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 O 2 ratio (PaO 2 /FiO 2 ) >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 PaO 2 /FiO 2 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. In this single-arm clinical trial, the authors show that treatment of COVID-19 patients with bevacizumab, an anti-vascular endothelial growth factor drug, can improve PaO 2 /FiO 2 ratios and oxygen-support status. Relative to an external control group, bevacizumab shows clinical efficacy by improving oxygenation.
【저자키워드】 SARS-CoV-2, viral infection, Drug development, 【초록키워드】 Randomized controlled trial, Treatment, clinical trial, severe COVID-19, Pneumonia, oxygen, Italy, China, Computed tomography, X-ray, Chest computed tomography, oxygen saturation, Fever, Patient, Controlled trial, patients, body temperature, COVID-19 patients, Clinical efficacy, chest imaging, COVID-19 patient, respiratory rate, Oxygenation, Anti-vascular endothelial growth factor, oxygen pressure, vascular changes, changes, reduction, endothelial, Vascular, control group, standard care, VEGF, fraction, bevacizumab, bevacizumab plus standard care, inspiration, mmHg, NCT04275414, oxygen-support status, partial arterial oxygen pressure, shortening oxygen-support duration, single-arm trial, relative, growth factor, ambient, controls, single-arm, IMPROVE, shown, recruited, conducted, pulmonary pathological, comparable, discharged, Significant, anti-vascular, improving oxygenation, lesion areas/ratio, PaO, 【제목키워드】 Patient, Tolerability,