Celebrex Adjuvant Therapy on Coronavirus Disease 2019: An Experimental Study

  1. Wenxin Hong
  2. Yan Chen
  3. Kai You
  4. Shenglin Tan
  5. Feima Wu
  6. Jiawang Tao
  7. Xudan Chen
  8. Jiaye Zhang
  9. Yue Xiong
  10. Fang Yuan
  11. Zhen Yang
  12. Tingting Chen
  13. Xinwen Chen
  14. Ping Peng
  15. Qiang Tai
  16. Jian Wang
  17. Fuchun Zhang
  18. Yin-Xiong Li

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Abstract

Background: The pandemic of coronavirus disease 2019 (COVID-19) resulted in grave morbidity and mortality worldwide. There is currently no effective drug to cure COVID-19. Based on analyses of available data, we deduced that excessive prostaglandin E 2 (PGE 2 ) produced by cyclooxygenase-2 was a key pathological event of COVID-19.

Methods: A prospective clinical study was conducted in one hospital for COVID-19 treatment with Celebrex to suppress the excessive PGE 2 production. A total of 44 COVID-19 cases were enrolled, 37 cases in the experimental group received Celebrex as adjuvant (full dose: 0.2 g, bid ; half dose: 0.2 g, qd ) for 7–14 days, and the dosage and duration was adjusted for individuals, while seven cases in the control group received the standard therapy. The clinical outcomes were evaluated by measuring the urine PGE 2 levels, lab tests, CT scans, vital signs, and other clinical data. The urine PGE 2 levels were measured by mass spectrometry. The study was registered and can be accessed at http://www.chictr.org.cn/showproj.aspx?proj=50474 .

Results: The concentrations of PGE 2 in urine samples of COVID-19 patients were significantly higher than those of PGE 2 in urine samples of healthy individuals (mean value: 170 ng/ml vs 18.8 ng/ml, p < 0.01) and positively correlated with the progression of COVID-19. Among those 37 experimental cases, there were 10 cases with age over 60 years (27%, 10/37) and 13 cases (35%, 13/37) with preexisting conditions including cancer, atherosclerosis, and diabetes. Twenty-five cases had full dose, 11 cases with half dose of Celebrex, and one case with ibuprofen. The remission rates in midterm were 100%, 82%, and 57% of the full dose, half dose, and control group, respectively, and the discharged rate was 100% at the endpoint with Celebrex treatment. Celebrex significantly reduced the PGE 2 levels and promoted recovery of ordinary and severe COVID-19. Furthermore, more complications, severity, and death rate were widely observed and reported in the COVID-19 group of elders and with comorbidities; however, this phenomenon did not appear in this particular Celebrex adjunctive treatment study.

Conclusion: This clinical study indicates that Celebrex adjuvant treatment promotes the recovery of all types of COVID-19 and further reduces the mortality rate of elderly and those with comorbidities.

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  1. Version published to 10.3389/fphar.2020.561674
  2. ScreenIT

    SciScore for 10.1101/2020.05.05.20077610: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: The enrolled patients are fully aware of the purpose, benefits and potential risks, and signed the informed consent prior to this study.
    IRB: This investigational study design was approved by the Medical Ethics Committee of Guangzhou Eighth People’s Hospital (Approve number: AF/sc-02/01.6).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The statistical analysis was conducted by using GraphPad Prism 7 software. p <0.05 was considered statistically significant.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.05.05.20077610v1 on medRxiv