Introduction and Objectives: After successful treatment of hepatitis C virus (HCV) infection with direct-acting antivirals (DAAs), the stage of liver fibrosis decreases by time. Here, we aimed to assess the changes in liver fibrosis stage using transient elastography (TE) after successful DAA therapy in HCV-infected cirrhotic patients who referred to Shariati hospital from 2016 to 2017. Material and Methods: In this observational cohort, all HCV-infected cirrhotic patients who were treated with a combination of sofosbuvir/daclatasvir and had achieved sustained virologic response (SVR) and also had undergone pre- and post-treatment TE, were enrolled. The primary outcome was the changes in TE parameters six months after the end of treatment compared to baseline. Results: A total of 442 eligible subjects received DAA therapy. Overall, the SVR rate was 96.6%. Of these, 149 patients had completed the protocol and were enrolled. The mean age of patients was 56.1±10.3 years and the predominant sex was male (77.9%). The median (Q1-Q3) liver stiffness (LS) value at baseline was 26.3 kPa (18.1-38 kPa), which significantly decreased to 20.9 kPa (12-29.7 kPa) [z = -8.45, p-value < 0.001]. Also, the liver steatosis of patients with baseline CAP ≥ 220 dB/m had a significant response to treatment [z = -2.3, p-value = 0.023]. Based on multivariate analysis, a higher baseline liver fibrosis stage was the only determinant of LS values improvement in our study. Conclusion: Successful HCV eradication in patients with liver fibrosis results in significant improvement in LS, even in cirrhotic patients.

OBJECTIVE We reported the clinical characteristics, laboratory findings, and radiologic features of a COVID-19 registry in Iran and compared disease manifestations between the deceased patients and those who recovered. DESIGN This was a retrospective cross-sectional study with census sampling. SETTING Three hundred forty-five patients were enrolled from February 25th, 2020, to April 21st, 2020, in a tertiary referral hospital. PARTICIPANTS Patients with suggestive lung computed tomography scans (CT scans) who had respiratory symptoms and one of the followings: 1) loss of consciousness, 2) Respiratory rate more than 24, 3) pulse rate more than 90, 4) Systolic blood pressure less than 90 mmHg, 5) abnormal respiratory sounds, or 6) O2 saturation less than 93% or high-risk patients with respiratory symptoms or fever were enrolled to the study. MAIN OUTCOME MEASURES The primary outcome measures were days of hospital stay, any event of intubation, ICU admission, and in-hospital death. Logistic regression was done to assess the association between survival status and patients’ characteristics. RESULTS Nearly 45% of patients were older than 65 years, and 57.6% were male. Twenty hundred and sixty-five patients (74.8%) survived. Univariate analysis showed a significant association between mortality and older age, higher body mass index, aspartate transaminase, consciousness, cancer, organ transplant, oxygen saturation (SO2), systolic and diastolic blood pressure, body temperature, respiratory rate, pulse rate, anemia, leukocytosis, neutrophil to lymphocyte ratio (NLR), thrombocytopenia, creatinine, CRP, PH, PCO2, and bicarbonate. The relationship between mortality and consciousness, cancer, low SO2, tachycardia, platelet count less than 150,000 per microliter of blood, creatinine over 1.2 mg/dL remained statistically significant in multivariate analysis. The average total length of hospital stay was 5.98 days (SD: 5.87). CONCLUSION We observed that increased tachycardia, high-grade fever, tachypnea, and NLR strongly correlated with in-hospital death. In contrast, higher levels of systolic blood pressure had a protective role.