RESULTS
In this study, the mean age of the patients was 57.82 ± 18.23 years, and
the mean hospitalization duration was 10.13 ± 6.07 days. In respect of
sex, 31 patients (51.7%) were female, without any significant
differences between the groups. Table 1 and Table 2 present the clinical
and paraclinical characteristics of the study population at admission
and discharge showing that CRP (F =9.102, P =0.008), alkaline
phosphatase (ALP) (F =7.650, P =0.001), and diff_segment (F
=5.156, P =0.007) at discharge were different between the 4
groups in such a way that the atazanavir/ritonavir + HCQ + NAC group had
the lowest value concerning CRP. Regarding ALP at discharge, the Kaletra
+ HCQ + NAC group had the highest value. Furthermore, diff_segment had
the highest value in the atazanavir/ritonavir + HCQ + NAC group.
According to the χ2 test, 6 patients in the Kaletra +
HCQ group received intravenous immune globulin (IVIG), while the
atazanavir/ritonavir + HCQ + NAC group did not receive any IVIG, with
the difference constituting statistical significance (P =0.015).
Given that the patients were randomly divided into 4 groups, the groups
were different with respect to fatigue and anorexia, cardiovascular
diseases, and hypertension (Table 3). Regarding binary variables, most
cases of fever were reported in the atazanavir/ritonavir + HCQ + NAC
group (n =12), most cases of cough in the atazanavir/ritonavir + HCQ +
NAC group (n =13) most cases of dyspnea in the atazanavir/ritonavir +
HCQ + NAC group (n =13), and most cases of fatigue in the
atazanavir/ritonavir + HCQ + NAC group (n =13) and the
atazanavir/ritonavir + HCQ group (n =13). Additionally, 12 cases of body
aches were reported in the atazanavir/ritonavir + HCQ group, 4 cases of
diarrhea in the Kaletra + HCQ group, 7 cases of sore throat in the
atazanavir/ritonavir + HCQ+ NAC group, 7 cases of chest discomfort in
the Kaletra + HCQ group, 7 cases of headache in the atazanavir/ritonavir
+ HCQ group, 14 cases of dizziness in the Kaletra + HCQ group + NAC,
only 1 case of seizure in the atazanavir/ritonavir + HCQ + NAC group, 6
cases of olfactory dysfunction in the Kaletra + HCQ + NAC group (fewest
cases of olfactory dysfunction were observed in the Kaletra + HCQ + NAC
group and the atazanavir/ritonavir + HCQ + NAC group), and 5 cases of
taste disorders in the Kaletra + HCQ + NAC group.
The administration of dexamethasone, acetaminophen, azithromycin,
ceftriaxone, interferon-β, and levofloxacin was not the same across the
4 groups. For instance, 6 patients in each of the atazanavir/ritonavir +
HCQ and atazanavir/ritonavir + HCQ + NAC groups received interferon-β
(P =.002), indicating that the zero mortality in the
atazanavir/ritonavir + HCQ + NAC. Two patients in the Kaletra + HCQ
group, 1 patient in the atazanavir/ritonavir + HCQ group, and 1 patient
in the Kaletra + HCQ + NAC died; this difference, however, was not
statistically significant (χ2 =2.134, P =.896).
All the patients in the atazanavir/ritonavir + HCQ + NAC group were
discharged in good condition (Table 4).
According to the linear regression model, performed to predict the
length of stay at the ICU, the use of IVIG, creatine phosphokinase (CPK)
elevation, and ESR decrease were correlated with an increased length of
stay at the ICU (Table 5). None of the used drugs had a significant
difference regarding mortality (Table 6).
Apropos of improvement in O2 saturation with the 4 types
of medicine, the results showed that such improvement with
atazanavir/ritonavir + HCQ + NAC (P =.001) and
atazanavir/ritonavir + HCQ (P =0.008) was significant insofar as
these 2 groups had a high level of O2 saturation after
treatment by comparison with the primary O2 saturation
level (before intervention) (Table 7). No statistically significant
differences in this regard were observed between the 4 groups (P>0.05) (Table 8 and Fig. 2).