Comparing outcomes of hospitalized patients with moderate and severe COVID-19 following treatment with hydroxychloroquine plus atazanavir/ritonavir.
Identifieur interne : 000D59 ( Main/Corpus ); précédent : 000D58; suivant : 000D60Comparing outcomes of hospitalized patients with moderate and severe COVID-19 following treatment with hydroxychloroquine plus atazanavir/ritonavir.
Auteurs : Hamid Rahmani ; Effat Davoudi-Monfared ; Anahid Nourian ; Morteza Nabiee ; Setayesh Sadeghi ; Hossein Khalili ; Ladan Abbasian ; Fereshteh Ghiasvand ; Arash Seifi ; Malihe Hasannezhad ; Sara Ghaderkhani ; Mostafa Mohammadi ; Mir Saeed YekaninejadSource :
- Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences [ 2008-2231 ] ; 2020.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Antiviral Agents (administration & dosage), Antiviral Agents (adverse effects), Atazanavir Sulfate (administration & dosage), Atazanavir Sulfate (adverse effects), COVID-19 (drug therapy), COVID-19 (mortality), COVID-19 (virology), Drug Therapy, Combination (MeSH), Female (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Hydroxychloroquine (administration & dosage), Hydroxychloroquine (adverse effects), Intensive Care Units (statistics & numerical data), Length of Stay (MeSH), Male (MeSH), Middle Aged (MeSH), Prospective Studies (MeSH), Ritonavir (administration & dosage), Ritonavir (adverse effects), Severity of Illness Index (MeSH), Time Factors (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , administration & dosage : Antiviral Agents, Atazanavir Sulfate, Hydroxychloroquine, Ritonavir.
- chemical , adverse effects : Antiviral Agents, Atazanavir Sulfate, Hydroxychloroquine, Ritonavir.
- drug therapy : COVID-19.
- mortality : COVID-19.
- statistics & numerical data : Hospitalization, Intensive Care Units.
- virology : COVID-19.
- Adult, Aged, Drug Therapy, Combination, Female, Humans, Length of Stay, Male, Middle Aged, Prospective Studies, Severity of Illness Index, Time Factors, Treatment Outcome.
Abstract
BACKGROUND
The role of the antiviral therapy in treatment of COVID-19 is still a matter to be investigated. Also efficacy and safety of antiviral regimens were not compared according severity of the disease. In this study the efficacy and safety of hydroxychloroquine plus atazanavir/ritonavir was compared in patients with moderate and severe COVID-19.
METHODS
We prospectively evaluated the clinical outcomes of 213 patients with COVID-19 during the hospitalization course and up to 56 days after the hospital discharge. The disease was categorized to moderate and severe based on the severity of pneumonia and peripheral oxygen saturation (SpO2). The patients received the national treatment protocol containing hydroxychloroquine (400 mg BD in first day and then 200 mg BD) plus atazanavir/ritonavir (300/100 mg daily) for 7 days. Main outcomes included discharge rates at day 7, 14 and 28, 28-day mortality, rate of intensive care unit (ICU) admission and intubation, length of hospital and ICU stay and incidence of adverse events.
RESULTS
The mean (SD) age of patients was 60(14) years and 53% were male. According to WHO definition, 51.64% and 48.36% of the patients had moderate (SpO2 ≥ 90%) and severe disease (SpO2 < 90%) at baseline, respectively. The discharge rate of the moderate group was significantly higher than the severe group at day 7, 14 and 28 (HR = 0.49; 95% CI: 0.35-0.69, p = < 0.001 at day 7, HR = 0.48; 95% CI: 0.35-0.66, p = < 0.001 at day 14 and HR = 0.49; 95% CI: 0.36-0.67, p = < 0.001at day 28). The 28-day mortality of the severe group was six times higher than the moderate group (HR = 6.00; 95% CI: 2.50-14.44), p = < 0.001). The need of admission in ICU for the severe group and the moderate group was 37.86% and 18.18% of the patients. Length of hospital stay was significantly shorter in the moderate group in comparison with the severe group (5 ± 4 vs. 8 ± 6 days, p < 0.001). Patients in the moderate group experienced the serious adverse events and complications less than the severe group. The discharged patients were followed up to 56 days after discharge. Some of the patients complained of symptoms such as exertional dyspnea, weakness and new-onset hair loss.
CONCLUSION
Our study did not support the use of hydroxychloroquine plus atazanavir/ritonavir in patients who had SpO
DOI: 10.1007/s40199-020-00369-2
PubMed: 32857301
PubMed Central: PMC7453126
Links to Exploration step
pubmed:32857301Le document en format XML
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last="Nourian">Anahid Nourian</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Nabiee, Morteza" sort="Nabiee, Morteza" uniqKey="Nabiee M" first="Morteza" last="Nabiee">Morteza Nabiee</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Sadeghi, Setayesh" sort="Sadeghi, Setayesh" uniqKey="Sadeghi S" first="Setayesh" last="Sadeghi">Setayesh Sadeghi</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Khalili, Hossein" sort="Khalili, Hossein" uniqKey="Khalili H" first="Hossein" last="Khalili">Hossein Khalili</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. khalilih@tums.ac.ir.</nlm:affiliation></affiliation></author><author><name sortKey="Abbasian, Ladan" sort="Abbasian, Ladan" uniqKey="Abbasian L" first="Ladan" last="Abbasian">Ladan Abbasian</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Ghiasvand, Fereshteh" sort="Ghiasvand, Fereshteh" uniqKey="Ghiasvand F" first="Fereshteh" last="Ghiasvand">Fereshteh Ghiasvand</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Seifi, Arash" sort="Seifi, Arash" uniqKey="Seifi A" first="Arash" last="Seifi">Arash Seifi</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Hasannezhad, Malihe" sort="Hasannezhad, Malihe" uniqKey="Hasannezhad M" first="Malihe" last="Hasannezhad">Malihe Hasannezhad</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Ghaderkhani, Sara" sort="Ghaderkhani, Sara" uniqKey="Ghaderkhani S" first="Sara" last="Ghaderkhani">Sara Ghaderkhani</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Mohammadi, Mostafa" sort="Mohammadi, Mostafa" uniqKey="Mohammadi M" first="Mostafa" last="Mohammadi">Mostafa Mohammadi</name><affiliation><nlm:affiliation>Department of Intensive Care Unit, Imam Khomeini Hospital Complex, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Yekaninejad, Mir Saeed" sort="Yekaninejad, Mir Saeed" uniqKey="Yekaninejad M" first="Mir Saeed" last="Yekaninejad">Mir Saeed Yekaninejad</name><affiliation><nlm:affiliation>Department of Epidemiology and Biostatistics, School of Public health, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32857301</idno><idno type="pmid">32857301</idno><idno type="doi">10.1007/s40199-020-00369-2</idno><idno type="pmc">PMC7453126</idno><idno type="wicri:Area/Main/Corpus">000D59</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000D59</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Comparing outcomes of hospitalized patients with moderate and severe COVID-19 following treatment with hydroxychloroquine plus atazanavir/ritonavir.</title><author><name sortKey="Rahmani, Hamid" sort="Rahmani, Hamid" uniqKey="Rahmani H" first="Hamid" last="Rahmani">Hamid Rahmani</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Davoudi Monfared, Effat" sort="Davoudi Monfared, Effat" uniqKey="Davoudi Monfared E" first="Effat" last="Davoudi-Monfared">Effat Davoudi-Monfared</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Nourian, Anahid" sort="Nourian, Anahid" uniqKey="Nourian A" first="Anahid" last="Nourian">Anahid Nourian</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Nabiee, Morteza" sort="Nabiee, Morteza" uniqKey="Nabiee M" first="Morteza" last="Nabiee">Morteza Nabiee</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Sadeghi, Setayesh" sort="Sadeghi, Setayesh" uniqKey="Sadeghi S" first="Setayesh" last="Sadeghi">Setayesh Sadeghi</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Khalili, Hossein" sort="Khalili, Hossein" uniqKey="Khalili H" first="Hossein" last="Khalili">Hossein Khalili</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. khalilih@tums.ac.ir.</nlm:affiliation></affiliation></author><author><name sortKey="Abbasian, Ladan" sort="Abbasian, Ladan" uniqKey="Abbasian L" first="Ladan" last="Abbasian">Ladan Abbasian</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Ghiasvand, Fereshteh" sort="Ghiasvand, Fereshteh" uniqKey="Ghiasvand F" first="Fereshteh" last="Ghiasvand">Fereshteh Ghiasvand</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Seifi, Arash" sort="Seifi, Arash" uniqKey="Seifi A" first="Arash" last="Seifi">Arash Seifi</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Hasannezhad, Malihe" sort="Hasannezhad, Malihe" uniqKey="Hasannezhad M" first="Malihe" last="Hasannezhad">Malihe Hasannezhad</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Ghaderkhani, Sara" sort="Ghaderkhani, Sara" uniqKey="Ghaderkhani S" first="Sara" last="Ghaderkhani">Sara Ghaderkhani</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Mohammadi, Mostafa" sort="Mohammadi, Mostafa" uniqKey="Mohammadi M" first="Mostafa" last="Mohammadi">Mostafa Mohammadi</name><affiliation><nlm:affiliation>Department of Intensive Care Unit, Imam Khomeini Hospital Complex, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Yekaninejad, Mir Saeed" sort="Yekaninejad, Mir Saeed" uniqKey="Yekaninejad M" first="Mir Saeed" last="Yekaninejad">Mir Saeed Yekaninejad</name><affiliation><nlm:affiliation>Department of Epidemiology and Biostatistics, School of Public health, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences</title><idno type="eISSN">2008-2231</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Antiviral Agents (administration & dosage)</term><term>Antiviral Agents (adverse effects)</term><term>Atazanavir Sulfate (administration & dosage)</term><term>Atazanavir Sulfate (adverse effects)</term><term>COVID-19 (drug therapy)</term><term>COVID-19 (mortality)</term><term>COVID-19 (virology)</term><term>Drug Therapy, Combination (MeSH)</term><term>Female (MeSH)</term><term>Hospitalization (statistics & numerical data)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (administration & dosage)</term><term>Hydroxychloroquine (adverse effects)</term><term>Intensive Care Units (statistics & numerical data)</term><term>Length of Stay (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Ritonavir (administration & dosage)</term><term>Ritonavir (adverse effects)</term><term>Severity of Illness Index (MeSH)</term><term>Time Factors (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiviral Agents</term><term>Atazanavir Sulfate</term><term>Hydroxychloroquine</term><term>Ritonavir</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiviral Agents</term><term>Atazanavir Sulfate</term><term>Hydroxychloroquine</term><term>Ritonavir</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term><term>Intensive Care Units</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Length of Stay</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Severity of Illness Index</term><term>Time Factors</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The role of the antiviral therapy in treatment of COVID-19 is still a matter to be investigated. Also efficacy and safety of antiviral regimens were not compared according severity of the disease. In this study the efficacy and safety of hydroxychloroquine plus atazanavir/ritonavir was compared in patients with moderate and severe COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We prospectively evaluated the clinical outcomes of 213 patients with COVID-19 during the hospitalization course and up to 56 days after the hospital discharge. The disease was categorized to moderate and severe based on the severity of pneumonia and peripheral oxygen saturation (SpO2). The patients received the national treatment protocol containing hydroxychloroquine (400 mg BD in first day and then 200 mg BD) plus atazanavir/ritonavir (300/100 mg daily) for 7 days. Main outcomes included discharge rates at day 7, 14 and 28, 28-day mortality, rate of intensive care unit (ICU) admission and intubation, length of hospital and ICU stay and incidence of adverse events.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The mean (SD) age of patients was 60(14) years and 53% were male. According to WHO definition, 51.64% and 48.36% of the patients had moderate (SpO2 ≥ 90%) and severe disease (SpO2 < 90%) at baseline, respectively. The discharge rate of the moderate group was significantly higher than the severe group at day 7, 14 and 28 (HR = 0.49; 95% CI: 0.35-0.69, p = < 0.001 at day 7, HR = 0.48; 95% CI: 0.35-0.66, p = < 0.001 at day 14 and HR = 0.49; 95% CI: 0.36-0.67, p = < 0.001at day 28). The 28-day mortality of the severe group was six times higher than the moderate group (HR = 6.00; 95% CI: 2.50-14.44), p = < 0.001). The need of admission in ICU for the severe group and the moderate group was 37.86% and 18.18% of the patients. Length of hospital stay was significantly shorter in the moderate group in comparison with the severe group (5 ± 4 vs. 8 ± 6 days, p < 0.001). Patients in the moderate group experienced the serious adverse events and complications less than the severe group. The discharged patients were followed up to 56 days after discharge. Some of the patients complained of symptoms such as exertional dyspnea, weakness and new-onset hair loss.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Our study did not support the use of hydroxychloroquine plus atazanavir/ritonavir in patients who had SpO</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32857301</PMID><DateCompleted><Year>2020</Year><Month>12</Month><Day>07</Day></DateCompleted><DateRevised><Year>2021</Year><Month>04</Month><Day>28</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2008-2231</ISSN><JournalIssue CitedMedium="Internet"><Volume>28</Volume><Issue>2</Issue><PubDate><Year>2020</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences</Title><ISOAbbreviation>Daru</ISOAbbreviation></Journal><ArticleTitle>Comparing outcomes of hospitalized patients with moderate and severe COVID-19 following treatment with hydroxychloroquine plus atazanavir/ritonavir.</ArticleTitle><Pagination><MedlinePgn>625-634</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s40199-020-00369-2</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The role of the antiviral therapy in treatment of COVID-19 is still a matter to be investigated. Also efficacy and safety of antiviral regimens were not compared according severity of the disease. In this study the efficacy and safety of hydroxychloroquine plus atazanavir/ritonavir was compared in patients with moderate and severe COVID-19.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We prospectively evaluated the clinical outcomes of 213 patients with COVID-19 during the hospitalization course and up to 56 days after the hospital discharge. The disease was categorized to moderate and severe based on the severity of pneumonia and peripheral oxygen saturation (SpO2). The patients received the national treatment protocol containing hydroxychloroquine (400 mg BD in first day and then 200 mg BD) plus atazanavir/ritonavir (300/100 mg daily) for 7 days. Main outcomes included discharge rates at day 7, 14 and 28, 28-day mortality, rate of intensive care unit (ICU) admission and intubation, length of hospital and ICU stay and incidence of adverse events.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The mean (SD) age of patients was 60(14) years and 53% were male. According to WHO definition, 51.64% and 48.36% of the patients had moderate (SpO2 ≥ 90%) and severe disease (SpO2 < 90%) at baseline, respectively. The discharge rate of the moderate group was significantly higher than the severe group at day 7, 14 and 28 (HR = 0.49; 95% CI: 0.35-0.69, p = < 0.001 at day 7, HR = 0.48; 95% CI: 0.35-0.66, p = < 0.001 at day 14 and HR = 0.49; 95% CI: 0.36-0.67, p = < 0.001at day 28). The 28-day mortality of the severe group was six times higher than the moderate group (HR = 6.00; 95% CI: 2.50-14.44), p = < 0.001). The need of admission in ICU for the severe group and the moderate group was 37.86% and 18.18% of the patients. Length of hospital stay was significantly shorter in the moderate group in comparison with the severe group (5 ± 4 vs. 8 ± 6 days, p < 0.001). Patients in the moderate group experienced the serious adverse events and complications less than the severe group. The discharged patients were followed up to 56 days after discharge. Some of the patients complained of symptoms such as exertional dyspnea, weakness and new-onset hair loss.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Our study did not support the use of hydroxychloroquine plus atazanavir/ritonavir in patients who had SpO<sub>2</sub> < 90% at the time of hospital admission. SpO2 was the only predictor of clinical outcomes (duration of hospital stay, discharge from the hospital and mortality) in patients treated with hydroxychloroquine plus atazanavir/ritonavir.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rahmani</LastName><ForeName>Hamid</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Davoudi-Monfared</LastName><ForeName>Effat</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nourian</LastName><ForeName>Anahid</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nabiee</LastName><ForeName>Morteza</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sadeghi</LastName><ForeName>Setayesh</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khalili</LastName><ForeName>Hossein</ForeName><Initials>H</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-1590-6396</Identifier><AffiliationInfo><Affiliation>Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. khalilih@tums.ac.ir.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Abbasian</LastName><ForeName>Ladan</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ghiasvand</LastName><ForeName>Fereshteh</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seifi</LastName><ForeName>Arash</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hasannezhad</LastName><ForeName>Malihe</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ghaderkhani</LastName><ForeName>Sara</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mohammadi</LastName><ForeName>Mostafa</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Intensive Care Unit, Imam Khomeini Hospital Complex, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yekaninejad</LastName><ForeName>Mir Saeed</ForeName><Initials>MS</Initials><AffiliationInfo><Affiliation>Department of Epidemiology and Biostatistics, School of Public health, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Daru</MedlineTA><NlmUniqueID>101125969</NlmUniqueID><ISSNLinking>1560-8115</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>4MT4VIE29P</RegistryNumber><NameOfSubstance UI="D000069446">Atazanavir Sulfate</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>O3J8G9O825</RegistryNumber><NameOfSubstance UI="D019438">Ritonavir</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000069446" MajorTopicYN="N">Atazanavir Sulfate</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004359" MajorTopicYN="N">Drug Therapy, Combination</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007902" MajorTopicYN="N">Length of Stay</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019438" MajorTopicYN="N">Ritonavir</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Atazanavir/ritonavir</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">Outcomes</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>07</Month><Day>04</Day></PubMedPubDate><PubMedPubDate 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