Introduction: In the coronavirus disease 2019 (COVID-19) era, kidney transplantation recipients (KTRs) are at high risk due to using immunosuppressive drugs. Considering the lack of definitive cure for COVID-19, repurposing existing pharmaceuticals is a way to find an immediate medication. Objectives: This study aimed to evaluate the COVID-19 outcomes in KTRs, receiving combination of sofosbuvir and daclatasvir (SOF-DAC) treatment. Patients and Methods: This research was an observational study of 12 adult kidney transplant recipients with COVID-19, admitted to Shariati hospital, Tehran, Iran (October to December 2020). All the patients received a once-daily combination pill of SOF-DAC at a dose of 400/60 mg for 10 days. Results: Around October to December 2020, 12 adult KTR patients were recruited; four patients (33.3%) died and eight patients survived (66.7%). Acute kidney injury (AKI) secondary to COVID-19 was seen in 11 patients of the study population (91.7%), including four dead cases. Two of the three patients who underwent dialysis due to kidney complications, died. The laboratory results showed that the mean level of each parameter white blood cells (WBC), international normalized ratio (INR), C-reactive protein (CRP), ferritin, D-dimer on the last day of hospital stay was significantly different between two groups of survived and dead patients at a 95% confidence level (P<0.05). Conclusion: Sofosbuvir combined with DAC for treatment of KTRs with COVID-19 infection reduced the mortality rate. Further, this medication was safe. Patients tolerated it well, and no serious adverse effects were observed. Larger studies are needed to validate these results.
Background: The world is still witnessing a largely ongoing spread of coronavirus disease 2019 (COVID-19); therefore, the scientific findings in this area need to be shared promptly. Objectives: This study aimed to assess the usefulness of Atorvastatin treatment in reducing COVID-19 mortality in patients with or without diabetes mellitus (DM) and to correlate them with C-reactive protein (CRP) levels. Methods: This study consecutively enrolled patients with pneumonia symptoms, positive lung CT scan, and confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on reverse transcription-polymerase chain reaction (RT-PCR). The outcome was defined as intensive care unit (ICU) admission and death. Clinical data and history of atorvastatin administration were evaluated. CRP levels were measured at baseline and repeated after one week in all patients. Results: A total of 200 patients were included. Their mean age was 60.5 (SD=16.5) years, 113 (56.5%) patients were male, 47 (23.5%) with pre-existing diabetes, and 64 (32%) patients were taking atorvastatin routinely. 68 (34%) required ICU admission of all the studied patients. No gender differences were found in ICU admission and death. The baseline CRP was not significantly different, but the secondary CRP was significantly different between DM and non-DM groups. Secondary CRP also showed a significant reduction in patients receiving atorvastatin (P=0.017). The mortality was the same in atorvastatin or non-atorvastatin groups (P=0.715). Conclusion: It seems that taking statin has only some beneficial effects on improving CRP levels in patients with COVID-19. To achieve a reliable result, clinical trials are recommended.
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