Enliven: Pharmacovigilance and Drug Safety

Brief Report: Rapid Clinical Recovery from Severe COVID-19 with High Dose Famotidine and High Dose Celecoxib Adjuvant Therapy
Author(s): Kevin M Tomera, Robert W Malone, and Joseph K Kittah

Celecoxib adjuvant therapy added to standard of care has been shown to provide clinical benefit in treating viral pneumonia. Prior clinical studies include
one double blinded randomized clinical trial for hospitalized influenza pneumonia which demonstrated that celecoxib adjuvant treatment reduced overall
mortality and circulating IL6 levels [1]. In a retrospective COVID-19 study, celecoxib was shown to reduce the high IL6 [2] levels associated with that
disease, A prospective randomized COVID-19 trial demonstrated that celecoxib administration prevented clinical deterioration and rapidly improved
characteristic COVID-19 thoracic computerized axial tomography (CT-chest) findings [3]. Multiple descriptive trials of high dose famotidine (both
inpatient and outpatient) administered to patients with COVID-19 have demonstrated clinical responses [4-6]. In this case series, we describe the rapid
clinical responses observed after increasing the celecoxib dosage from 200mg BID to 400mg BID when administered together with high dose famotidine
(80mg PO QID) in three critical COVID-19 patients; one of whom on baseline required 55 liters per minute (l/min) (40 l/min nasal insufflation under
a 15 l/min nonrebreather mask) at the time of hospital admission, another which required 40 l/min high velocity nasal insufflation on admission, and an
outpatient who declined admission but had critical Covid-19 biomarkers.