Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8170
Peer-review started: March 5, 2022
First decision: March 27, 2022
Revised: March 30, 2022
Accepted: July 5, 2022
Article in press: July 5, 2022
Published online: August 16, 2022
Processing time: 149 Days and 4.8 Hours
Famotidine is a histamine-2 receptor antagonist that suppresses gastric acid production. In vitro, famotidine inhibits human immunodeficiency virus replication. Recently, computational methods were applied to predict structures of proteins encoded by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) genome and identified famotidine as one of the drugs most likely to inhibit the 3-chymotrypsin-like protease which processes proteins essential for viral replication. Famotidine use was associated with a reduced risk of intubation and mortality among the patients hospitalized with coronavirus disease 2019 (COVID-19). Therefore, it is necessary to evaluate the potential use of the existing drugs like famotidine that could be used as options for the medical management of COVID-19 patients.
COVID-19 is a worldwide pandemic. Hence SARS-CoV-2 is a novel virus; there is no specific medication against it. Thus, clinicians and scientists all over the world are struggling with the treatment of this disease. Besides antiviral drugs, immunosuppressive agents and symptomatic therapy like the H2 receptor blocker famotidine came to the limelight due to its role in reducing the symptoms of COVID-19 patients.
To evaluate the role of H2 receptor blocker “famotidine” in COVID-19 illness.
COVID-19 patients admitted in the intensive care unit (ICU) of Chattogram General hospital, M. Abdur Rahim Medical College Hospital, and 250 bed Cox’s Bazar Sadar Hospital Bangladesh from July 20, 2020 and onward were enrolled in this study. Patients were divided into famotidine treatment group “A” (famotidine 40 mg to 60 mg oral formulation at 8 h intervals with other treatment as given), and control group “B” (treatment as given). National early warning score (NEWS)-2 and sequential organ failure assessment day-1 score was calculated to evaluate the outcome of the patients.
(1) The recovery (75% in group A and 70% in group B and death (25% in group A and 30% in group B) were found preferable in group A than that in group B; (2) Superior improvement of the computed tomography (CT) chest findings was observed in the famotidine treatment group; (3) Among the group A survivors, the duration of ICU and hospital stays were low; (4) However, the difference between the time to symptomatic recovery, ICU stay duration and the time to clinical failure/death among the groups were not significant, P ≥ 0.05; (5) Group A achieved a reduction of hospital stay and rapid recovery; (6) Viral recovery was delayed in the control group; and (7) The Kaplan Meier survival analysis was performed. The difference involving survival among the two study groups did not show any statistical significance (P = 0.989).
The famotidine treatment group demonstrated a comparatively better clinical outcome than the control. A rapid recovery time, less duration of ICU stay among the survivors, favorable improvement in the CT findings and an earlier viral clearance was observed in the famotidine treatment group; and were statistically significant in a t-test with the control. However, survival benefit was not significant with the famotidine treatment for severe COVID-19 disease.
The results of this study will add up to an important point in treating the SARS-CoV-2 infection during this time of desperate need which will have an overall effect in the long run from every perspective.