Oral famotidine versus placebo in non-hospitalised patients with COVID-19: a randomised, double-blind, data-intense, phase 2 clinical trial

OBJECTIVE

We assessed whether famotidine improved inflammation and symptomatic recovery in outpatients with mild to moderate COVID-19.

DESIGN

Randomised, double-blind, placebo-controlled, fully remote, phase 2 clinical trial (NCT04724720) enrolling symptomatic unvaccinated adult outpatients with confirmed COVID-19 between January 2021 and April 2021 from two US centres. Patients self-administered 80 mg famotidine (n=28) or placebo (n=27) orally three times a day for 14 consecutive days. Endpoints were time to (primary) or rate of (secondary) symptom resolution, and resolution of inflammation (exploratory).

RESULTS

Of 55 patients in the intention-to-treat group (median age 35 years (IQR: 20); 35 women (64%); 18 African American (33%); 14 Hispanic (26%)), 52 (95%) completed the trial, submitting 1358 electronic symptom surveys. Time to symptom resolution was not statistically improved (p=0.4). Rate of symptom resolution was improved for patients taking famotidine (p<0.0001). Estimated 50% reduction of overall baseline symptom scores were achieved at 8.2 days (95% CI: 7 to 9.8 days) for famotidine and 11.4 days (95% CI: 10.3 to 12.6 days) for placebo treated patients. Differences were independent of patient sex, race or ethnicity. Five self-limiting adverse events occurred (famotidine, n=2 (40%); placebo, n=3 (60%)). On day 7, fewer patients on famotidine had detectable interferon alpha plasma levels (p=0.04). Plasma immunoglobulin type G levels to SARS-CoV-2 nucleocapsid core protein were similar between both arms.

CONCLUSIONS

Famotidine was safe and well tolerated in outpatients with mild to moderate COVID-19. Famotidine led to earlier resolution of symptoms and inflammation without reducing anti-SARS-CoV-2 immunity. Additional randomised trials are required.

Combined membrane filtration-electrochemical microbial detection method

The electrochemical method was used successfully to detect Escherichia coli cells retained on membrane filters. Preliminary results suggest that the combined technique could be used to predict the microbial loading of water samples.

Rat lymphocytes in cell culture exposed to 2450 MHz (CW) microwave radiation

Rat lymphocytes were exposed to continuous wave microwave radiation at a frequency of 2450 MHz at intensities of 5, 10 and 20 mW/cm2. The corresponding rates of absorption of energy were determined to be 0.7, 1.4 and 2.8 mW/g. The lymphocytes were exposed for 4, 24 or 44 h either with or without the addition of a mitogen (phytohemagglutinin). The transformation of lymphocytes into lyphoblasts was monitored by the addition of tritiated thymidine. No significant differences (P less than .05) were found in the uptake of tritiated thymidine between exposed and control cultures.

Critical appraisal of domiciliary obstetric and neonatal practice

Obstetric and neonatal data on 155 domiciliary deliveries were analysed. The findings illustrated the problems in adhering to generally recognised risk criteria for selecting cases for domiciliary confinement and the unpredictability of events in the newborn period. Awareness of the risks of home confinement have led to increased efforts to achieve 100% hospital delivery. At the West Middlesex Hospital, to make hospital confinement more acceptable to mothers, we have tried to alter inflexible hospital routines and to make previously austere labour wards less impersonal. The same midwife who has supervised the antenatal period brings the mother into the unit, and transfers her home as soon as possible afterwards..

Operant control of neural events in humans

Human subjects were trained by traditional methods of instrumental conditioning to change the amplitude of a late component of the auditory evoked potential with and without oscilloscopic feedback of their performance.

Operant controlled neural event: formal and systematic approach to electrical coding of behavior in brain

Traditional studies of electrophysiological correlates of behavior contain inherent high variability resulting from the arbitrary choice of behaviors, brain locations, and wave parameters. The operant control of neural events is a formal and systematic approach to the study of prespecified parameters and components of brain activity as they encode behaviors. Two studies in which the electrical activity of brain was the criterion for reinforcement demonstrate the acquisition, under such operant control, of two mutually exclusive behaviors or states which selectively alter evoked potential components.

Motor effects of copper in the caudate nucleus: reversible lesions with ion-exchange resin beads

A method employing the use of ion-exchange resin beads is described for the punctate introduction of discrete amounts of various anions, cations, or zwitterions into given brain regions. A series of experiments utilizing the method to introduce ionic copper into the caudate nucleus with the resulting motor manifestations are discussed.

Functional congruence: an index of neural homogeneity and a new measure of brain activity

Extremely high correlation between the probability that a single cell will fire and the amplitude of microelectrode electroencephalogram was established in on-line, real-time computer experiments. Such congruence between spike and wave shows orderly biological variation under sensory control. Congruence, as a measure of brain activity, provides an immediate estimate of regional neural homogeneity of function of cell populations in brain.

Duplication of Evoked Potential Waveform by Curve of Probability of Firing of a Single Cell

Computer compilation of the probability of firing of a single cell in cat cortex following a physiological sensory stimulus (somatic or light flash) indicates that the frequency distribution of the firing of a single cell closely corresponds to the average waveform of the evoked potential recorded from the same microelectrode. This high correlation holds for both positive and negative and early and late components of the evoked response.