Purpose: This study was conducted to assimilate evidence on the efficacy of 2-deoxy-glucose (2-DG), a glucose analog, in the treatment of moderate to severe COVID-19 patients in a hospital setting.

Patients and Methods: Medical records of adult patients with moderate to severe illness, admitted to intensive care units (ICU) of a multispecialty hospital were retrospectively analyzed. The inclusion criteria comprised of laboratory diagnosis of COVID-19 and the completeness of records. 2-DG was administered to patients on day-1 of receiving oxygen support in ICU. Details obtained from the medical record included demographics, laboratory investigations, clinical outcomes, and survival.

Results: Records of 29 patients, with an average age of 51.3 ± 11.7 years were included in the study. Males constituted 82.8% of the patient population. Co-morbidities (hypertension and diabetes) were present in 35.5 % of patients. Standard biological markers for COVID-19 were elevated on the day of admission for all the patients. Following the 2-DG intervention, oxygen saturation levels improved to > 93 % in > 70 % of the patients within 7 days of intervention. The average length of the hospital stays and average time to viral clearance was 21.2 days and 11.8 days respectively. Improvement on the World Health Organization (WHO) defined ordinal scale was observed in 37.9 % of the patients (movement from category 5 and 6 to category 4, i.e., from moderate/severe to mild illness) post-intervention. Mortality was observed to be 20.7% in this study. No 2-DG related side effects were observed.

Conclusion: This is the first retrospective case series examining the efficacy of 2-DG in COVID-19 management in real-world settings. In this case series, 2-DG was found to be effective in reducing oxygen requirement and time to viral clearance in moderate to severely ill COVID- 19 patients as reflected in improvement on the WHO ordinal scale.