Camostat Mesylate May Reduce Severity of Coronavirus Disease 2019 Sepsis: A First Observation
Hofmann-Winkler, Heike ; Moerer, Onnen ; Alt-Epping, Sabine ; Bräuer, Anselm ; Büttner, Benedikt ; Müller, Martin ; Fricke, Torben ; Grundmann, Julian et al.
Citable Link (URL):http://resolver.sub.uni-goettingen.de/purl?gs-1/17663
Journal Article (Published version)
First published (peer reviewed)
Critical Care Explorations 2020; 2(11) p.1-5: Art. e0284
Abstract
Objectives:
Severe acute respiratory syndrome coronavirus 2 cell entry depends on angiotensin-converting enzyme 2 and transmembrane serine protease 2 and is blocked in cell culture by camostat mesylate, a clinically proven protease inhibitor. Whether camostat mesylate is able to lower disease burden in coronavirus disease 2019 sepsis is currently unknown.
Design:
Retrospective observational case series.
Setting:
Patient treated in ICU of University hospital Göttingen, Germany.
Patients:
Eleven critical ill coronavirus disease 2019 patients with organ failure were treated in ICU.
Interventions:
Compassionate use of camostat mesylate (six patients, camostat group) or hydroxychloroquine (five patients, hydroxychloroquine group).
Measurements and Main Results:
Clinical courses were assessed by Sepsis-related Organ Failure Assessment score at days 1, 3, and 8. Further, viral load, oxygenation, and inflammatory markers were determined. Sepsis-related Organ Failure Assessment score was comparable between camostat and hydroxychloroquine groups upon ICU admission. During observation, the Sepsis-related Organ Failure Assessment score decreased in the camostat group but remained elevated in the hydroxychloroquine group. The decline in disease severity in camostat mesylate treated patients was paralleled by a decline in inflammatory markers and improvement of oxygenation.
Conclusions:
The severity of coronavirus disease 2019 decreased upon camostat mesylate treatment within a period of 8 days and a similar effect was not observed in patients receiving hydroxychloroquine. Camostat mesylate thus warrants further evaluation within randomized clinical trials.
Sponsor:
Open-Access-Publikationsfonds 2020
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