Efficacy and tolerability of bevacizumab in patients with severe Covid-19
Open Access
- 5 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Nature Communications
- Vol. 12 (1), 1-10
- https://doi.org/10.1038/s41467-021-21085-8
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.Funding Information
- Ministry of Science and Technology of the People’s Republic of China (2020YFC0846600)
- Department of Science and Technology of Shandong Province (2020SFXGFY03)
- National Key Research and Development Program of China Shandong Provincial Key Research and Development Program
This publication has 29 references indexed in Scilit:
- Severe flu management: a point of viewIntensive Care Medicine, 2020
- A Subset of Type I Conventional Dendritic Cells Controls Cutaneous Bacterial Infections through VEGFα-Mediated Recruitment of NeutrophilsImmunity, 2019
- Effect of Bevacizumab vs Aflibercept on Visual Acuity Among Patients With Macular Edema Due to Central Retinal Vein OcclusionJAMA, 2017
- Activation of Vascular Endothelial Growth Factor Receptor-3 in Macrophages Restrains TLR4-NF-κB Signaling and Protects against Endotoxin ShockImmunity, 2014
- Genetic Delivery of Bevacizumab to Suppress Vascular Endothelial Growth Factor-Induced High-Permeability Pulmonary EdemaHuman Gene Therapy, 2009
- Vascular endothelial growth factor (VEGF) induces remodeling and enhances TH2-mediated sensitization and inflammation in the lungNature Medicine, 2004
- Vascular Endothelial Growth Factor May Contribute to Increased Vascular Permeability in Acute Respiratory Distress SyndromeAmerican Journal of Respiratory and Critical Care Medicine, 2001
- Lung Overexpression of the Vascular Endothelial Growth Factor Gene Induces Pulmonary EdemaAmerican Journal of Respiratory Cell and Molecular Biology, 2000
- Systemic hypoxia changes the organ-specific distribution of vascular endothelial growth factor and its receptorsProceedings of the National Academy of Sciences of the United States of America, 1998
- Hypoxia Regulates Vascular Endothelial Growth Factor Gene Expression in Endothelial CellsCirculation Research, 1995