Recombinant Human Angiotensin-converting Enzyme 2 (rhACE2) as a Treatment for Patients With COVID-19

Bundgaard et al., NCT04335136, APN01-COVID-19, NCT04335136, Dec 2020
Mortality -31% improvement lower risk ← → higher risk Ventilation 23% Alunacedase alfa  APN01-COVID-19  LATE TREATMENT RCT Is late treatment with alunacedase alfa beneficial? Double-blind RCT 185 patients in Austria Trial underpowered to detect differences c19early.org Bundgaard et al., NCT04335136, December 2020 0 0.5 1 1.5 2+ RR
RCT 181 hospitalized COVID-19 patients showing no significant improvement with alunacedase alfa.
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risk of death, 31.5% higher, RR 1.31, p = 0.61, treatment 9 of 88 (10.2%), control 7 of 90 (7.8%), day 28.
risk of mechanical ventilation, 23.3% lower, RR 0.77, p = 0.64, treatment 9 of 88 (10.2%), control 12 of 90 (13.3%), NNT 32, day 28.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Bundgaard et al., 26 Dec 2020, Double Blind Randomized Controlled Trial, placebo-controlled, Austria, preprint, 1 author, trial NCT04335136 (history) (APN01-COVID-19). Contact: romana.gugenberger@apeiron-biologics.com.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2025 Austria United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR Austria favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2025 Austria United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria Austria favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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