Background: Adult T-cell leukemia (ATL) is one of the most important hematological malignancies caused by the HTLV-I virus. The disease has a poor prognosis due to the low median survival of the patients. Aim: Given the need for effective therapeutic interventions, this study aimed to investigate the efficacy of Hyper-CVAD and As/IFN/AZT regimens and compare their performance. Methods and Results: This study is a randomized clinical trial conducted on individuals recently diagnosed with acute ATL. Individuals who tested positive in a HTLV-I serological test based on ELISA and/or PCR were randomly assigned to receive treatment with either Hyper-CVAD or As/IFN/AZT using block randomization. The drug regimens were administered for 60 days, and patients underwent follow-up assessments. Overall, 29 individuals were enrolled in the trial. No significant differences were found in gender distribution, LDH levels, and lymphocyte counts between the two groups (P-value>0.05). The treatment response rates for the Hyper-CVAD and As/IFN/AZT regimens were 46.67% and 35.71%, respectively, with no significant differences between the two groups (P-value >0.05). Survival analysis revealed a significant difference in survival between the two groups, favoring those under the Hyper-CVAD regimen (P-value<0.05). The predominant toxicities were hematological toxicities; one patient in the Hyper-CVAD group experienced Grade 3 toxicity, while three patients in the As/IFN/AZT group experienced Grade 3 toxicity. Conclusion: The results of this study suggest no significant differences in efficacy between the Hyper-CVAD and As/IFN/AZT regimens. Additionally, higher toxicity rates were observed in the As/IFN/AZT regimen. Further investigations into frontline treatments and the timing of the As/IFN/AZT regimen in future studies may provide valuable insights in this regard. Clinical Trial Registration: IRCT20210703051770N1.

Background: The emergence of the coronavirus disease in late 2019 (COVID-19) has become one of the greatest health problems of the 21st century. Many aspects of this viral disease are still hidden. The current study is conducted to investigate COVID-19’s clinical manifestation, mortality factors, and their association with each other in the COVID-19 pandemic in Razavi-Khorasan province, Iran. Methods & Materials: This retrospective epidemiological population-based study was conducted from January 21, 2020, to March 20, 2021. The data including demographic characteristics and clinical presentations of the patients were extracted from the Medical Care Monitoring System (MCMC), disease management portal in the deputy of health and Hospital Information System (HIS). Results: A total of 80499 patients were admitted to all hospitals of Khorasan-Razavi University of Medical Sciences with laboratory/clinical COVID-19 confirmed disease, between January 2020 and March 2021. The male-to-female ratio was 1.10:1 and the mean age of our COVID-19 individuals was 55.67 ± 23.27. The most frequently reported presenting symptoms at admission were respiratory distress (58.2%), fever (36.7%), and cough (34.9%), and alternation in smell/taste (0.9%) was the less frequent. Being male, aging older than 60 years and having comorbidities were significantly associated with higher mortality rates. Conclusion: Due to the genetic mutations in the virus and the emergence of the new variants of the virus, clinical presentations, and mortality rates of the COVID-19 have been shifted through three reviewed waves. Further studies are needed to determine the impact of the new variants of the virus on individuals.