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Research Paper | Medicine | India | Volume 12 Issue 3, March 2023

Clinical Profile and Outcome of Severe COVID-19 Patients receiving Bevacizumab in Tertiary Care Hospital in India (COSCO-B Study)

Anil Kumar Behera | Naqueeb ul Hassan Syed | H Guruprasad ^[2] | Navoday Gilla | Shivram Krishna | K Divya | Madhusudhan Reddy ^[7] | V Bharat ^[2] | R Bharadwaj ^[2] | Atahullah | Manaswini

Abstract: We hypothesize that the anti-vascular endothelial growth factor (anti-VEGF) drug bevacizumab might be beneficial for treating severe COVID-19, on the basis of COVID-19-induced pulmonary vascular and pathological changes. From April 1 to May 30, 2021, we conducted an observational study and recruited 11 patients in a tertiary care hospital in India, with respiratory rate ?30 times/min, oxygen saturation ?94% with ambient air, or partial arterial oxygen pressure to fraction of inspiration O2 ratio (PaO2/FiO2) ratio >100 mmHg and ?300 mmHg. And followed it up for 14 days. Among these, bevacizumab plus standard care markedly improved the PaO2/FiO2 ratios at Days 1 and 7. After receiving a single dose of bevacizumab, 7 out of 11 patients (63.6%) showed clinical improvement in terms of oxygen-support status and inflammatory markers.63.6% patients were discharged. Of 10 patients with fever, body temperature normalized within 24hrs in 8patients (80%). Relative to non-bevacizumab patients, improvement in oxygenation and shortening oxygen-support duration was observed in patients receiving bevacizumab. Our findings suggest bevacizumab plus standard care is highly beneficial for patients with severe Covid-19. Further studies including randomized and placebo-controlled trials are warranted for validation of bevacizumab monotherapy and combination therapy.

Keywords: Bevacizumab, anti-VEGF, monoclonal antibody, PaO2/FiO2 ratio, COVID-19

Edition: Volume 12 Issue 3, March 2023,

Pages: 106 - 111