Background: Severe coronavirus disease 2019 (COVID-19) may lead to the cytokine storm syndrome which may cause acute respiratory failure syndrome and death. Our aim was to investigate the therapeutic effects of infliximab, intravenous gammaglobulin (IVIg) or combination therapy in patients with severe COVID-19 disease admitted to the intensive care unit (ICU). Methods: In this observational research, we studied 104 intubated adult patients with severe COVID-19 infection (based on clinical symptoms, and radiographic or CT scan parameters) who were admitted to the ICU of a multispecialty hospital during March 2020 in Tehran, Iran. All cases received standard treatment regimens as local protocol (Oseltamivir + hydroxychloroquine + lopinavir/ritonavir or sofosbuvir or atazanavir ± ribavirin). The cases were grouped as controls (n = 43), infliximab (n = 27), IVIg (n = 23) and combination (n = 11). Results: There was no significant difference between controls and treatment groups in terms of underlying diseases or the number of underlying diseases. The mean age (SD) of cases was 72.42 (16.06) in the control group, 64.52 (12.965) in IVIg, 63.40 (17.57) in infliximab and 64.00 (11.679) in combination therapy; (P = 0.047, 0.031 and 0.11, respectively). Also, 37% in the infliximab group, 26.1% in IVIg, 45.5% in combination therapy, and 62.8% in the control group expired (all P < 0.05). Hazard ratios were 0.31 in IVIg (95% CI: 0.12-0.76, P = 0.01), 0.30 in infliximab (95% CI: 0.13-0.67, P = 0.004), 0.39 in combination therapy (95% CI: 0.12-1.09, P = 0.071). Conclusion: According to the findings of this study, it seems that infliximab and IVIg, alone or together, in patients with severe COVID-19 disease can be considered an effective treatment.
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and treatment are significant health organizations' concerns worldwide. Although there is no proven drug license against the virus, a variety of components have under investigation. In this regard, the present study was intended to evaluate the consequences of Sovodak (Sofosbuvir/Daclatasvir) treatment in COVID-19 patients compared with Kaletra (Lopinavir/ritonavir). Methods: This study was conducted as a randomized trial using 120 COVID19 confirmed cases between August 19th and September 19th, 2020, in which subjects were classified into two treatment groups, 58 (Sovodak group) and 54 (Kaletra group). Related statistical operations calculated significant outcomes such as survival rate and hazard ratio via SPSS v.16. Sovodak was composed of Sofosbuvir 400mg and Daclatasvir 60mg, and Kaletra included Lopinavir 400 mg and ritonavir 100 mg. Results: We observed that there was no significant difference concerning the comorbidities, death, ICU admission, remission. Besides, Kaletra had a higher rate of discharge versus Sovodak (HR=1.551 (95% CI=1.008-2.386), P-value=0.046), and a better outcome was observed in patients receiving Conclusion: Sovodak compared to Kaletra by Hazard plot. Sovodak (Sofosbuvir/Daclatasvir) therapy in COVID19 cases was accompanied by a significantly higher survival rate and better outcome than Kaletra (Lopinavir/ritonavir).
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