Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Clinical Research Center of Shandong University, Jinan, Shandong, China.
Nat Commun. 2021 Feb 5;12(1):814. doi: 10.1038/s41467-021-21085-8.
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 ratio (PaO/FiO) >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/FiO 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.
基于新冠病毒引起的肺部病理和血管变化，我们假设抗血管内皮生长因子（VEGF）药物贝伐珠单抗可能有益于治疗新冠病毒患者。从 2020 年 2 月 15 日至 4 月 5 日，我们进行了一项单臂试验（NCT04275414），从 2 个中心（中国和意大利）招募了 26 名患有严重新冠病毒的患者，其呼吸频率≥30 次/分钟，氧饱和度≤93%，与环境空气相比，或部分动脉血氧分压与吸入氧分数比（PaO/FiO）>100mmHg 且≤300mmHg，且弥漫性肺炎通过胸部影像学检查确认。随访 28 天。其中，贝伐珠单抗联合标准治疗可显著改善第 1 天和第 7 天的 PaO/FiO 比值。在第 28 天，24 名（92%）患者的氧支持状态得到改善，17 名（65%）患者出院，无患者氧支持状态恶化或死亡。胸部计算机断层扫描（CT）或 X 线在 7 天内显示病变面积/比值明显减少。在 14 名发热患者中，13 名（93%）患者的体温在 72 小时内恢复正常。与可比对照组相比，贝伐珠单抗通过改善氧合和缩短氧支持时间显示出临床疗效。我们的发现表明，贝伐珠单抗联合标准治疗对严重新冠病毒患者非常有益。需要进行随机对照试验。
