Summary of COVID-19 atovaquone studies

1. Jain et al., Atovaquone for treatment of COVID-19: A prospective randomized, double-blind, placebo-controlled clinical trial

60 patient atovaquone late treatment RCT: 39% higher mortality (p=1), 20% greater improvement (p=0.56), and 16% shorter hospitalization (p=0.07).
RCT 60 hospitalized COVID-19 patients showing no significant difference in viral clearance with atovaquone. Patients were randomized 2:1 to receive atovaquone 1500mg BID or placebo for up to 10 days, with both groups receiving standard of care treatments including remdesivir and dexamethasone. Pharmacokinetic data revealed that adequate inhibitory drug concentrations were likely not achieved in most patients by day 3, with higher BMI negatively correlating with drug levels. Authors observed an inverse correlation between atovaquone plasma concentration and viral load, suggesting a potential antiviral effect might be possible with adequate dosing.
Sep 2022, Frontiers in Pharmacology, https://www.frontiersin.org/articles/10.3389/fphar.2022.1020123/full, https://c19p.org/jain5