Objective: Treatment options for nonhospitalized patients with coronavirus disease 2019 (COVID-19) to reduce morbidity, mortality, and spread of the disease are an urgent global need. The over-the-counter histamine-2 receptor antagonist famotidine is a putative therapy for COVID-19. We quantitively assessed longitudinal changes in patient-reported outcome measures in nonhospitalized patients with COVID-19 who self-administered high-dose famotidine orally.

Design: Patients were enrolled consecutively after signing written informed consent. Data on demographics, COVID-19 diagnosis, famotidine use, drug related side-effects, temperature measurements, oxygen saturations, and symptom scores were obtained using questionnaires and telephone interviews. Based on an NIH-endorsed Protocol to research Patient Experience of COVID-19, we collected longitudinal severity scores of five symptoms (cough, shortness of breath, fatigue, headaches, and anosmia) and general unwellness on a 4-point ordinal scale modeled on performance status scoring. All data are reported at the patient level. Longitudinal combined normalized symptom scores were statistically compared.

Results: Ten consecutive patients with COVID-19 who self-administered high-dose oral famotidine were identified. The most frequently used famotidine regimen was 80mg three times daily (n=6) for a median of 11 days (range: 5 to 21 days). Famotidine was well tolerated. All patients reported marked improvements of disease-related symptoms after starting famotidine. The combined symptom score improved significantly within 24 hours of starting famotidine and peripheral oxygen saturation (n=2), and device recorded activity (n=1) increased.

Conclusions: The results of this case series suggest that high-dose oral famotidine is well tolerated and associated with improved patient reported outcomes in nonhospitalized patients with COVID-19. A blinded outpatient trial is planned. The findings may be transferable and relevant to the treatment of patients with cancer and COVID-19.

Citation Format: Tobias Janowitz, Eva C. Gablenz, David J. Pattinson, Timothy C. Wang, Joseph Conigliaro, Kevin J. Tracey, David A. Tuveson. Famotidine use and quantitative symptom tracking for COVID-19 in nonhospitalized patients: A case series [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S04-01.