Efficacy and tolerability of bevacizumab in patients with severe Covid-19.

Abstract

On the basis of Covid-19-induced pulmonary pathological and vascular changes, we hypothesize that the anti-vascular endothelial growth factor (VEGF) drug bevacizumab might be beneficial for treating Covid-19 patients. From Feb 15 to April 5, 2020, we conducted a single-arm trial (NCT04275414) and recruited 26 patients from 2-centers (China and Italy) with severe Covid-19, with respiratory rate ≥30 times/min, oxygen saturation ≤93% with ambient air, or partial arterial oxygen pressure to fraction of inspiration O2 ratio (PaO2/FiO2) >100 mmHg and ≤300 mmHg, and diffuse pneumonia confirmed by chest imaging. Followed up for 28 days. Among these, bevacizumab plus standard care markedly improves the PaO2/FiO2 ratios at days 1 and 7. By day 28, 24 (92%) patients show improvement in oxygen-support status, 17 (65%) patients are discharged, and none show worsen oxygen-support status nor die. Significant reduction of lesion areas/ratios are shown in chest computed tomography (CT) or X-ray within 7 days. Of 14 patients with fever, body temperature normalizes within 72 h in 13 (93%) patients. Relative to comparable controls, bevacizumab shows clinical efficacy by improving oxygenation and shortening oxygen-support duration. Our findings suggest bevacizumab plus standard care is highly beneficial for patients with severe Covid-19. Randomized controlled trial is warranted.

• Authors: Jiaojiao Pang, Feng Xu, Gianmarco Aondio, Yu Li, Alberto Fumagalli, Ming Lu, Giuseppe Valmadre, Jie Wei, Yuan Bian, Margherita Canesi, Giovanni Damiani, Yuan Zhang, Dexin Yu, Jun Chen, Xiang Ji, Wenhai Sui, Bailu Wang, Shuo Wu, Attila Kovacs, Miriam Revera, Hao Wang, Xu Jing, Ying Zhang, Yuguo Chen, Yihai Cao
• Journal: Nature communications (Nat Commun) Vol. 12 Issue 1 Pg. 814 (02 05 2021) ISSN: 2041-1723 [Electronic] England
• PMID: 33547300 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Angiogenesis Inhibitors
• Bevacizumab

Topics

• Aged
• Angiogenesis Inhibitors (therapeutic use)
• Bevacizumab (therapeutic use)
• Body Temperature (drug effects)
• COVID-19 (virology)
• China
• Female
• Fever (prevention & control)
• Humans
• Italy
• Male
• Middle Aged
• SARS-CoV-2 (drug effects, physiology)
• Treatment Outcome
• COVID-19 Drug Treatment