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Common anticancer drug may improve outcome in severe COVID-19

In a new study, researchers found that treating severe COVID-19 patients with the anticancer drug bevacizumab may reduce mortality and speed up recovery.

On average, blood oxygen levels, body temperature, and inflammatory markers strongly improved in patients treated with a single dose of bevacizumab in addition to standard care.

The findings suggest that bevacizumab plus standard care is highly beneficial for patients with severe COVID-19 and should be considered as a first-line treatment for these people.

The research was led by a team at Karolinska Institutet in Sweden.

Bevacizumab is a medication that has been used to treat various types of cancer since 2004.

It works by slowing the formation of new blood vessels by inhibiting a growth factor known as VEGF.

Many patients with severe COVID-19 have elevated levels of VEGF as well as symptoms associated with this marker, including excess fluid and disorganized blood vessels in the lungs.

In the study, the team examines the effect of combining bevacizumab with standard care for treating patients with severe COVID-19.

Twenty-six patients were recruited from two hospitals in China and Italy between mid-February and early April in 2020.

The patients had confirmed COVID-19 and symptoms such as difficulty breathing, low blood oxygen levels, and pneumonia.

They were matched with 26 patients of similar characteristics who received standard care at the same hospitals in roughly the same time period and thus served as the control group.

The recruits received standard care plus a single low dose of about 7.5 mg/kg bevacizumab, which markedly improved blood oxygen levels within 24 hours compared to the control group.

By the end of the 28-day follow-up period, 92% of the bevacizumab-treated patients no longer needed the same level of oxygen support as before the trial began, compared with an improvement rate of 62% for the controls.

None of the bevacizumab-treated patients died and 17 (65%) improved so much that they were able to leave the hospital within the follow-up period.

In the control group, three died and only 46% were discharged within 28 days.

Bevacizumab also shortened the duration of oxygen-support to a median of nine days compared with 20 for the standard care group.

Other interesting findings include a reduction in fever, an increase in white blood cells, and a sharp decrease of c-reactive protein (CRP) levels, an inflammatory marker. No severe safety concerns were detected.

The study shows that bevacizumab could help reduce the need for oxygen support and reduce days in the hospital, thus improving the outcome for the individual patient while easing pressure on medical resources.

One author of the study is Yihai Cao, a professor of vascular biology at the Department of Microbiology, Tumor and Cell Biology.

The research is published in Nature Communications.

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