Assessment of methemoglobin, hemoglobin, ferritin and lactate dehydrogenase in COVID-19 patients

Today world is trying to cope with the biggest pandemic caused by Coronavirus disease 2019 (COVID-19). The disease is graded as mild, moderate, serious and critical illness. Very few studies are done with methemoglobin along with other parameters for the assessment of the severity of COVID-19 disease. The objectives of the study were to estimate methemoglobin (Met-Hb), hemoglobin (Hb), ferritin and lactate dehydrogenase (LDH) levels in patients with COVID-19 disease and to investigate the interaction between these parameters and the severity of the disease. This observational study was conducted in three groups of COVID-19 patients- moderate, severe and critical, each group containing 30 patients, between June 2021 and September 2021 in the biochemistry department of a tertiary care hospital. For all patients, Met-Hb, Hb, ferritin, and LDH levels were estimated on the 2nd-3rd day of hospital admission. Patients in the critical group were older and had significantly high values of Met-Hb, ferritin and LDH and significantly low values of Hb (P<0.05). In multivariate ordinal regression analysis, older age (OR-3.08;95%CI:1.19-7.19;P-0.019), higher values of LDH (OR-8.66;95%CI:2.53-29.5;P-0.001) and ferritin (OR-3.08;95%CI:1.09-8.7;P-0.033) were independently associated with severity of the disease. A cut-off value of 410.50 U/L for LDH predicted the severity of the disease with 90% sensitivity and 88.3% specificity. In conclusion, higher levels of LDH and ferritin were related to the severity of the disease in COVID-19 cases. Although Met-Hb showed a minimal increase without any association with severity, it may be an underlying cause of hypoxia that may go unnoticed. So, monitoring of all these parameters should be done at intervals.

Serum NT-proBNP levels in predicting severity of COVID19 infection

Background: Patients with COVID commonly have mild symptoms or even be asymptomatic, a notable proportion of patients may develop severe pneumonia, acute respiratory distress syndrome, multiorgan failure and, death. NT-proBNP reflects haemodynamic stress and has proven useful for risk stratification in heart failure (HF) and other conditions such as pulmonary embolism and pneumonia. NT-proBNP is an important biomarker for the diagnosis and estimation of prognosis in cardiac insufficiency. Therefore, in the current study, we are aiming to investigate the association between the serum NT pro BNP levels in covid-19 patients and to correlate the same with the severity of COVID-19 infection. Methods: A cohort study involving 68 covid patients whose NT pro BNP levels was estimated at the time of admission and compared with other covid biomarkers. Patients classified as moderate and severe according to ICMR guidelines were included. Serum NTproBNP levels & other covid biomarkers like CRP, IL6, Ddimer, Ferritin, LDH were estimated. Results: Serum NT pro BNP levels were high in severely ill covid patients compared to moderately ill covid 19 patients and was found statistically significant. Serum NT pro BNP levels was positively correlating with other biomarkers. Mortality rate of 4.41% was reported. Conclusion: Serum NT-proBNP levels of COVID 19 patients can be used to predict the prognosis of covid which can help in early diagnosis and management of complications.

Clinical, laboratory and radiological parameters of COVID 19 pneumonia: a single-centered retrospective observational study in Pune, India

Background: The severe acute respiratory syndrome coronavirus called the novel coronavirus caused the pandemic coronavirus disease 19 (COVID-19). All over the world, SARS-CoV-2 pneumonia is causing significant short-term morbidity and mortality, but the medium-term impact on lung function and quality of life of affected patients is still unknown. Aims: To assess clinical, laboratory, and radiological parameters of COVID-19 Patients and to correlate radiological findings and disease severity among patients. Methodology: In this retrospective observational study a total of 630 patients with radiologically confirmed pneumonia and COVID-19 RT PCR positive were included from a tertiary care centre in Pune, Maharashtra, following their voluntary informed consent. Patients underwent clinical, laboratory, and radiological investigations. Results: It was observed that the majority 174 (27.6%) were in the age group of 31 to 40 years and male predominance was observed compared to female. The majority of the patients 314 (49.8%) had mild, 232 (36.8%) were moderate and 84 (13.3%) had severe illness as per CT scores (HRCT Chest score). Mean BSL levels were 181 +or- 81.44, mean pulse rate was 94.03 +or- 14.93 bpm, mean respiratory rate was 22.84 +or- 3.71cpm, systolic blood pressure was 129.09 +or- 13.18 mmHg, diastolic blood pressure was 82.80 +or- 9.67 mmHg and mean temperature was 98.56 +or- 1.67 degrees F. The mean ferritin levels were 181 +or- 81.44, the mean LDH level was 94.03 +or- 14.93, mean HbA1C was 7.45 +or- 1.68. The mean NLR was 5.51 +or- 2.41, the mean WBC count was 7238.38 +or- 4942.23 and the mean hematocrit was 39.69 +or- 4.80. The mean D dimer level was 402.29 +or- 424.70, median levels were 260 (170-450). 503 (79.8%) had CRP levels more than 5 and 127 (20.2%) had levels less than 5. The mean duration of hospital stay was 9.18 days +or- 4.34 days. Majority 570 (90.5%) had fever, 493 (78.3%) had cough, 286 (45.4%) had breathlessness, 66 (10.5%) had sore throat. Other symptoms include vomiting, and loose motion in 17 (2.7%). Among 630 subjects included in the present study, the majority 584 (92.7%) have recovered/were discharged from the hospital and 46 (7.3%) succumbed to the illness. The mean SGOT and SGPT levels were 44.86+or- 31.29 and 43.60 +or- 31.25 respectively. Mean serum creatinine and BUN levels were 0.87+or- 0.80 and 13.96 +or- 9.46 respectively. The mean values of pulse rate, systolic blood pressure, diastolic blood pressure, respiratory rate and temperature showed an increasing trend across the grades of severity. Conclusion: We concluded that age, gender, blood sugar level, blood pressure, clinical symptoms, comorbidities, inflammatory biomarkers and CT severity score were independently associated with the severity and mortality based on our findings.

Principles of glucocorticosteroid administration in patients with COVID-19

Introduction. This article discusses the treatment of coronavirus infection (COVID-19) with glucocorticosteroid drugs (GCS), side effects of drugs and their prevention, transfer from intravenous to intramuscular and then to oral administration, and the development of withdrawal syndrome. The article describes the conditions under which antibiotic therapy is prescribed, as well as the conditions under which the combined use of corticosteroids and antibiotics is necessary. Aim. The aim to analyze the basic principles of corticosteroids prescribing in the treatment of COVID-19: indications for corticosteroids administration, administration regimens and required dosages, side effects of corticosteroids administration. Material and methods. The article uses data from the Interim Guidelines for the Prevention, Diagnosis and Treatment of New Coronavirus Infection (COVID-19), the Federal Clinical Guidelines for the Specialty "Rheumatology", as well as using the literature on basic and clinical endocrinology, cardiology and pharmacology. The work was written using a systems approach, methods of analysis, induction and observation. Results and discussion. Systemic corticosteroids are used in cases of severe and critical course of the disease COVID-19 (confirmation may be an increase in ferritin, procalcitonin, C-reactive protein (CRP), decreased cognitive functions, development of sopor). Their appointment is also justified when the initial course of the disease was not diagnosed as severe, but suddenly the patient's condition deteriorated. The use of antibiotic therapy is advisable when a bacterial infection is attached - (procalcitonin (PCT) > 0.5 ng / ml, purulent sputum, leukocytosis> 12 x 109 / L (in the absence of previous use of glucocorticoids), an increase in band neutrophils of more than 10%). In the presence of chronic infectious diseases in patients with COVID-19 (for example, chronic obstructive pulmonary disease-COPD, chronic pyelonephritis, etc.), antibiotics are prescribed to prevent exacerbations of these diseases. Conclusion. In the course of the study, the authors of the article formulated the following principles of glucocorticoid therapy: drugs should be prescribed according to strict indications;maximum doses are applied in a short course;when the patient's condition is stabilized, it is necessary to reduce the dose in a timely manner and gradually to complete withdrawal to prevent the development of "withdrawal" syndrome, adrenal insufficiency of central genesis, sympathoadrenal crises;during and after treatment, prevention of complications of glucocorticoid therapy (hyperglycemia, hypocalcemia, osteopenia, inflammatory diseases of the urinary system) is recommended;collegial management of patients by infectious diseases and endocrinologists is mandatory.

Impact of acute kidney injury in COVID 19 infected patients

Background: Corona virus disease 2019 (covid-19) is a novel disease caused by a newly identified virus, severe acute respiratory syndrome corona virus 2 (sars-cov-2). The novel disease which begun in Wuhan, China in Dec 2019 was declared pandemic by world health organization on 11 march 2020. The most common reported reasons for intensive care unit admission for patients with severe corona virus disease 2019 (covid-19) are either hypoxemic respiratory failure leading to mechanical ventilation or hypotension requiring vasopressor support. Data on AKI are either lacking in this perspective, we emphasize that AKI can be a severe complication of covid-19 and highlight the importance of assessing, defining, and reporting the course of AKI in patients admitted in intensive care unit. Methods: This is a single centre retrospective observational study. 542 patients with real time-PCR and rapid antigen test confirmed COVID 19 infection admitted in KIMS intensive care unit, Hubballi were taken for study. Patients with chronic kidney disease were excluded from the study. Clinical examination and laboratory investigations including renal function test, liver function test, complete blood count, chest x-ray, d-dimer, ferritin, LDH, CRP was done for all the patients. Duration: 1 year (2020 August -2021 July) Results: Out of 542 patients, 166 patients developed acute kidney injury accounting for 30.62%. 145 patients died (87.47) who had acute kidney injury. And 27 patients were discharged (12.6%) who recovered from acute kidney injury. Results: Among the patients who did not developed AKI(376) .300(79.81) died and 76(20.2) got discharged. The p value was 0.034 which was significant for increase in mortality among patients who developed AKI. The incidence of mortality among COVID patient admitted to KIMS ICU was 82.1%. Conclusion: The mortality was significantly higher in COVID patients developing AKI. So we can predict the outcome in COVID infected patients who develops acute kidney injury. AKI is one of manifestation in COVID patients due to tropism of corona virus to ace receptors present in kidney.

The relationship of laboratory parameters and rates with prognosis and mortality in COVID-19 infection

Objective:In this study, to evaluate the clinical course and prognosis in COVID-19 patients, to evaluate the hematological and biochemical parameters at the time of admission to the hospital.

An update on pathogenesis, diagnosis and treatment of COVID-19-related cytokine storm

CoronaVirus Disease 2019 (COVID-19) is a viral infection caused by the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), which is globally influential and has killed more than 6 million patients until today. Hyper-secretion of pro-inflammatory cytokines triggered by the viral infection that cannot be eliminated by the immune system and an ongoing hyper-inflammatory state primarily in the lung seem to be the major causes of death. The mechanisms proposed to explain the pathogenesis of the cytokine storm associated with COVID-19 included poor viral clearance and persistent robust cytokine response despite inadequate antiviral immunity. The diagnosis can be made easily by clinical features, imaging techniques, and nasopharyngeal PCR. The diagnosis of this hyper-inflammatory state in a patient with COVID-19 can be made with rapid deterioration in clinical features, and laboratory findings including abnormally high serum CRP, ferritin and D-dimer levels, and rapidly progressive pulmonary radiological findings. In addition to the anti-viral and supportive treatments, corticosteroids, IL-1, or IL-6 receptor blockers are frequently used to suppress the increased cytokine response.

Cross antigenicity of Salmonella typhi and novel coronavirus antibody in second wave of COVID-19 pandemic

During second wave of COVID-19 pandemic, increase in incidence of typhoid was observed in different cities of Pakistan. Rapid diagnostic tests for COVID-19 and typhoid are less sensitive and confirmatory tests are required to diagnose the infection. Moreover, COVID-19 IgM mimic Salmonella typhi IgM and have same clinical presentations as typhoid. Muzaffargarh is a district of province Punjab. Being a hotspot for COVID-19, it also has high prevalence of Typhoid. Therefore, in this study we aim to evaluate the cross antigenicity of COVID-19 IgM with Salmonella typhi IgM. 593 patients were enrolled in study with informed consent. Blood samples were collected from patients and laboratory biomarkers were analyzed. Data was recorded and statistical analysis was done. Among study participants, 64% were males while 36% were females. All the laboratory biomarkers were elevated in all the patients. Different age groups didn't exhibit difference in all laboratory biomarkers except ferritin. Significant difference was observed in creatinine, LDH and ferritin levels in male and female patients. It can be concluded that all age groups are under same risk. However, disease severity is higher in male population.

Acute ischemic stroke in COVID-19: a case-based systematic review

In patients with acute ischemic stroke and COVID-19, the highest ratio between neutrophils and lymphocytes and increased serum levels of C-reactive protein, ferritin, D-dimer and fibrinogen are associated with poor neurological prognosis;75% of these patients die or survive with significant disability. At the moment, however, they cannot be established firm conclusions about the long-term evolution of these patients. Thus, the objective of this systematic review was to identify and correlate clinical and biochemical findings in patients with infection confirmed by SARS-CoV-2 and acute ischemic stroke.

Root cause analysis of maternal mortality at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia retrospective analysis of serum ferritin and hemoglobin level in COVID-19 patients in various stages of illness, in a tertiary care hospital

COVID-19 is an ongoing global pandemic of coronavirus disease 2019. This disease spreads through air contaminated with viral particles. All the age groups are affected by this disorder. The immunocompromised and elderly individuals with risk factors are commonly prone for serious complications due to coronavirus. Patients affected by this infection presence with a range of clinical manifestations, from no symptoms to critical illness. Studies have shown that Mild to moderate respiratory infection recover without treatment. Patients with comorbidities like hypertension. diabetes, cardiac illness cancer, prolonged respiratory illness are prone for critical illness. Studies also reported alterations in the morphology of various organs, circulatory systems, biochemical and haematological parameters. My study focused on analysis of serum ferritin in covid -19 positive patients in various stages of illness.

Evaluation of antibody levels and certain biochemical parameters in the patients infected with SARS-CoV-2

Objective: In cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease clinical usefulness of serological tests remains uncertain. The study aimed to evaluate anti-SARS-CoV-2 antibody and some biochemical parameters such as leukocyte (WBC), neutrophil (NEU), lymphocyte (LYM), thrombocyte (PLT), erythrocyte (RBC), hemoglobin (Hb), ferritin, procalcitonin (PCT), C-reactive protein (CRP) and D-dimer in the patient specimens sent from the polyclinic and service/intensive care unit. Materials and Methods: A total of 110 patients' specimens sent from the polyclinic and from the service/intensive care unit were used. SARS-CoV-2 RT PCR, immunoassay SARS-CoV-2 antibody and other biochemical tests were assessed.

Alteration of certain biochemical and hematological parameters in COVID -19 patients

Background: Covid 19 is a newly emergent contagious infectious disease caused by severe acute respiratory syndrome (SARS) - Cov-2 virus that was not found previously in human which belongs to a large family of corona virus. The severity of the disease is altered by alteration of biochemical parameters. This study aims to evaluate somehematological and biochemical parameters in Covid 19 patients admitted at dedicated Covid 19 hospital. To determines hematological and biochemical parameters in Covid 19 patients. Material and Methods: Present study comprised of 70 Covid 19 patients who admitted at dedicated Covid 19 ward during second wave. They include 22 female and 48 male subjects aged between 15 - 75 years. The data was entered in MS EXCEL spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 25.0.

Assessment of coagulopathy, inflammation and LDH activity in SARS-CoV-2-infected patients

The patho-physiology of COVID19 is still not clear. This study investigated the status of coagulation, LDH activity, and inflammation in SARS-CoV-2 infected patients. One hundred and thirty-four newly diagnosed COVID19 infected patients (age ranged 65-82 years) attending Mullingar Regional Hospital, Mullingar, Republic of Ireland, volunteered to participate in this study. They all presented with a pulmonary disorder, pyrexia, vomiting, body pains, etc. SARS-CoV-2 confirmatory test was done with RT-PCR molecular test using Cepheid Genexpert System. The data of another 121 plasma samples of apparently normal, non-COVID19 infected individuals taken before the emergence of COVID19 served as controls. Levels of blood platelets was determined in the participants using Siemen ADVIA 2120 Haematological System, and plasma D-dimer was determined in the participants using Star Max-Stago-Automatic Coagulation Analyzer LDH activity, plasma ferritin, and C-reactive protein (CRP) were determined in the participants using Beckman AU680-Chemistry Analyser. SARS-CoV-2 -infected patients showed significantly (p< 0.001) higher levels of D-dimer (1522.95+1395.45 ng/ml), CRP (125.3+116.4 mg/l), ferritin (488.5+514.9pg/l), and LDH activity (574.4+446.7iu/l) compared to controls (78.8+18.1 ng/ml, 2.4+1.7 mg/l, 61.3+58.2pg/l, 304.1+76.6iu/l respectively). The blood platelet count did not show significant (p>0.05) change in the COVID19 patients (252.2 x 109+101 x 109) compared to controls (256.4 x 109+63.2 x 109). Elevated LDH activity could indicate tissue breakdown in the SARS-Cov-2 infected patients. Hyper-coagulation and inflammation are imminent in the COVID19 patients. Adjuvant anticoagulant and anti-inflammatory therapies may be useful as part of therapeutic regimen in the SARS-CoV-2 infected patients.

Evaluation of COVID-19 cases who received immunosuppressive therapy at a tertiary care hospital

Objective: Immunosuppressive drugs are included in the treatment protocols of severe COVID-19 cases that may present with cytokine storm. In this study, we aimed to examine the characteristics of COVID-19 patients who received immunosuppressive therapy Methods: Patients diagnosed with COVID-19 and followed in the quarantine wards of our hospital between 01.03.2020-24.05.2020 were included in the study. Patient information was obtained retrospectively from patient files and discharge reports, and 263 COVID-19 patients -aged 18 and over- were included in the study.

Features of patients admitted for COVID-19 at a regional hospital in the Chilean Araucania region

Background: The Araucania region in Chile had the greatest COVID-19 incidence and lethality in Chile Aim: To describe the clinical characteristics and evolution of patients admitted for COVID-19 in a high complexity Hospital in the region of La Araucan..a-Chile. Material and Methods: Review of medical records of the first 169 patients aged 55 .. 17 years (50% women) admitted for COVID-19 between march and may, 2020 at a regional hospital in Temuco Chile.

Analyzing correlation of clinical severity of COVID-19 with other biochemical parameters: a retrospective study from Pakistan

The third wave of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing damage all over the world, especially in Pakistan and India. Although vaccines are available and preventive measures are being taken, but SARS-CoV-2 is unstoppable. Currently, there are around 841,636 positive cases in Pakistan and 18,429 deaths, whereas, in India, both are high. From April 8th to 12th, 2021, nasopharyngeal swabs of 190 patients were submitted to PRL (PACP) lab for the SARS-CoV-2 testing, and blood samples were collected at the Mayo Hospital lab for ferritin, D-dimers, lactate dehydrogenase (LDH), and C-reactive protein (CRP) testing. This study observed that coronavirus disease 2019 (COVID-19) was more likely in individuals aged 51-60 than 61-70. In addition, our study found that COVID-19 patients exhibited a statistically significant increase in levels of ferritin, D-dimers, LDH, and CRP. In addition, this study revealed that SARS-CoV-2 relapsed. Furthermore, we concluded that these biochemical parameters are useful indicators for severity of COVID-19.

Diagnosis of COVID-19 in children

The world is facing an unprecedented crises with the advent and spread of COVID-19. Fortunately children are less affected. Diagnosis begins with identifying the right suspect which in turn depends on local prevalence of infection and contact history. In high burden areas any acute illness with or without fever can be COVID-19. The gold standard for diagnosis is RT-PCR in respiratory specimen. Correct collection and transport of specimen is important. Since the sensitivity of RT-PCR is at best 70%, a negative test does not rule out the diagnosis. Sick children may have lymphopenia and elevated CRP, D-dimer, ferritin, CPK, LDH, IL-6. CT chest is more sensitive than CXR and may be abnormal even in those who are asymptomatic or have mild symptoms. The role of serologic tests in children at this time is limited to diagnosis of pediatric multi system inflammatory syndrome.

A study on correlation of pattern of fever in COVID 19 positive patients with correlation to biochemical parameters

"Introduction: The novel coronavirus, SARS-CoV-2 presented with a wide array of clinical, inflammatory and radiological manifestations. Currently, a very few data is available about the relationship in between pattern of fever and biochemical parameters in patients affected by COVID-19. Our objective is to find out the clinical and inflammatory status of COVID-19 patients and whether there is a relationship in between pattern of fever and biochemical parameters of severe acute respiratory syndrome coronavirus disease 2. Methodology: A retrospective study conducted on 60 COVID-19 positive patients, who were clinically/radiologically evaluated and screened for inflammatory markers. Result: 39 men and 21 women had Fever and elevated inflammatory markers like CRP, D-dimer, ferritin, ESR. Altered neutrophil lymphocyte ratio was also found. Patients with moderate and severe grade fever had more significant rise in CRP (60%), D-dimer (50%).patients with mild and moderate fever had more rise of ferritin (65%). ESR and NLR were not significantly increased. Patients with intermittent fever had high rise in CRP (80%), D-dimer (75%), and ferritin (72%). Again, ESR was not significantly raised. NLR was moderately raised in patients with continuous fever (66%). Sub acute and chronic rise of temperature shows more significant rise in CRP (60%), D-dimer (82%), ferritin (80%), NLR and ESR.

Clinical and autoimmune characteristics of COVID-19 patients in a tertiary care centre: a cross-sectional study

Introduction: Since the end of 2019, the world is witnessing the emergence of the coronavirus disease 2019 (COVID-19) outbreak and pandemic caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This disease presented with a wide array of clinical, inflammatory and possible autoimmune manifestations. Currently, a very few data is available about the involvement of autoimmunity in patients affected by coronavirus disease 2019 (COVID-19). Aim: To find out the clinical and inflammatory status of COVID-19 patients and whether this disease (SARS-CoV-2) stimulates autoantibody production and contributes to autoimmunity activation. Methodology: A hospital based retrospective study conducted on 60 COVID-19 patients. All patients were clinically and radiologically evaluated and screened for common inflammatory markers and auto antibodies. Result: Patients included were 39 men (65%) and 21 women (35%). 33 patients were mild cases, 15 were moderate and 12 were severe cases with a mean age of 44.27. Fever and shortness of breath were the dominant symptoms;most patients had at least one coexisting disorder on admission;the most common characteristic on chest CT was groundglass opacity;the most common findings on laboratory measurements of inflammatory markers were elevated levels of CRP, LDH, ferritin and altered neutrophil lymphocyte ratio;and prevalence of autoantibodies, anti SSA/Ro antibody, anti SSB/La antibody, and antinuclear antibody was 20%, 10%, and 15%, respectively and Anti-TPO antibody was positive in 33.3% patients.

Efficacy of Sofosbuvir and Daclatasvir on the prognosis of kidney transplantation recipients with SARS-CoV-2 infection;a single-center study in Shariati Hospital

Introduction. The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory coronavirus 2 (SARS-COV-2), was reported in Wuhan, China, in early December 2019 and spread rapidly worldwide. In the COVID-19 era, Kidney transplantation recipients (KTRs) are at high risk due to using immunosuppressive drugs. Therefore, finding an efficient treatment for the management of COVID-19 in KTR patients is crucial due to its poor prognosis. Despite the use of various antiviral and anti-inflammatory drugs, there is yet no definitive cure for Covid-19. Repurposing existing pharmaceuticals is a way to find an immediate medication. Thus, we assessed the antiviral treatment efficacy of Sofosbuvir combined with Daclatasvir on KTRs with SARS-COV-2 infection. Methods. We conducted a single-center retrospective cross-sectional study of all adult kidney transplant recipients with COVID-19, admitted to Shariati Hospital, Tehran, Iran, from October to December 2020. All the patients received a once-daily combination pill of SOF and DAC at a dose of 400/60 mg for 10 days. The study protocol was approved by the Ethical Committee of the Tehran University of Medical Sciences under ID: IR. TUMS. DDRI. REC.1399.028. Statistical analysis was performed using IBM SPSS version 26.0. A P value less than 0.05 was considered statistically significant for all tests. Results. From October to December 2020, 12 adult KTR patients were recruited;four patients (33.3%) died and eight patients survived (66.7%). The dead patients were older than those who survived. However, it was not statistical significance (53.67 .. 3.786 vs. 47.63 .. 11.868, P = 0.422). Acute kidney injury (AKI) due to COVID-19 infection was seen in 11 patients of the study population (91.7%) and all four dead KTRs. Also, three patients underwent dialysis, which two died (50%). The most common comorbidities were hypertension (6 patients, 50%) and diabetes mellitus (4 patients, 33.3%), while no significant correlation was seen between comorbidities and mortality (P > 0.05). About the immunosuppressive drugs, of four dead patients, three (75%) used Mycophenolate, and all of them used Prednisolone. The laboratory results showed that the mean level of each parameter WBC, INR, CRP, Ferritin, D-Dimer on the last day of hospital stay was significantly different between two groups of survived and dead patients at a 95% confidence level (P < 0.05). Conclusion. Sofosbuvir combined with Daclatasvir for treatment of KTRs with SARS-COV-2 infection showed efficacy by reducing the mortality rate. Also, the medication was safe. Patients tolerated it well, and no serious adverse effects were observed. Larger studies are needed to validate these results.