2 MATERIALS AND METHODS
2.1 Study and subjects . Patients with laboratory confirmed COVID-19 infection, diagnosed using quantitative reverse transcriptase–polymerase chain reaction (qRT-PCR), and clinical symptomatology of COVID-19 (history of fever, any respiratory symptom and chest radiographs confirmed pulmonary lesions (for moderate and severe cases), were included. The baseline characteristics of the patients for their classification are shown in Table 1.
The patients were classified into two groups according to disease severity considering the following parameters. I) Viremia: Patients with fever (>38 oC), d-dimer (0.6-0.9 mg/ml), lactate (˂2mmol/L), leukopenia, anosmia, myalgia, arthralgia, fatigue, cough, sore throat, runny nose, and sneezing. II) Severe sepsis with multi-organ dysfunction syndrome (MODS): Patients with d-dimer (˃10mg/ml), creatinine (>1.5 mg/dl), procalcitonin (+), lactate (˃2mmol/L), hypotension, electrolyte imbalance and who had any of the following were considered in critical condition: acute respiratory distress syndrome (ARDS), respiratory failure requiring mechanical ventilation, may have shock, encephalopathy, myocardial injury, heart failure, coagulation dysfunction and acute kidney injury or failure of other organs requiring admission to the intensive care unit.
In addition, patients with respiratory problems similar to COVID-19 disease but with a negative confirmatory test, were included as damage control.