatment that resulted in the decrease of inflammatory cytokine signaling would seem a promising approach. Chinese researchers have identified IL-6 as a main driver of immune overreaction in COVID-19 patients and have already included elevated IL-6 levels as a biomarker of disease worsening. China’s National Health Commission has updated its treatment guidelines for COVID-19 to include Roche’s injected biologic, Actemra (tocilizumab), an inhibitor of the IL-6 receptor. Actemra, first approved by the U.S. FDA in 2010 for rheumatoid arthritis, can now be used in China to treat serious coronavirus patients with lung damage.