Relationship between Vitamin D, Vitamin C, and Selenium Intake and Disease Severity and Outcomes in Patients Hospitalized with COVID-19: A Retrospective Study

Background and purpose: COVID-19 is a viral respiratory disease that results in high mortality. Evidence suggests that micronutrients affect viral and bacterial infections. This study was performed to evaluate the effectiveness of micronutrients (vitamin D, vitamin C, and selenium) on the disease severity in patients hospitalized with COVID-19. Materials and methods: This retrospective cross-sectional study was carried out in patients with diagnosis of COVID-19 in Qaemshahr Razi Hospital, 2020. Medical records were reviewed and 42 were selected. Data of patients that received micronutrients including vitamin D, vitamin C, and selenium and those that did not receive these supplements were compared. Duration of hospitalization, respiratory support, oxygen therapy, requiring invasive/non-invasive mechanical ventilation, and incident of death were investigated. Statistical analysis was done in SPSS V25. Results: Survival rates in the groups receiving vitamin C, D, and selenium were not significantly different from the groups that did not receive these supplements (P= 0.42, 0.63, 0.084, respectively). The study showed no significant relationship between vitamin D, C, and selenium intake and the need for ventilation due to respiratory distress (P= 0.139, 0.2, and 0.8, respectively). Conclusion: No remarkable difference was seen between the recipients of vitamin C, D, and selenium and those who did not receive supplements in terms of survival and the need for mechanical ventilation. So, these supplements did not affect the clinical outcomes of patients with COVID-19

The Efficacy and Safety of Adding Chlorpromazine to Atazanavir/Ritonavir Regimen in the Treatment of Moderate COVID-19 Patients, a Randomized Double-blind Clinical Trial

Background: According to COVID-19 mutation and no defined treatment, it is necessary to find effective treatment. Chlorpromazine, a phenothiazine antipsychotic drug, has been shown in animal studies to have antiviral effects by inhibiting clathrin-mediated endocytosis. The aim of this study was to evaluate the effectiveness of adding chlorpromazine to the atazanavir/ritonavir regimen in the treatment of moderate COVID-19 patients. Methods: In this randomized double-blind clinical trial, sixty hospitalized patients with moderate COVID-19 confirmed by CT findings or polymerase chain reaction (PCR) were enrolled. All patients received atazanavir/ritonavir 300mg/100mg once daily. In two parallel groups, chlorpromazine 25 mg three times a day or a placebo was administered for up to 14 days. Complete blood count with differential, C-reactive protein (CRP), liver enzymes, and erythrocyte sedimentation rate was measured on days 1, 3, 5, 7, and 10. The primary outcome was the improvement of oxygen saturation and the secondary outcome was the duration of hospitalization and conversion of PCR test results.  Results: Oxygen saturation during the hospitalization was not different among the two groups. The mean duration of hospitalization in the chlorpromazine group was 7.4±2.7 days and in the placebo was 8.2±3 days (P=0.2). Compared to baseline, both groups showed an increase in white blood cell count (P=0.04) and polymorphonuclear cells (P=0.04) but lymphocyte count decreased. At the end of the study, the PCR test was negative in 100% of patients in the chlorpromazine group and 95% of patients in the placebo group. Conclusion: In adult hospitalized patients with moderate symptomatic COVID-19, adding chlorpromazine to the atazanavir/ritonavir regimen did not improve outcomes