Clinical Outcomes of Pentoxifylline Use in Hospitalized COVID-19 Patients Compared with Standard Therapy (2020–2021)

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Abstract
The COVID-19 pandemic, driven by SARS-CoV-2, has challenged global healthcare systems, necessitating exploration of adjunctive therapies to mitigate severe outcomes. This retrospective cross-sectional study, conducted at Shahid Sadoughi Hospital in Yazd, Iran, from 2020 to 2021, compared clinical outcomes in 200 patients with COVID-19, divided evenly between those receiving pentoxifylline (a phosphodiesterase inhibitor with anti-inflammatory properties) in addition to standard treatment and those receiving standard therapy alone (the control group). The outcomes assessed in the study included mortality rates, hospital stay duration, ICU admissions, and inflammatory markers (CRP, LDH, ESR, WBC, and lymphocyte percentage). The group treated with pentoxifylline experienced significantly higher mortality rates, with 30% compared to 11% in the control group (P < 0.05). Additionally, the average hospital stay was longer in the pentoxifylline recipient group (14.74 ± 8.645 days) than in the control group (6.29 ± 4.048 days; P < 0.05). There was also an increased rate of ICU admissions, with 30% in the pentoxifylline recipient group versus 6% in the control group (P < 0.05). Furthermore, elevated CRP and LDH levels and lymphopenia were associated with worse outcomes in the pentoxifylline recipient group (P<0.05). These findings contrast with prior studies suggesting that pentoxifylline may reduce inflammation and improve outcomes, highlighting the need for randomized controlled trials to clarify its role in COVID-19 management. 

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