Bevacizumab in Patients With Severe Covid-19

Inclusion Criteria:

1. Age: ≥18 years old, both genders;
2. Confirmed COVID-19 diagnosis (any body fluid tested positive for SARS-CoV-2 nucleicacid by PCR, or positive for SARS-CoV-2 antigen);
3. Respiratory rate ≥ 30 times/min, partial pressure of oxygen (PaO2)/ fraction ofinspiration O2 (FiO2)≤ 300mmHg (1mmHg = 0.133kPa), or SpO2 ≤ 93% at rest withoutsupplemental oxygen;
4. Article (3) above is newly appeared within 7 days;
5. Chest radiography or computed tomography shows bilateral chest infiltrates.

Exclusion Criteria:

1. Unable to obtain informed consent.
2. Physician with more than 5 years of clinical experience determines that death wasinevitable within 24 hours.
3. Severe hepatic dysfunction (Child Pugh score ≥ C, or AST> 5 times the upper limit);Severe renal dysfunction (estimated glomerular filtration rate ≤ 30mL/ min/1.73 m2) orreceive continuous renal replacement therapy, hemodialysis, or peritoneal dialysis.
4. Uncontrolled hypertension (sitting systolic blood pressure> 160mmHg, or diastolicblood pressure>100mmHg); previous history of hypertension crisis or hypertensiveencephalopathy.
5. Poorly controlled heart diseases, such as NYHA class II and above cardiacinsufficiency, unstable angina pectoris, myocardial infarction within 1 year beforeenrollment, supraventricular or ventricular arrhythmia need treatment or intervention.
6. Severe or above chronic obstructive pulmonary disease (GOLD grade, FEV1/FVC < 0.5).
7. Hereditary bleeding tendency or coagulopathy;
8. Arterial/venous thromboembolic events within 6 months before enrollment, such asischemic stroke, transient ischemic attack, deep venous thrombosis, pulmonaryembolism, etc. Severe vascular disease (including aneurysms or arterial thrombosisrequiring surgery) within 6 months before enrollment.
9. Unhealed wounds, active gastric ulcers or fractures. Gastrointestinal perforation,gastrointestinal fistula, abdominal abscess, visceral fistula formation within 6months before enrollment. Major surgery (including preoperative Chest biopsy) or majortrauma (such as a fracture) within 28 days before enrollment. May have surgery duringthe trial.
10. Severe, active bleeding such as hemoptysis, gastrointestinal bleeding, central nervoussystem bleeding, and nosebleeds within 1 month before enrollment.
11. Malignant tumors within 5 years before enrollment.
12. Allergic to bevacizumab or its components.
13. Active tuberculosis, uncontrollable infection, untreated active hepatitis orHIV-positive patients.
14. Pregnant and lactating women and those planning to get pregnant.
15. Participated in other clinical trials, not considered suitable for this study by theresearchers.