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Effect of Ammonium Chloride in Addition to Standard of Care in Outpatients and Hospitalized Covid-19 Patients: A Randomized Clinical Trial Publisher Pubmed



Siami Z1 ; Aghajanian S2 ; Mansouri S2 ; Mokhames Z3 ; Pakzad R4, 5 ; Kabir K6 ; Norouzi M7, 8 ; Soleimani A1 ; Hedayat Yaghoobi M1 ; Shadabi S2 ; Tajbakhsh R9 ; Kargar Kheirabad A7 ; Mozhgani SH10, 11
Authors
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Authors Affiliations
  1. 1. Department of Infectious Diseases, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
  2. 2. Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
  3. 3. Department of Molecular Diagnostics, Emam Ali Educational and Therapeutic Center, Alborz University of Medical Sciences, Karaj, Iran
  4. 4. Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
  5. 5. Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
  6. 6. Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
  7. 7. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Department of Internal Medicine, School of Medicine, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran
  10. 10. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  11. 11. Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran

Source: International Journal of Infectious Diseases Published:2021


Abstract

Objective: The COVID-19 pandemic has called an urgent need for drug repurposing to improve the outcome of the disease. Quaternary ammonium compounds have been demonstrated to have antiviral effects and may be of use against SARS-CoV-2 infections. Design: In this double-blind, single-center study, we enrolled patients with positive PCR test and/or CT findings for COVID-19. The participants of each group were randomly assigned to Diphenhydramine Compound (Diphenhydramine + Ammonium Chloride) plus standard of care or to Diphenhydramine alone and standard of care groups. The primary outcome was all-cause mortality within 30 days of randomization. Secondary outcomes include viral burden, clinical status, assessed by a 5-point ordinal scale, and length of stay in hospitalized patients. Results: A total of 120 patients were included in the trial, 60 of which were assigned to the Ammonium Chloride group. The primary endpoint was not statistically different between the two groups (HR: 3.02 (95% CI, 0.57–16.06; p = 0.195)). Recovery time and viral burden were significantly lower in the Ammonium Chloride group, corresponding to an odds ratios of 1.8 (95% CI, 1.15–2.83; p = 0.01) and 7.90 (95% CI, 1.62–14.17; p = 0.014), respectively. Conclusion: The findings of this study advocate the careful addition of Ammonium Chloride to standard of care for COVID-19 patients. © 2021 The Authors