Comparison the Effect of Arbidol Plus Hydroxychloroquine vs Hydroxychloroquine Alone in Treatment of COVID-19 Disease: A Randomized Clinical Trial

Abstract

Background and aim: The main challenging issue about coronavirus disease 2019 (COVID-19) is the production of safe and stable vaccines, which is a very long process. Due to the emergency situation, regular and extensive screening of available and traditional drugs, which are commonly used for the treatment of similar viral diseases, can be a reasonable option. The present study aimed to compare the administration of hydroxychloroquine (HCQ) plus arbidol to the use of HCQ alone in the treatment of COVID-19 infection. Methods and Materials: This single-blind randomized controlled trial was carried out on a total of 100 patients with COVID-19 referring to the infection ward of Imam Reza Hospital in Mashhad, Iran, in 2020. The patients were randomly assigned to two HCQ alone and HCQ plus arbidol groups. Results: According to the obtained results, hematological parameters, including white blood cell count, hemoglobin level, lymphocyte count, and platelet count, improved in patients with COVID-19 after the treatment with both HCQ plus arbidol and HCQ alone (P<0.005). The mean values of the reduction time of C-reactive protein (CRP) were4.48±1.24 and 8.22±2.08 days in the arbidol and HCQ alone groups, respectively, indicating that CRP decreased faster in the arbidol group than that reported for the HCQ alone group (Z=0.-7.85; P<0.000).The mean scores of hospital stay were reported as 5.89±2.04 and 9.35±3.72 days in the arbidol and HCQ alone groups, respectively (Z=-4.31; P<0.005). All the patients in the arbidol group survived; while 6% of the subjects in the HCQ alone group died. In addition, the drug regimen was not changed for any patient, and no subject was transferred to the intensive care unit in the arbidol group. Conclusion: In summary, the administration of both arbidol and HCQ leads to the improvement of the hematological parameters. The present study introduced arbidol as an effective treatment for moderate to severe patients with COVID-19, which not only reduced the time of CRP normalization level but also decreased the hospitalization duration and mortality compared to those reported for HCQ.

Antivirals and the Potential Benefits of Orally Inhaled Drug Administration in COVID-19 Treatment

“…The study introduced Umifenovir as an effective treatment for moderate to severe patients, showing not only a reduced time of CRP (C-reactive protein) normalization, but also a decreased hospitalization stay and mortality compared with those reported for Hydroxychloroquine. 31 Conversely, another study has shown that additional Umifenovir was not effective in decreasing the duration of SARS-CoV-2 in severe patients and improving the prognosis in non-intensive care unit (non-ICU) patients and mortality. 32 A recent retrospective study concluded that Umifenovir did not provide a significant improvement in the treatment of COVID-19 for non-ICU patients and that randomized clinical trials should be performed.…”

COVID-19: Failure of the DisCoVeRy Clinical Trial, and Now–New Hopes?

“…Following molecular dynamics simulations, umifenovir targets the virus by exhibiting a higher affinity than the angiotensin-converting enzyme 2 for the receptor-binding domain of the spike protein [ 72 , 73 ]. Because the drug is not approved by the FDA and is of limited access worldwide, the substance is poorly involved in large clinical trials and some contradictory results, obtained on small cohorts, have been reported [ 74 , 75 , 76 ].…”

Comparison of Six Scoring Systems for Predicting In-hospital Mortality among Patients with SARS-COV2 Presenting to the Emergency Department

“…The COVID-19 pandemic has led to an unprecedented volume of hospital visits and admissions, including those with suspected COVID-19, resulting in elevated levels of overcrowding in hospitals and healthcare centers. 1 , 10 , 11 This circumstance has contributed to a delay in care and poorer outcomes, such as increased morbidity and mortality, especially in emergency departments (EDs) where resources are limited. 3 , 12 , 13 Critically ill patients are particularly vulnerable to encountering these adverse events.…”

“…We performed the study on a cohort of patients from Iran, a country with a high number of confirmed COVID-19 cases and related deaths. 3 , 6 , 11 , 13 , 30 …”