ABSTRACT
RAAS could play a substantial role in the pathophysiology of COVID-19. Also, the dynamics of the HPA axis may have changed in COVID-19. So, we aimed to assess RAAS and the HPA axis in COVID-19 suspicious outpatients referred to 16-hour comprehensive health centers in Abadan. Demographic and clinical data were collected. Serum cortisol and aldosterone measurements and blood grouping were done. Clinical symptoms of the positive PCR group were followed up on for four weeks. SPO2 was significantly lower in the positive PCR group, but the respiratory rate was significantly higher (P= 0.03 and P=0.001, respectively). Outpatients with the O blood group showed higher levels of cortisol in comparison to those with A and AB blood groups (P= 0.003 and P= 0.03 respectively) in the positive PCR group. Negative PCR individuals with the AB blood type had significantly higher levels of cortisol compared with those who had A (P= 0.02) and O (P=0.03) blood types. We saw significantly higher levels of aldosterone in males of the negative PCR group in comparison with females (P= 0.05). Cortisol (OR= 0.937, P= 0.033) and aldosterone (OR= 1.005, P= 0.020) levels had a decreasing and increasing effect on the chances of respiratory symptoms occurring over time, respectively. Also, over time, women were twice as likely as men to develop neurologic symptoms (OR= 0.530, P= 0.015). Cortisol and aldosterone are associated with the chance of respiratory symptoms occurring over time. However, the levels of these two markers do not seem to be related to the lower grades of COVID-19.
Subject(s)
COVID-19 , Neuroendocrine TumorsABSTRACT
Background: The combination of sofosbuvir (SOF) and daclatasvir (DCV) has shown preliminary efficacy for patients with COVID-19 in five open-label studies with small sample sizes. This larger trial aimed to assess if the addition of sofosbuvir and daclatasvir to standard care improved clinical endpoints in hospitalized patients with moderate or severe COVID-19. Methods: This was a placebo-controlled, randomized clinical trial in adults with moderate or severe COVID-19 admitted to 19 hospitals in Iran. Patients were randomized to SOF/DCV 400/60mg once-daily or placebo in addition to standard of care. Patients were included if they had positive PCR or diagnostic chest CT, O 2 saturation <95%, and compatible symptoms. The primary endpoint was discharge from hospital within 10 days of first treatment. The trial is registered on Iran Registry of Clinical Trials under IRCT20200624047908N1 available at https://www.irct.ir/trial/49198.Results: Between July and October 2020, 1083 patients were allocated to either the SOF/DCV treatment arm (n=541) or matching placebo (n=542). The primary endpoint was achieved by 358 / 541 (66%) in the SOF/DCV arm and 370 /542 (68%) in controls (relative risk = 0.97, 95% CI = 0.89-1.05). The in-hospital death rates were 58/541 (11%) in the SOF/DCV group versus 53/542 (10%) in the placebo group (relative risk = 1.1, 95% CI = 0.77 to 1.56). Conclusions: We observed no significant effect of SOF/DCV versus placebo on the rate of hospital discharge or survival in hospitalized COVID-19 patients. However, the patient population was generally severe cases that may have been too advanced for antiviral drugs to be effective. Trial Registration: Iran Registry of Clinical Trials under IRCT20200624047908N1 available at https://www.irct.ir/trial/49198.Funding: This trial was sponsored by Abadan University of Medical Sciences and funded by the International Treatment Preparedness Coalition (grant number ITPC-2020)Declaration of Interests: S.Merat has received travel grants from and is a stockholder of Fanavaran Rojan Mohaghegh Daru Co. ANB and HNB are stockholders of Fanavaran Rojan Mohaghegh Daru Co. All other authors: none to declare.Ethics Approval Statement: The study protocol has been approved by the Abadan Faculty of Medicine Sciences Institutional Review Board and the Iranian Registry of Clinical Trials (IRCT) registry team.
Subject(s)
COVID-19ABSTRACT
The pandemic of severe acute respiratory syndrome virus 2 (SARS-CoV-2) is a serious threat to global health. Since tuberculosis-COVID-19 co-infection is a great risk for tuberculosis patients. This is the first report from Iran. Rapid screening of respiratory infections caused by COVID-19, isolation, and treatment of tuberculosis patients is vital.