Evaluation of the Efficacy of Arbidol in Comparison with the Standard Treatment Regimen of Hospitalized Patients with Covid-19: A Randomized Clinical Trial

Abstract

Background: Coronavirus disease 2019 (COVID-19) is an infectious illness that causes severe respiratory disease of varying severity. The disease was first reported in Wuhan (China) and caused the first pandemic of the new millennium. Still, a global push is on the way to develop a treatment for COVID-19. Arbidol (Umifenovir) is an orally administered antiviral agent approved for the prophylaxis and treatment of influenza types A and B, SARS, and Lassa viruses in Russia and China. Objectives: The current study aimed to investigate the effectiveness of Arbidol in patients with mild to moderate and severe symptoms suffering from COVID-19. Methods: The first phase of the research was a retrospective study on 47 patients (18 females and 29 males) with mild to moderate symptoms suffering from COVID-19 who were admitted to Labafinejad Hospital in Tehran, Iran, from March to April 2020. Patients were separated into two groups of Hydroxicholoroquine and Kaletra as control (7 subjects) (1a) and intervention. The experiment group who were 20 COVID-19 patients (16 males and 4 females) with mild to moderate symptoms were received Hydroxicholoroquine, Kaletra, and Arbidol (1b). Also, two groups comprised of 17 patients (13 males and 4 females) with severe symptoms of COVID-19 infection who received Hydroxicholoroquine, Kaletra, and Ribavirin as the control group (2a) and 17 patients (13 males and 4 females) with severe symptoms who received Hydroxicholoroquine, Kaletra, Ribavirin, and Arbidol (2b) were compared. Results: The average temperature of patients in groups 1a and 1b (both suffering from mild to moderate illness) on the fifth day of admission was 37.3 and 36.4°C, respectively, which was statistically significant (P value = 0.07). Concerning the respiratory rate, patients in group 1b were significantly different on the fifth day of admission (P value = 0.015). The comparison of neutrophil to lymphocyte (N/L) ratio in the complete blood cell count on the fifth day of admission showed a significant difference (P value = 0.024) between the two groups. Mean O2 saturation on the fifth day of admission in groups 1a and 1b was 91.9% and 94%, respectively, which was significant (P value = 0.04). In groups suffering from severe disease, no significant difference was found regarding the O2 saturation, respiratory rate, and temperature. Also, in laboratory tests, no significant difference was observed in N/L and Plt/L ratios five days after admission. This study demonstrated that Arbidol didn’t cause any significant change in the hospitalization period and mortality rate of COVID-19 patients. Conclusions: In COVID-19 patients with mild to moderate symptoms, treatment with Arbidol could decrease the duration of fever and improved O2 saturation and respiratory rate on the fifth day of admission. The N/L ratio was significantly different in patients with mild to moderate symptoms who received Arbidol, but in patients with severe symptoms, Arbidol couldn’t improve O2 saturation and respiratory rate and was not associated with decreased temperature. Moreover, there was no significant difference concerning the N/L and plt/L ratios and severely of the disease.