Meplazumab treats COVID-19 pneumonia: an open-labelled, concurrent controlled add-on clinical trial

Huijie Bian; Zhao-Hui Zheng; Ding Wei; Zheng Zhang; Wen-Zhen Kang; Chun-Qiu Hao; Ke Dong; Wen Kang; Jie-Lai Xia; Jin-Lin Miao; Rong-Hua Xie; Bin Wang; Xiu-Xuan Sun; Xiang-Min Yang; Peng Lin; Jie-Jie Geng; Ke Wang; Hong-Yong Cui; Kui Zhang; Xiao-Chun Chen; Hao Tang; Hong Du; Na Yao; Shuang-Shuang Liu; Lin-Na Liu; Zhe Zhang; Zhao-Wei Gao; Gang Nan; Qing-Yi Wang; Jian-Qi Lian; Zhi-Nan Chen; Ping Zhu

Coronavirus is an enveloped positive stranded RNA virus belonging to the family Cornonaviridae, order Nidovirales. 1 Over the past 20 years, two human coronaviruses, SARS-CoV and MERS-CoV were reported to lead to severe and fatal lower respiratory tract infection. 2, 3 In Dec 2019, an outbreak of a respiratory syndrome, COVID-19, was detected in China which is caused by a novel coronavirus, named SARS-CoV-2. 4 The genome sequence of SARS-CoV-2 shows it belongs to betacoronavirus genus, and has extremely high homology with SARS-CoV at genome and proteome. 5, 6 Illness onset among rapidly increasing numbers of COVID-19 in China and globe indicates that SARS-CoV-2 is more contagious than both SARS-CoV and MERS-CoV. The infection of SARS-CoV-2 leads to acute viral exudative pneumonia, with multiple organ damages, especially in lung, presenting bilateral diffuse alveolar damage with cellular fibromyxoid exudates. 7 80% cases have mild symptoms (including nonpneumonia and mild pneumonia cases), while about 20% patients have developed severe pneumonia and acute respiratory distress syndrome, which attribute to death. 8 As of Mar 12th, 2020, 125,048 cases and 4,613 death have been reported globally. 9 The current standard treatment including oxygen therapy, antiviral treatment, fluid management, and antimicrobial therapy for secondary bacterial infections. 10 Although several drugs, such as remdesivir and chloroquine phosphate, have been registered in ongoing clinical trials for COVID-19, no specific antiviral drugs against this novel coronavirus are approved so far. The latest report indicates the infection of SARS-CoV-2 increases the expression levels of multiple proinflammatory cytokines, including IFN-γ, TNF-α, MCP1, and IL-6 in the serum, which suggests the inflammation storm may involve in the progression of COVID-19. 4 Therefore, inhibiting virus replication and limiting excessive inflammation are of equal importance in COVID-19 therapy.