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Sofosbuvir and Daclatasvir Compared With Standard of Care in the Treatment of Patients Admitted to Hospital With Moderate or Severe Coronavirus Infection (Covid-19): A Randomized Controlled Trial Publisher Pubmed



Sadeghi A1 ; Asgari AA1 ; Norouzi A2 ; Kheiri Z3 ; Anushirvani A1 ; Montazeri M4 ; Hosamirudsai H5 ; Afhami S6 ; Akbarpour E1 ; Aliannejad R7 ; Radmard AR8 ; Davarpanah AH9 ; Levi J10 ; Wentzel H11 Show All Authors
Authors
  1. Sadeghi A1
  2. Asgari AA1
  3. Norouzi A2
  4. Kheiri Z3
  5. Anushirvani A1
  6. Montazeri M4
  7. Hosamirudsai H5
  8. Afhami S6
  9. Akbarpour E1
  10. Aliannejad R7
  11. Radmard AR8
  12. Davarpanah AH9
  13. Levi J10
  14. Wentzel H11
  15. Qavi A11
  16. Garratt A12
  17. Simmons B13
  18. Hill A14
  19. Merat S1
Show Affiliations
Authors Affiliations
  1. 1. Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Science, Gorgan, Iran
  3. 3. Department of Internal Medicine, Baharloo hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of infectious diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Infectious Diseases, Baharloo Hospital, Tehran University of Medical Science, Tehran, Iran
  6. 6. Department of infectious diseases, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
  7. 7. Department of Pulmonary and Critical Care, Shariati Hospital, Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
  10. 10. Department of Emergency Medicine, Homerton University Hospital, London, United Kingdom
  11. 11. School of Public Health, Imperial College London, London, United Kingdom
  12. 12. Cardiff and Vale University Health Board, Cardiff, United Kingdom
  13. 13. Department of Infectious Disease, Imperial College London, London, United Kingdom
  14. 14. Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, United Kingdom

Source: Journal of Antimicrobial Chemotherapy Published:2020


Abstract

Background: Currently no effective antiviral therapy has been found to treat COVID-19. The aim of this trial was to assess if the addition of sofosbuvir and daclatasvir improved clinical outcomes in patients with moderate or severe COVID-19. Methods: This was an open-label, multicentre, randomized controlled clinical trial in adults with moderate or severe COVID-19 admitted to four university hospitals in Iran. Patients were randomized into a treatment arm receiving sofosbuvir and daclatasvir plus standard care, or a control arm receiving standard care alone. The primary endpoint was clinical recovery within 14 days of treatment. The study is registered with IRCT.ir under registration number IRCT20200128046294N2. Results: Between 26 March and 26 April 2020, 66 patients were recruited and allocated to either the treatment arm (n = 33) or the control arm (n = 33). Clinical recovery within 14 days was achieved by 29/33 (88%) in the treatment arm and 22/33 (67%) in the control arm (P = 0.076). The treatment arm had a significantly shorter median duration of hospitalization [6 days (IQR 4-8)] than the control group [8 days (IQR 5-13)]; P = 0.029. Cumulative incidence of hospital discharge was significantly higher in the treatment arm versus the control (Gray's P = 0.041). Three patients died in the treatment arm and five in the control arm. No serious adverse events were reported. Conclusions: The addition of sofosbuvir and daclatasvir to standard care significantly reduced the duration of hospital stay compared with standard care alone. Although fewer deaths were observed in the treatment arm, this was not statistically significant. Conducting larger scale trials seems prudent. © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
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