The Effectiveness of Bevacizumab in COVID-19 Pneumonia Among Critically Ill Patients

Background:Bevacizumab, an antiangiogenic drug, is being evaluated for the management of novel coronavirus disease (COVID-19) pneumonia among critically ill patients. The objective of this study was to assess the effectiveness of bevacizumab in severe COVID-19 pneumonia. Methods:This was a retrospective, observational study performed in 111 patients diagnosed with COVID-19 pneumonia. Bevacizumab was administered intravenously at 7.5 mg/kg along with standard care in a non-randomly selected subset of patients (n = 29) with evidence of acute respiratory distress syndrome (ARDS) within 72 hours of worsening of oxygenation. The primary outcome measure was intensive care unit (ICU)-related mortality. Results:Bevacizumab was administered for a median of 9.4 (4-24) days from the onset of symptoms and 2.2 (1-3) days from the day of ICU admission. Bevacizumab-treated patients showed a statistically significant improvement in PF ratio and reduction in radiological severity score. In the bevacizumab group, 13 (44.8%) of 29 patients died in ICU, and in the standard-of-care group, 37 (45.1%) of 82 patients died. The difference in clinical status assessed using the World Health Organization 7-category Ordinary Scale at 28 days between the bevacizumab group and the standard-of-care group was not statistically significant (odds ratio 1.02, 95% confidence interval 0.44-2.4, P = .94). Conclusion:Bevacizumab plus standard care was not superior to standard care alone in reducing mortality and improving clinical outcomes at day 28.