Chansu Injection Improves the Respiratory Function of Severe COVID-19 Patients

Abstract Chansu and its major active constituent of bufalin have been reported to have broad-spectrum antiviral effects. This study aims to assess the efficacy of Chansu injection in treating patients with severe COVID-19. The patients diagnosed as severe or critical COVID-19 in The First People’s Hospital of Jiangxia District, Wuhan, China from February 5 to March 5, 2020 were randomly allocated in a 1:1 ratio to receive general treatment plus Chansu injection or only general treatment as the control group. The treatment course was 7 days. The changes of PaO 2 /FiO 2 and ROX index indicating respiratory function, the white blood cell (WBC) count, peripheral blood mononuclear lymphocyte (PBML) count, respiratory support step-down time (RSST), and safety indicators for the 7th day were retrospectively analyzed. After 7 days treatment, the oxygenation index was improved in 20 of 21 patients (95.2%) in the treatment group, as compared with 13 of 19 patients (68.4%) in the control group. The PaO 2 /FiO 2 and ROX indices in the treatment group (mean, 226.27±67.35 and 14.01±3.99 respectively) were significantly higher than the control group (mean, 143.23±51.29 and 9.64±5.54 respectively). The RSST was 1 day shorter in the treatment group than the control group. Multivariate regression analysis suggested that Chansu injection contributed the most to the outcome of PaO 2 /FiO 2 . No obvious adverse effects were observed. Preliminary data showed that Chansu injection had apparent efficacy in treating patients with severe COVID-19. Significance Statement Patients with severe COVID-19 usually have dyspnea and/or hypoxemia one week after the onset of symptoms, and can quickly progress to acute respiratory distress syndrome, septic shock, metabolic acidosis that is difficult to correct, coagulation dysfunction and multiple organs failure. Chansu injection, a widely used drug in clinical cancer and chronic hepatitis B therapy in China, can improve the respiratory function and shorten the respiratory support step-down time with 1 day in patients with severe COVID-19. These preliminary findings raise the possibility that Chansu injection may be helpful in the treatment of patients with severe COVID-19.