Eslami, GMousaviasl, SRadmanesh, EJelvay, SBitaraf, SSimmons, BWentzel, HHill, ASadeghi, AFreeman, JSalmanzadeh, SEsmaeilian, HMobarak, MTabibi, RKashi, AHJLotfi, ZTalebzadeh, SMWickramatillake, AMomtazan, MFarsani, MHMarjani, SMobarak, S2023-03-222023-03-222020Eslami, G., Mousaviasl, S., Radmanesh, E., Jelvay, S., Bitaraf, S., Simmons, B., Wentzel, H., Hill, A., Sadeghi, A., Freeman, J., Salmanzadeh, S., Esmaeilian, H., Mobarak, M., Tabibi, R., Jafari Kashi, A. H., Lotfi, Z., Talebzadeh, S. M., Wickramatillake, A., Momtazan, M., … Mobarak, S. (2020). The impact of sofosbuvir/daclatasvir or ribavirin in patients with severe COVID-19. Journal of Antimicrobial Chemotherapy, 75(11), 3366–3372. https://doi.org/10.1093/jac/dkaa3310305-7453http://dl.lib.uom.lk/handle/123/20792Objectives: Sofosbuvir and daclatasvir are direct-acting antivirals highly effective against hepatitis C virus. There is some in silico and in vitro evidence that suggests these agents may also be effective against SARS-CoV-2. This trial evaluated the effectiveness of sofosbuvir in combination with daclatasvir in treating patients with COVID-19. Methods: Patients with a positive nasopharyngeal swab for SARS-CoV-2 on RT–PCR or bilateral multi-lobar ground-glass opacity on their chest CT and signs of severe COVID-19 were included. Subjects were divided into two arms with one arm receiving ribavirin and the other receiving sofosbuvir/daclatasvir. All participants also received the recommended national standard treatment which, at that time, was lopinavir/ritonavir and single-dose hydroxychloroquine. The primary endpoint was time from starting the medication until discharge from hospital with secondary endpoints of duration of ICU stay and mortality. Results: Sixty-two subjects met the inclusion criteria, with 35 enrolled in the sofosbuvir/daclatasvir arm and 27 in the ribavirin arm. The median duration of stay was 5 days for the sofosbuvir/daclatasvir group and 9 days for the ribavirin group. The mortality in the sofosbuvir/daclatasvir group was 2/35 (6%) and 9/27 (33%) for the ribavirin group. The relative risk of death for patients treated with sofosbuvir/daclatasvir was 0.17 (95% CI 0.04–0.73, P = 0.02) and the number needed to treat for benefit was 3.6 (95% CI 2.1–12.1, P < 0.01). Conclusions: Given these encouraging initial results, and the current lack of treatments proven to decrease mortality in COVID-19, further investigation in larger-scale trials seems warranted.en-USantiviral agentsintensive care unitpatient dischargeribavirinarmmortalitydaclatasvirsofosbuvirsars-cov-2covid-19Article-Full-text2020Journal of Antimicrobial Chemotherapy11753366–3372https://doi.org/10.1093/jac/dkaa331