Background: COVID-19 is a new disease for which a definitive treatment has not yet been proposed.
Objectives: The present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance
of finding an appropriate treatment for this epidemic disease.
Methods: This two-center cohort study included 175 confirmed COVID-19 inpatients at two medical centers designated for the treatment
of COVID-19 patients in Qom and Qazvin, Iran. In this study, four different groups of drug regimens were studied which included
G1 (azithromycin, prednisolone, and naproxen), G2 (lopinavir/ritonavir, azithromycin, naproxen, and prednisolone), G3
(hydroxychloroquine, azithromycin, naproxen, and prednisolone), and G4 (levofloxacin, vancomycin, hydroxychloroquine, and
oseltamivir). It should be noted that G1, G2, G3, and G4 treatment regimens were used on 48, 39,30, and 77 patients, respectively.
Results: The study participants included 175 confirmed COVID-19 patients with mean±SD age of 58.9 ±15.1 years, out of whom 80 (46%)
patients were male and the rest were females. The results indicated that the hospital stay period was significantly shorter in the G1
compared to other groups (G1:5.9±2.4, G2:8.1±4.2, G3: 6.3±1.7, and G4: 6.4±2.9; [P-value=0.008]). It should be noted that pulse rate,
oxygen saturation, hemoglobin, and platelet count (PLT) changed significantly during the study in four treatment groups; however, a
significant change in temperature, creatinine, and white blood cell (WBC) was observed only in G3, G4, and G1 groups, respectively. The
number of ICU admissions and deaths were not statistically significant among the patients who received the four treatment regimens
(P=0.785). Based on the results, the history of ischemic heart disease, baseline oxygen saturation, WBC, neutrophil, lymphocyte count, and
C-reactive protein (CRP) are the risk factors for the prolonged hospital stay in COVID-19 patients.
Conclusion: The obtained results in this study indicated that the combination of azithromycin, prednisolone, and naproxen is the most
effective regimen for the treatment of COVID-19, compared to three other combination treatment regimens.
Keywords: Anti-inflammatory drugs, Antiviral drugs, Combination therapy, Corticosteroid, COVID-19, Immunomodulators drug
