Role of H2 receptor blocker famotidine over the clinical recovery of COVID-19 patients: A randomized controlled trial

BACKGROUND Coronavirus disease 2019(COVID-19)is a global pandemic putting the population at a high risk of infection-related health hazards,mortality and a potential failure of proper medical therapies.Therefore,it is necessary to evaluate the potential use of the existing drugs that could be used as options for the medical management of COVID-19 patients.AIM To evaluate the role of the H_(2) receptor blocker“famotidine”in COVID-19 illness.METHODS This study was done on seriously ill COVID-19 patients admitted to the intensive care unit(ICU)from different institutes in Bangladesh.Patients were divided into famotidine treatment group“A”(famotidine 40 mg to 60 mg oral formulation every 8 h 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.Outcomes were evaluated by the time required for clinical improvement,characterized as duration required from enrollment to the achievement of NEWS-2 of≤2 maintained for 24 h;time to symptomatic recovery,defined as the duration in days(from randomization)required for the recovery of the COVID-19 symptoms;mortality rate;duration of ICU and hospital stay;total period of hospitalization;the rate of supplementary oxygen requirement;the computed tomography(CT)chest recovery(%),the time required for the viral clearance and“NEWS-2”on discharge.RESULTS A total of 208 patients were enrolled in this study with 104 patients in each group.The famotidine treatment group had comparatively better recovery of 75%and a low mortality of 25%than the control with a recovery of 70%and a mortality of 30%.Duration of clinical improvement(group A 9.53 d,group B 14.21 d);hospitalization period among the recovered patients(group A 13.04 d,group B 16.31 d),pulmonary improvement in chest CT(group A 21.7%,group B 13.2%),and the time for viral clearance(group A 20.7 d,group B 23.8 d)were found to be statistically significant P≤0.05.However,the Kaplan Meier survival test was not significant among the two study groups,P=0.989.CONCLUSION According to our study,treatment with famotidine achieved a better clinical outcome compared to the control group in severe COVID-19 illness,although no significant survival benefit was found.