ABSTRACT
Here, we report six cases of spontaneous pneumothorax and pneumomediastinitis in patients with COVID‐19 in Iran, which were treated with different drugs such as hydroxychloroquine, sofosbuvir, atazanavir, and remdesivir as antiviral agents. Despite the differences in the type of drugs, pneumothorax occurred in all patients. Chest CT can provide useful information in patients with COVID‐19‐associated pneumonia. Pneumothorax and pneumomediastinum may develop in COVID‐19‐associated pneumonia due to alveolar damage. Pneumothorax and pneumomediastinum may be the first symptom of COVID‐19 or a late complication. Pneumothorax and pneumomediastinum may appear in the patients with different antiviral therapy.
ABSTRACT
Here, we report six cases of spontaneous pneumothorax and pneumomediastinitis in patients with COVID-19 in Iran, which were treated with different drugs such as hydroxychloroquine, sofosbuvir, atazanavir, and remdesivir as antiviral agents. Despite the differences in the type of drugs, pneumothorax occurred in all patients.
ABSTRACT
The purpose of this study was to compare the effectiveness of Atazanavir/Ritonavir/Dolutegravir/Hydroxychloroquine and Lopinavir/Ritonavir/Hydroxychloroquine treatment regimens in COVID-19 patients based on clinical and laboratory parameters. We prospectively evaluated the clinical and laboratory outcomes of 62 moderate to severe COVID-19 patients during a 10-day treatment plan. Patients were randomly assigned to either KH (receiving Lopinavir/Ritonavir [Kaletra] plus Hydroxychloroquine) or ADH (receiving Atazanavir/Ritonavir, Dolutegravir, and Hydroxychloroquine) groups. During this period, clinical and laboratory parameters and outcomes such as intensive care unit (ICU) admission or mortality rate were recorded. Compared to the KH group, after the treatment period, patients in the ADH group had higher activated partial thromboplastin time (aPTT) (12, [95% confidence interval [CI]: 6.97, 17.06), p = <0.01), international normalized ratio (INR) (0.17, [95% CI: 0.07, 0.27), p = <0.01) and lower C-reactive protein (CRP) (-14.29, (95% CI: -26.87, -1.71), p = 0.03) and potassium (-0.53, (95% CI: -1.03, -0.03), p = 0.04) values. Moreover, a higher number of patients in the KH group needed invasive ventilation (6 (20%) vs. 1 (3.1%), p = 0.05) and antibiotic administration (27 (90%) vs. 21(65.6), p = 0.02) during hospitalization while patients in the ADH group needed more corticosteroid administration (9 (28.1%) vs. 2 (6.7%), p = 0.03). There was no difference in mortality rate, ICU admission rate, and hospitalization period between the study groups. Our results suggest that the Atazanavir/Dolutegravir treatment regimen may result in a less severe disease course compared to the Lopinavir/Ritonavir treatment regimen and can be considered as an alternative treatment option beside standard care. However, to confirm our results, larger-scale studies are recommended.