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COVID-19
Famotidine use and quantitative symptom tracking for COVID-19 in non-hospitalised patients: a case series
  1. Tobias Janowitz1,2,
  2. Eva Gablenz1,3,
  3. David Pattinson4,
  4. Timothy C Wang5,
  5. Joseph Conigliaro6,7,
  6. Kevin Tracey7,
  7. David Tuveson1
  1. 1 Cancer Center, Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, USA
  2. 2 Northwell Health Cancer Institute, New Hyde Park, New York, USA
  3. 3 Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
  4. 4 Department of Zoology, University of Cambridge, Cambridge, United Kingdom
  5. 5 Columbia University Medical Center, New York City, New York, USA
  6. 6 Divion of General Internal Medicine, Department of Medicine, Manhasset, New York, USA
  7. 7 The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
  1. Correspondence to Dr Tobias Janowitz, Cold Spring Harbor Laboratory; One Bungtown Road; Cold Spring Harbor, New York, USA; janowitz{at}cshl.edu; Kevin Tracey, The Feinstein Institute for Medical Research; Northwell Health; Manhasset, New York, New York; KJTracey{at}northwell.edu; Dr David Tuveson, Cold Spring Harbor Laboratory; One Bungtown Road; Cold Spring Harbor, New York, USA; dtuveson{at}cshl.edu

Abstract

Objective Treatment options for non-hospitalised patients with coronavirus disease 2019 (COVID-19) to reduce morbidity, mortality and spread of the disease are an urgent global need. The over-the-counter histamine-2 receptor antagonist famotidine is a putative therapy for COVID-19. We quantitively assessed longitudinal changes in patient reported outcome measures in non-hospitalised patients with COVID-19 who self-administered high-dose famotidine orally.

Design Patients were enrolled consecutively after signing written informed consent. Data on demographics, COVID-19 diagnosis, famotidine use, drug-related side effects, temperature measurements, oxygen saturations and symptom scores were obtained using questionnaires and telephone interviews. Based on a National Institute of Health (NIH)-endorsed Protocol to research Patient Experience of COVID-19, we collected longitudinal severity scores of five symptoms (cough, shortness of breath, fatigue, headaches and anosmia) and general unwellness on a four-point ordinal scale modelled on performance status scoring. All data are reported at the patient level. Longitudinal combined normalised symptom scores were statistically compared.

Results Ten consecutive patients with COVID-19 who self-administered high-dose oral famotidine were identified. The most frequently used famotidine regimen was 80 mg three times daily (n=6) for a median of 11 days (range: 5–21 days). Famotidine was well tolerated. All patients reported marked improvements of disease related symptoms after starting famotidine. The combined symptom score improved significantly within 24 hours of starting famotidine and peripheral oxygen saturation (n=2) and device recorded activity (n=1) increased.

Conclusions The results of this case series suggest that high-dose oral famotidine is well tolerated and associated with improved patient-reported outcomes in non-hospitalised patients with COVID-19.

  • SARS-CoV-2
  • COVID-19
  • COVID-19 symptoms
  • coronavirus
  • Famotidine
  • outpatients
  • PROMs
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/gutjnl-2020-321852

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    Footnotes

    • Correction notice This article has been corrected since it published Online First. Figures 1 and 3 have been replaced.

    • Contributors This study was designed and interpreted by TJ, TCW, JC, KT and DT. EG and DP performed data collection, and interpretation. TJ and DT wrote the manuscript, and all authors edited the manuscript.

    • Funding TJ and DT are supported by NIH grant 5P30CA045508-30. KT is supported by NIH grant R35GM118182-01.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

    • Patient consent for publication Not required.

    • Ethics approval The Cold Spring Harbor Laboratory institutional review board approved this registered study (IRB 1605914–1; NCT04389567).

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. The anonymised data from this case series are included and available on request.