Comparison of mucormycosis infection between patients with and without a history of COVID-19 infection: a retrospective cohort study.

BACKGROUND: Mucormycosis infection is a complication seen in some coronavirus disease 2019 (COVID-19) patients. This study compares the characteristics of mucormycosis infection between COVID-19 and non-COVID-19 patients. METHODS: This retrospective cohort comprised 87 patients with mucormycosis divided into two groups. The first included 44 patients who had COVID-19 recently before hospitalization due to mucormycosis at Namazi Hospital, Shiraz, Iran, between February 2019 and August 2021. The second group included all 43 patients hospitalized at the same hospital due to mucormycosis between 2010 and 2019 (pre-pandemic). RESULTS: Mucormycosis patients with a history of recent COVID-19 infection had a higher rate of diabetes mellitus, fewer malignancies and higher blood glucose, erythrocyte sedimentation rate and C-reactive protein levels (p<0.05). Glucocorticoid use was common (77%) in the COVID-19 group. CONCLUSIONS: In the pre-COVID-19 era, mucormycosis mainly affected immunodeficient patients like those receiving chemotherapy due to malignancy but now seems to affect COVID-19 patients with uncontrolled blood glucose and glucocorticoids use. Special care must be taken in prescribing glucocorticoids and controlling the blood glucose levels of COVID-19 patients.

Mortality-Related Risk Factors for Coronavirus Disease (COVID-19)-Associated Mucormycosis: a systematic review and meta-analysis.

Purpose of Review: Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) can increase the susceptibility of individuals to contracting mucormycosis through several mechanisms. Nowadays, coronavirus disease (COVID-19)-associated mucormycosis (CAM) is a serious public health concern, particularly in developing countries. This meta-analysis aims to identify the risk factors that affect the mortality rate of patients with CAM. Recent Findings: We systematically searched PubMed, Google Scholar, Scopus, Cochrane library, and preprint databases using pertinent keywords and the reference lists of the included relevant articles from inception till October 27, 2021. In order to reduce the effects of small-scale studies, we only selected cross-sectional, case-control, and cohort studies and case series with at least four patients. We identified 26 articles that included 821 patients with CAM. The effect size (ES) of mortality rate was 28% (95% confidence interval (CI) 20%-38%; I2 =82.28%; p for Cochran Q<0.001). The CAM patients with a history of comorbidities other than diabetes (malignancies, transplant, or renal failure), mechanical ventilation due to COVID-19, pulmonary and cerebral mucormycosis, and those who only received medical treatment for mucormycosis had the highest mortality rate. Summary: Coronavirus disease (COVID-19)-associated mucormycosis (CAM) is a major public health problem, particularly in developing countries. Severe COVID-19 infection, history of mechanical ventilation, early CAM, comorbidities other than diabetes (malignancies, transplant, or renal failure), pulmonary and rhino-orbito-cerebral mucormycosis, and delivering only medical treatment for mucormycosis were the worst prognostic factors in CAM patients. Identifying the mortality-related risk factors in CAM patients may help reduce the mortality rate by implementing optimized treatment approaches. Supplementary Information: The online version contains supplementary material available at 10.1007/s12281-022-00440-2.

Evaluation of the Costs and Outcomes of COVID-19 Therapeutic Regimens in Hospitalized Patients in Shiraz.

COVID-19 patients in critical conditions are hospitalized and treated with various protocols including antiviral drugs, which have been updated repeatedly. This study was aimed to analyze the demographics, costs, and outcomes of drug regimens in COVID-19 patients hospitalized in "Ali Asghar" hospital, affiliated with Shiraz University of Medical Sciences, from March 2019 to December 2020 as a retrospective study, approved by the ethics committee of Shiraz University of Medical Sciences (IR.SUMS.REC.1399.1003) on Dec. 28, 2020. Using hospital information system (HIS) data, 2174 patients receiving favipiravir, remdesivir, interferon-ß, and Kaletra® were analyzed. Descriptive, univariate, and regression analyses were used. The costs and consequences of different drug regimens were significantly different (P value < 0.05); the highest and lowest costs belonged to remdesivir and Kaletra®, respectively. The highest and lowest mean length of stay and mortality were related to remdesivir and favipiravir, respectively. Mortality did not differ significantly with various regimens. Length of stay was significantly shorter with favipiravir and Kaletra® than interferon-ß. Remdesivir had significantly the highest cost. Age presented a significantly positive relationship with mortality and length of stay. Besides, ICU admission significantly increased mortality, length of stay, and costs. Underlying diseases and low blood oxygen saturation contributed to mortality. COVID-19 correlation with age and underlying diseases is accordant with the published data. Given the highest costs and broad usage of remdesivir, besides controversies regarding its outcomes and side effects, a stricter evaluation of remdesivir benefits seems essential. Totally, COVID-19 therapeutic protocols should be selected carefully to optimize costs and outcomes.

Evaluation of the Costs and Outcomes of COVID-19 Therapeutic Regimens in Hospitalized Patients in Shiraz

COVID-19 patients in critical conditions are hospitalized and treated with various protocols including antiviral drugs, which have been updated repeatedly. This study was aimed to analyze the demographics, costs, and outcomes of drug regimens in COVID-19 patients hospitalized in “Ali Asghar” hospital, affiliated with Shiraz University of Medical Sciences, from March 2019 to December 2020 as a retrospective study, approved by the ethics committee of Shiraz University of Medical Sciences (IR.SUMS.REC.1399.1003) on Dec. 28, 2020. Using hospital information system (HIS) data, 2174 patients receiving favipiravir, remdesivir, interferon-β, and Kaletra® were analyzed. Descriptive, univariate, and regression analyses were used. The costs and consequences of different drug regimens were significantly different (P value < 0.05);the highest and lowest costs belonged to remdesivir and Kaletra®, respectively. The highest and lowest mean length of stay and mortality were related to remdesivir and favipiravir, respectively. Mortality did not differ significantly with various regimens. Length of stay was significantly shorter with favipiravir and Kaletra® than interferon-β. Remdesivir had significantly the highest cost. Age presented a significantly positive relationship with mortality and length of stay. Besides, ICU admission significantly increased mortality, length of stay, and costs. Underlying diseases and low blood oxygen saturation contributed to mortality. COVID-19 correlation with age and underlying diseases is accordant with the published data. Given the highest costs and broad usage of remdesivir, besides controversies regarding its outcomes and side effects, a stricter evaluation of remdesivir benefits seems essential. Totally, COVID-19 therapeutic protocols should be selected carefully to optimize costs and outcomes.

Mortality-Related Risk Factors for Coronavirus Disease (COVID-19)-Associated Mucormycosis: a systematic review and meta-analysis

Purpose of Review Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) can increase the susceptibility of individuals to contracting mucormycosis through several mechanisms. Nowadays, coronavirus disease (COVID-19)-associated mucormycosis (CAM) is a serious public health concern, particularly in developing countries. This meta-analysis aims to identify the risk factors that affect the mortality rate of patients with CAM. Recent Findings We systematically searched PubMed, Google Scholar, Scopus, Cochrane library, and preprint databases using pertinent keywords and the reference lists of the included relevant articles from inception till October 27, 2021. In order to reduce the effects of small-scale studies, we only selected cross-sectional, case–control, and cohort studies and case series with at least four patients. We identified 26 articles that included 821 patients with CAM. The effect size (ES) of mortality rate was 28% (95% confidence interval (CI) 20%–38%;I2 =82.28%;p for Cochran Q<0.001). The CAM patients with a history of comorbidities other than diabetes (malignancies, transplant, or renal failure), mechanical ventilation due to COVID-19, pulmonary and cerebral mucormycosis, and those who only received medical treatment for mucormycosis had the highest mortality rate. Summary Coronavirus disease (COVID-19)-associated mucormycosis (CAM) is a major public health problem, particularly in developing countries. Severe COVID-19 infection, history of mechanical ventilation, early CAM, comorbidities other than diabetes (malignancies, transplant, or renal failure), pulmonary and rhino-orbito-cerebral mucormycosis, and delivering only medical treatment for mucormycosis were the worst prognostic factors in CAM patients. Identifying the mortality-related risk factors in CAM patients may help reduce the mortality rate by implementing optimized treatment approaches. Supplementary Information The online version contains supplementary material available at 10.1007/s12281-022-00440-2.

Effectiveness of Coronavirus Disease 2019 Vaccines in Preventing Infection, Hospital Admission, and Death: A Historical Cohort Study Using Iranian Registration Data During Vaccination Program.

Background: There are some concerns about the effectiveness of the inactivated and vector-based vaccines against severe acute respiratory syndrome coronavirus 2 in real-world settings with the emergence of new mutations, especially variants of concern. Data derived from administrative repositories during mass vaccination campaigns or programs are of interest to study vaccine effectiveness. Methods: Using 4-repository administrative data linkage, we conducted a historical cohort study on a target population of 1 882 148 inhabitants aged at least 18 years residing in southern Iran. Results: We estimated a 71.9% [95% confidence interval [CI], 70.7%-73.1%], 81.5% [95% CI, 79.5%-83.4%], 67.5% [95% CI, 59.5%-75.6%], and 86.4% [95% CI, 84.1%-88.8%] hospital admission reduction for those who received the full vaccination schedule of BBIBP-CorV (Sinopharm), ChAdOx1-S/nCoV-19 vaccine (AZD1222, Oxford-AstraZeneca), rAd26-rAd5 (Gam-COVID-Vac, Sputnik V), and BIV1-CovIran (COVIran Barekat) vaccines, respectively. A high reduction in mortality (at least 85%) was observed in all age subgroups of the fully immunized population. Conclusions: The pragmatic implementation of a vaccination plan including all available vaccine options in the Iranian population was associated with a significant reduction in coronavirus disease 2019 (COVID-19) detected infections as well as hospital admissions and deaths associated with COVID-19.

Left ventricular thrombosis and endogenous endophthalmitis in the setting of COVID-19: A case report.

Aside from typical pneumonia, the coronavirus disease 2019 (COVID-19) has shown several extra-pulmonary manifestations. This study was done on a 66-year-old male patient who concomitantly had endogenous endophthalmitis and left ventricular thrombosis one month after being hospitalized due to COVID-19.

The role of educating health-care personnel in prevention, diagnosis, or treatment of COVID-19: A narrative mini review

Front-line clinicians and health-care workers need to be educated to provide care in critical situations such as large-scale catastrophes and pandemics. This narrative review is focused on investigating educational strategies in confrontation with coronavirus disease 2019 (COVID-19) pandemic. We conducted a literature search in December 2020 through LitCovid, PubMed, ERIC, and Cochrane Library in order to retrieve relevant studies regarding the role of education in prevention, diagnosis, and treatment of COVID-19. There were 12 reviewed studies related to this specific subject. The articles selected for this study demonstrated that education and training had a positive impact on the knowledge and attitude of the participants and also the educational interventions, whether they were simulation-based or other formats of training, would be deemed crucial for enhancing participants’ level of perceptions and confidence. Therefore, it is highly recommended that public health policymakers consider this important issue.

The role of educating health-care personnel in prevention, diagnosis, or treatment of COVID-19: A narrative mini review.

Front-line clinicians and health-care workers need to be educated to provide care in critical situations such as large-scale catastrophes and pandemics. This narrative review is focused on investigating educational strategies in confrontation with coronavirus disease 2019 (COVID-19) pandemic. We conducted a literature search in December 2020 through LitCovid, PubMed, ERIC, and Cochrane Library in order to retrieve relevant studies regarding the role of education in prevention, diagnosis, and treatment of COVID-19. There were 12 reviewed studies related to this specific subject. The articles selected for this study demonstrated that education and training had a positive impact on the knowledge and attitude of the participants and also the educational interventions, whether they were simulation-based or other formats of training, would be deemed crucial for enhancing participants' level of perceptions and confidence. Therefore, it is highly recommended that public health policymakers consider this important issue.

Predictive determinants of overall survival among re-infected COVID-19 patients using the elastic-net regularized Cox proportional hazards model: a machine-learning algorithm.

BACKGROUND: Narrowing a large set of features to a smaller one can improve our understanding of the main risk factors for in-hospital mortality in patients with COVID-19. This study aimed to derive a parsimonious model for predicting overall survival (OS) among re-infected COVID-19 patients using machine-learning algorithms. METHODS: The retrospective data of 283 re-infected COVID-19 patients admitted to twenty-six medical centers (affiliated with Shiraz University of Medical Sciences) from 10 June to 26 December 2020 were reviewed and analyzed. An elastic-net regularized Cox proportional hazards (PH) regression and model approximation via backward elimination were utilized to optimize a predictive model of time to in-hospital death. The model was further reduced to its core features to maximize simplicity and generalizability. RESULTS: The empirical in-hospital mortality rate among the re-infected COVID-19 patients was 9.5%. In addition, the mortality rate among the intubated patients was 83.5%. Using the Kaplan-Meier approach, the OS (95% CI) rates for days 7, 14, and 21 were 87.5% (81.6-91.6%), 78.3% (65.0-87.0%), and 52.2% (20.3-76.7%), respectively. The elastic-net Cox PH regression retained 8 out of 35 candidate features of death. Transfer by Emergency Medical Services (EMS) (HR=3.90, 95% CI: 1.63-9.48), SpO2≤85% (HR=8.10, 95% CI: 2.97-22.00), increased serum creatinine (HR=1.85, 95% CI: 1.48-2.30), and increased white blood cells (WBC) count (HR=1.10, 95% CI: 1.03-1.15) were associated with higher in-hospital mortality rates in the re-infected COVID-19 patients. CONCLUSION: The results of the machine-learning analysis demonstrated that transfer by EMS, profound hypoxemia (SpO2≤85%), increased serum creatinine (more than 1.6 mg/dL), and increased WBC count (more than 8.5 (×109 cells/L)) reduced the OS of the re-infected COVID-19 patients. We recommend that future machine-learning studies should further investigate these relationships and the associated factors in these patients for a better prediction of OS.

Development of a recombinant nucleocapsid protein-based ELISA for the detection of IgM and IgG antibodies to SARS-CoV-2.

Coronavirus 2019 (COVID-19) is a global concern for public health. Thus, early and accurate diagnosis is a critical step in management of this infectious disease. Currently, RT-PCR is routine diagnosis test for COVID-19, but it has some limitations and false negative results. enzyme-linked immunosorbent assay (ELISA) against SARS-CoV-2 antigens seems to be an appropriate approach for serodiagnosis of COVID-19. In the current study, an ELISA system, using a recombinant nucleocapsid (N) protein, was developed for the detection of IgM and IgG antibodies to SARS-CoV-2. The related protein was expressed, purified, and used in an ELISA system. Sera samples (67) for COVID-19 patients, as well as sera samples from healthy volunteers (112), along with sera samples from non-COVID-19 patients were examined by the ELISA system. The expression and purity of the recombinant N protein were approved by SDS-PAGE and Western blotting. The sensitivity of ELISA system was 91.04 and 92.53% for the detection of IgG and IgM antibodies, respectively. Moreover, the specificity of the developed ELISA system for IgG and IgM were 98.21 and 97.32%, respectively. Our developed ELISA system showed satisfactory sensitivity and specificity for the detection of antiSARS-CoV-2 IgM and IgG antibodies and could be used as a complementary approach for proper diagnosis of COVID-19.

Graphene‐Based Femtogram‐Level Sensitive Molecularly Imprinted Polymer of SARS‐CoV‐2

Rapid distribution of viral‐induced diseases and weaknesses of common diagnostic platforms for accurate and sensitive identification of infected people raises an urgent demand for the design and fabrication of biosensors capable of early detection of viral biomarkers with high specificity. Accordingly, molecularly imprinted polymers (MIPs) as artificial antibodies prove to be an ideal preliminary detection platform for specific identification of target templates, with superior sensitivity and detection limit (DL). MIPs detect the target template with the “lock and key” mechanism, the same as natural monoclonal antibodies, and present ideal stability at ambient temperature, which improves their practicality for real applications. Herein, a 2D MIP platform consisting of decorated graphene oxide with the interconnected complex of polypyrrole‐boronic acid is developed that can detect the trace of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) antigen in aquatic biological samples with ultrahigh sensitivity/specificity with DL of 0.326 and 11.32 fg mL–1 using voltammetric and amperometric assays, respectively. Additionally, the developed MIP shows remarkable stability, selectivity, and accuracy toward detecting the target template, which paves the way for developing ultraspecific and prompt screening diagnostic configurations capable of detecting the antigen in 1 min or 20 s using voltammetric or amperometric techniques. A molecularly imprinted polymer as an artificial monoclonal IgG antibody is developed for prompt, accurate, sensitive, and specific detection of betacoronaviruses, i.e., severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), in various biological and non‐biological media. The as‐developed configuration shows femtogram‐level detection limit and only reacts with its imprinted template via “lock and key” mechanism the same as a natural monoclonal antibody.

Antibody mounting capability of 1D/2D carbonaceous nanomaterials toward rapid-specific detection of SARS-CoV-2.

Carbonaceous immunosensors are ideal nanoplatforms for developing rapid, precise, and ultra-specific diagnostic kits capable of early detection of viral infectious illnesses such as COVID-19. However, developing a proper carbonic immunosensor requires stepwise protocols to find optimum operating conditions to minimize drawbacks. Herein, for the first time and through a stepwise protocol, activation, and monoclonal IgG antibody mounting capability of multi-walled carbon nanotubes (MWCNTs) at two diverse outer diameters (ODs), viz., 20-30 nm and 50-80 nm, and graphene deriv atives (graphene oxide (GO) and reduced graphene oxide (rGO)) were examined and compared with each other toward finding the prime carbonaceous nanomaterial(s) for maximized antibody loading efficiency along with an ideal detection limit (DL) and sensitivity. Next, the effect of common amplifying agents, i.e., Au nanostars (Au NSs) and Ag nanowires (Ag NWs), on the total performance of the best carbonaceous structure was carefully assessed, and the responsible detection mechanism is investigated in detail. Next, the developed carbonaceous immunosensors were assessed via voltammetric and impedance assays, and their performances toward specific detection of SARS-CoV-2 antigen through immunoreaction were examined in detail. The study's outcome showed the superior performance of conjugated rGO-based immunosensor with Au NSs toward specific and quick (1 min) detection of SARS-CoV-2 antigen in biological fluids compared with other 1D/2D carbonaceous nanomaterials.

Medical education and COVID-19 pandemic: a crisis management model towards an evolutionary pathway.

The COVID-19 crisis has had a profound effect on higher education, especially medical education due to its sensitive nature, dealing with people's life and wellbeing. This study presented a crisis management model of how to direct medical education during crises. A qualitative design was used via a focus group among 83 medical education administrators at Shiraz University of Medical Sciences. Four major challenges emerged regarding medical education during the COVID-19 pandemic including "The health and wellbeing of faculty members and students"; "Spatial constraints"; "Time constraints", and "Access to resources". A total of 13 strategies were suggested to tackle the challenges, including virtualization, technological support, empowerment, participation, sharing, helping, integration, compression, omission, flexibility and diversity, severance, protection; and monitoring. For a sustainable educational pathway in medical education, personalized approach to education via the incorporation of technology is essential. This provides opportunities to tackle the issues caused by the crisis, by provision of any time and anywhere approach to education via flexible technologies/platforms adjusted based on the audiences. The scope of crisis management expands not only on individual and academic levels but also on social and global relations.

The interactions of folate with the enzyme furin: a computational study.

Entrance of coronavirus into cells happens through the spike proteins on the virus surface, for which the spike protein should be cleaved into S1 and S2 domains. This cleavage is mediated by furin, a member of the proprotein convertases family, which can specifically cleave Arg-X-X-Arg↓ sites of the substrates. Here, folate (folic acid), a water-soluble B vitamin, is introduced for the inhibition of furin activity. Therefore, molecular insight into the prevention of furin activity in the presence of folic acid derivatives is presented. To this aim, molecular docking, molecular dynamics (MD) simulations, and binding free energy calculations were performed to clarify the inhibitory mechanism of these compounds. In this regard, molecular docking studies were conducted to probe the furin binding sites of folic acid derivatives. The MD simulation results indicated that these drugs can efficiently bind to the furin active site. While the folic acid molecule tended to be positioned slightly towards the Glu271, Tyr313, Ala532, Gln488, and Asp530 amino acids of furin at short and long ranges, the folinic acid molecule interacted with Glu271, Ser311, Arg490, Gln488, and Lys499 amino acids. Consequently, binding free energy calculations illustrated that folic acid (-27.90 kcal mol-1) has better binding in comparison with folinic acid (-12.84 kcal mol-1).

Ultrasensitive Biomolecule‐Less Nanosensor Based on β‐Cyclodextrin/Quinoline Decorated Graphene Oxide toward Prompt and Differentiable Detection of Corona and Influenza Viruses

Rapid mutation of airborne pathogenic viruses, e.g., SARS‐CoV‐2, and their similar symptoms with flu or influenza, raises an urgent demand for the development of biomolecule‐less nanosensors capable of rapid, sensitive, specific, and differentiable detection of viruses in a single potential window to distinguish infected people from healthy ones through a precise and prompt manner that do not require highly purified biological receptors. To address this vital requirement, a label‐free, and biomolecule‐less nanosensor is designed and developed based on the modified graphene oxide (GO) with NHS/EDC activated β‐cyclodextrin/8 hydroxyquinoline (8HQ) complex toward rapid (in 1 min) and differentiable detection of betacoronaviruses (viz., SARS‐CoV‐2) and influenza viruses (viz., H1N1 and H3N2) in a single potential window. The outcome of the process shows that the employed process leads to considerable soar in the electrical conductivity, porosity, active surface area, available active sites for trapping viruses, and sensitivity of the nanosensor that leads to rapid, sensitive, specific, and simultaneous detection of selected pathogenic viruses with a superiorly low detection limit (DL) and high sensitivity. Obtained results highlight the potential of the developed nanoplatform as a capable screening tool for quick detection of infected people. [ABSTRACT FROM AUTHOR] Copyright of Advanced Materials Technologies is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ultra-precise label-free nanosensor based on integrated graphene with Au nanostars toward direct detection of IgG antibodies of SARS-CoV-2 in blood.

Rapid distribution of airborne contagious pathogenic viruses such as SRAS-CoV-2 and their severely adverse impacts on different aspects of the human society, along with significant weaknesses of traditional diagnostic platforms, raised the global requirement for the design/fabrication of precise, sensitive, and rapid nanosystems capable of specific detection of viral illnesses with almost negligible false-negative results. To address this indispensable requirement, we have developed an ultra-precise fast diagnostic platform capable of detecting the trace of monoclonal IgG antibody against S1 protein of SARS-CoV-2 within infected patients' blood specimens with COVID-19 in about 1 min. The as-developed electrochemical-based nanosensor consists of a highly activated graphene-based platform in conjunction with Au nanostars, which can detect SARS-CoV-2 antibodies with a fantastic detection limit (DL) and sensitivity of 0.18 × 10-19%V/V and 2.14 µA.%V/V.cm-2, respectively, in human blood plasma specimens even upon the presence of a high amount of interfering compound/antibodies. The nanosensor also exhibited remarkable sensitivity/specificity compared with the gold standard (i.e., ELISA assay), which furtherly confirmed its superb performance.

Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial.

BACKGROUND: Although almost a year has passed since the Coronavirus disease 2019 (COVID-19) outbreak and promising reports of vaccines have been presented, we still have a long way until these measures are available for all. Furthermore, the most appropriate corticosteroid and dose in the treatment of COVID-19 have remained uncertain. We conducted a study to assess the effectiveness of methylprednisolone treatment versus dexamethasone for hospitalized COVID-19 patients. METHODS: In this prospective triple-blinded randomized controlled trial, we enrolled 86 hospitalized COVID-19 patients from August to November 2020, in Shiraz, Iran. The patients were randomly allocated into two groups to receive either methylprednisolone (2 mg/kg/day; intervention group) or dexamethasone (6 mg/day; control group). Data were assessed based on a 9-point WHO ordinal scale extending from uninfected (point 0) to death (point 8). RESULTS: There were no significant differences between the groups on admission. However, the intervention group demonstrated significantly better clinical status compared to the control group at day 5 (4.02 vs. 5.21, p = 0.002) and day 10 (2.90 vs. 4.71, p = 0.001) of admission. There was also a significant difference in the overall mean score between the intervention group and the control group, (3.909 vs. 4.873 respectively, p = 0.004). The mean length of hospital stay was 7.43 ± 3.64 and 10.52 ± 5.47 days in the intervention and control groups, respectively (p = 0.015). The need for a ventilator was significantly lower in the intervention group than in the control group (18.2% vs 38.1% p = 0.040). CONCLUSION: In hospitalized hypoxic COVID-19 patients, methylprednisolone demonstrated better results compared to dexamethasone. TRIAL REGISTRATION: The trial was registered with IRCT.IR (08/04/2020-No. IRCT20200204046369N1 ).