DISCUSSION
ADVERSE REACTIONS, DISEASE PROGRESSION, POSITIVE, ADVERSE EVENTS, CHRONIC PANCREATITIS, SECONDARY, ADVERSE DRUG REACTIONS
In this phase 2 clinical trial, we assessed the clinical benefit and safety of camostat mesylate in the treatment of mild to moderate COVID-19. No primary or secondary endpoint was statistically significant, according to the A recent randomized, placebo-controlled clinical trial showed that camostat mesylate was not effective in clinical improvement, disease progression, or reduction of mortality. The median times to clinical improvement were 5 days in the camostat group and 5 days in the placebo group. The hazard ratio (HR) for 30-day mortality in the camostat group versus the placebo group was 0.82 (CI, 0.24 to 2.79). The median change in viral loads from baseline to day 5 in the camostat group was −0.22 logThe RES Q-HR [Reconvalescent Plasma/Camostat Mesylate Early in SARS-CoV-2 Q-PCR (COVID-19) Positive High-risk Individuals] trial also aims to assess the effectiveness of camostat in prevention of disease progression in high-risk patients. It has recruited 22 patients, and its results are pending (The COMOVID trial, another clinical trial for camostat mesylate in ambulatory adult patients, was terminated due to SARS-CoV2 pandemic evolution, with a decrease in inclusions and widespread distribution of vaccines (Anticough medications were given to 134 patients: 60 patients in the camostat group and 74 patients in the placebo group (In this study, the efficacy of camostat mesylate was evaluated after administrating for 14 days and the safety profiles were monitored up to 28 days according to the requirement of the South Korea Ministry of Food and Drug Safety. The safety profile of patients who received camostat mesylate was similar to that of placebo-treated patients. In addition, the safety of camostat mesylate has been well established. Foistar has been on the market in South Korea and Japan for more than 2 decades as a treatment for chronic pancreatitis. In South Korea, over 22,400,000 tablets have been used from 2012 to 2020, but only 40 adverse events, 11 adverse drug reactions, and 5 serious adverse reactions have been reported (Korea Institute of Drug Safety & Risk Management, unpublished data). These data underscore the potential value of developing camostat mesylate as a safe, orally bioavailable, affordable, and widely available therapeutic agent for COVID-19.Limitations of our study include insufficient power to detect anticipated differences in the primary endpoint; as this was a phase 2 clinical study, the number of participants was small. Our study results did not elucidate clinical improvement with camostat mesylate in mild and moderate COVID-19 patients. However, subgroup analysis of the high-risk group suggested clinical benefit. To further assess clinical efficacy of camostat mesylate, phase 3 clinical studies are needed.