Intervention and measurement
The routin regimen include: Azithromycin 500 mg/daily, Hydroycholoroquine 200 mg/12 h (subgroup A), which can fallowed with Lopinavir/ritonavir ( 200/50 mg tablets two times/12h) if patients need and their hospitalization continued and their conditions worsened, with or with out Ribavirin (1200 mg/daily) (subgroup B).
Patients received Acetaminophen for fever as needed, Antiacid(Pantoprazole) for prevention of gastritis induced by stress or drugs, and other antimicrobial empiric treatments for secondary bacterial pneumonia if they need (Levofloxacin 500 mg/daily, vancomycin 1gr/12h, meropenem 1gr/8h, ceftriaxone 1gr/12h).
The severity of patient’s disease evaluated with National Early Warning Score (NEWS) which is used for standardizing the assessment of acute illness severity in the NHS (physicians, 2017), in this scoring we gave scores to patients vital signs (PR,RR,T,SO2,SYS BP), the level of consciousness and requirement to supplemental oxygen at the first visit when they admitted, scores between 1-4 show Mild disease, 5-6 show Moderate disease and >=7 show severe disease, and the degree of involvement of their lungs at chest CT scans to compare the severity of disease between our two groups with an expert radiologist in this hospital, according to this score both lungs divided into 5 lobes and each lobe can get a score of involvement between 1 to 5 so every CT scans scored between 1 to 25 (Assistant, 2020).