Background
The combination of sofosbuvir and daclatasvir has shown preliminary efficacy for hospitalized patients with COVID-19 in four open-label studies with small sample sizes. This larger trial aimed to assess if the addition of sofosbuvir/daclatasvir to standard care improved clinical outcomes in hospitalized patients with COVID-19.
Methods
This was a placebo-controlled, double-blind, randomized clinical trial in adults hospitalized with COVID-19 at 19 hospitals in Iran. Patients were randomized to oral sofosbuvir/daclatasvir 400/60 mg once-daily or placebo in addition to standard of care. Patients were included if they had positive PCR or diagnostic chest CT, O2 saturation <95% and compatible symptoms. The primary outcome was hospital discharge within 10 days of randomization. Secondary outcomes included mortality and time to clinical events. The trial is registered on the Iran Registry of Clinical Trials under IRCT20200624047908N1.
Results
Between July and October 2020, 1083 patients were randomized to either the sofosbuvir/daclatasvir arm (n = 541) or the placebo arm (n = 542). No significant difference was observed in the primary outcome of hospital discharge within 10 days, which was achieved by 415/541 (77%) in the sofosbuvir/daclatasvir arm and 411/542 (76%) in the placebo arm [risk ratio (RR) 1.01, 95% CI 0.95–1.08, P = 0.734]. In-hospital mortality was 60/541 (11%) in the sofosbuvir/daclatasvir arm versus 55/542 (10%) in the placebo arm (RR 1.09, 95% CI 0.77–1.54, P = 0.615). No differences were observed in time to hospital discharge or time to in-hospital mortality.
Conclusions
We observed no significant effect of sofosbuvir/daclatasvir versus placebo on hospital discharge or survival in hospitalized COVID-19 patients.
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The purpose of this study was to investigate injuries resulting from accidents and incidents referred to medical centers and hospitals of Shahid Beheshti University of Medical Sciences. Materials and Methods: This study is a cross-sectional study. The data of all injured patients admitted to hospitals of Shahid Beheshti University of Medical Sciences from March 2014 to March 2015 were reviewed. Accidents and injuries were categorized according to the tenth version of international classification of diseases. Data collected by means of forms and software injury register by Hospital emergency department staff to interview and hospital records, were completed. Results: In total, 131967 cases were reviewed,in which 66% were male and 34 % were female. Traumas, traffic accidents, and falls were major causes of accidents and injuries. Accidents and injuries were more prevalent in 20-29 years old (the younger age groups; 51%). Individuals living in urban areas sustained more injuries compared to individuals from rural areas. A total of 194 deaths were reported due to accidents and injuries. Conclusion: Our findings indicated that traffic accidents constitute a large proportion of accident and injuries. Productive groups (young male) were the most victims of accidents and injuries. Training of different groups, including before and during recruitment, training mothers, and elderly seems to be beneficial. Further studies to improve the registration tools for a better access to reliable data are needed. Promotion knowledge and training, especially in the younger age group, intervention to resolve the accident prone spots as well as technical defects are recommended to reduce the traffic accidents.
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