Objective: The aim of this study is to evaluate and compare the clinical efficacy of lopinavir/ritonavir with oseltamivir plus hydroxychloroquine for the treatment of Covid-19, in order to find a better treatment for Covid-19 patients. Methods: In this single-center, mixed designed cohort study, 198 patients admitted for Covid-19, to Ziaeian Hospital, Tehran, Iran were included. According to the date of admission, the patients were received different treatments and divided into two groups. Group 1 received oseltamivir with hydroxychloroquine and azithromycin whereas group 2 received lopinavir/ritonavir with azithromycin. Patients’ outcomes were measured based on duration of hospitalization, a requirement to intensive care unit (ICU) admission, need for intubation and mortality. Results: Patients in group 1 had greater clinical improvement and shorter duration of hospitalization. Although small in number, mortality, ICU admission, and intubation was also less in this group, but due to the small number of events in incidence of ICU admission, intubation, and mortality, it could not be analyzed and was not possible to investigate the relationship between the type of treatment and these variables. In group 1, one patient was admitted to ICU, while 12 patients were admitted to ICU in group2. None of the patients in group 1 required intubation whereas 4 in group 2 received intubation. One patient in group 1 and 9 patients in group 2 died. Conclusion: This study showed that administration of Oseltamivir plus hydroxychloroquine is likely to be associated with earlier clinical improvement and shorter duration of hospitalization however, further studies are required.

Background: it is important to identify patients at higher risk for severity and poor outcomes of Covid-19 infection, to have better disease management and pandemic control. In this study, we aimed to assess the distribution of ABO and Rh blood groups in hospitalized Covid-19 infected patients and demonstrate its association with severity and outcomes of the disease. Methods: This is a cross-sectional study at Ziaeian specialist Hospital, in Tehran, Iran. Off all confirmed Covid-19 infected patients who were admitted to this hospital, 273 patients were enrolled in this study and categorized based on their disease severity or clinical outcomes including ICU admission, need for mechanical ventilation and mortality. The distribution of ABO and Rh blood groups was assessed and compared between different groups, to investigate the association of blood group types with disease severity or outcomes. Also, the study population was categorized based on their blood group types to demonstrate the association of laboratory parameters, radiologic findings and length of hospitalization with blood groups. Sex, age and underlying disease were adjusted in final model by multivariate regression analysis. Results: This study showed that Blood group A (35.9%) was the most prevalent among hospitalized Covid-19 patients followed by O (34.8%), B (21.6%), and AB (7.7%) (A>O>B>AB). ABO and Rh blood group was not associated with disease severity, need for mechanical ventilation, or ICU admission, while blood group B was associated with an increased risk of death in comparison with type O, in hospitalized Covid-19 patients (P=0.02). The number of patients with severe levels of CRP test results was lower in O blood group patients in comparison with non-O blood groups (P=0.01). Conclusion No significant association was found between blood groups and other lab tests, radiologic findings, and length of hospitalization.

Background: In this study, we aimed to assess the prevalence of vitamin D deficiency in hospitalized Covid-19 patients and demonstrate its association with severity and mortality of the disease. Methods: This observational study at Ziaeian Hospital, Tehran, Iran. Of all confirmed Covid-19 patients who were admitted to this hospital 276 patients were enrolled in this study and divided into two groups; 145 patients in group1 with a serum 25(OH)D level >20 ng/ml and 131 patients in group 2 with a serum 25 (OH)D level =<20 ng/ml. The severity, outcome, and mortality of Covid-19 disease were compared in these two groups, based on chest CT scans findings, laboratory data, and patient’ vital signs on admission day, and the duration of hospitalization, requirement to ICU admission, need for intubation, and mortality. Results: The prevalence of vitamin D deficiency was 22.1 %, and vitamin D insufficiency by definition of serum 25(OH)D levels 12-20 ng/ml was 25.4%. Despite, an increase in serum levels of CPK, Ferritin, LDH, CRP, D-dimer, AST, and ALT, there was not any significant relationship between serum level of 25(OH)D with laboratory tests, chest CT scan scores, and patient’s vital signs on admission day by univariate and multivariate analysis. The odds of incidence of ICU admission, mechanical ventilation, and mortality were higher in group 2 which was not statistically significant by univariate and multivariate analysis, but the mortality was significantly higher in subgroup 2 by multivariate regression analysis. Conclusions: This study showed that vitamin D deficiency was associated with a higher mortality rate, while could not show any significant association between serum 25(OH)D levels with the incidence of ICU admission, need for mechanical ventilation, and length of hospital stay, also we did not find any significant relationship with laboratory tests, radiologic findings, and patient’s vital signs on admission day.