inclusion criteria: 1. patients with pcr-confirmed covid-19 2. minimal age:18 years 3. agree to participate in the trial with written informed consent 4. moderate or severe covid-19 at the time of enrollment . a. definition of moderate disease (according to siddiqi et al): moderate covid-19 is defined as disease with fever, respiratory symptoms (dry cough, chest distress, or shortness of breath after activities), and pulmonary imaging findings, and at least one of the following findings: i) abnormal coagulation parameters: * d-dimer \>1 µg/ml (normal \<0.5 µg/ml) * prothrombin time (\>13.6 second) or international normalized ratio (inr) ≥1.8 * thrombocyte count \<100x 10\^3/ml ii) increased pro-inflammatory markers: * c-reactive protein (crp) ≥26.9 mg/l * procalcitonin ≥0.5 ng/ml, * lymphocyte count \<1.5x 10\^9/l) or neutrophil/lymphocyte ratio (nlr) \>3.3 iii) presence of risk factors or comorbidities: * age \>65 years * type 1 diabetes mellitus or type 2 diabetes mellitus (with any of the following: fasting blood glucose ≥126 mg/dl, 2-h plasma glucose ≥200 mg/dl, or random plasma glucose ≥200 mg/dl, plus hba1c \>6.5%) * chronic kidney disease (creatinine \>2.0 mg/dl) or with routine hemodialysis * chronic liver disease with signs of liver cirrhosis; child-turcotte-pugh (ctp) class a (score 5-6) or class b (score 7-9) or higher; or model for end-stage liver disease (meld) score \<39 * heart failure (new york health association \[nyha\] class i or ii) * bronchial asthma, chronic obstructive pulmonary disease (copd), or pulmonary tuberculosis * cancer (particularly patients with chemotherapy or immunotherapy) * immunocompromised conditions, including hiv/aids, post-organ transplantation, or judged by attending physician (preferable after specialist consultation) * long-term corticosteroid use * autoimmune disease * sequential organ failure assessment \[sofa\] score ≥5.65 * body mass index (bmi) ≥35 kg/m2 b. definition of severe covid-19 (according to siddiqi et al): severe covid-19 is defined as disease with a respiratory rate ≥30 breaths/min, oxygen saturation \<90% or oxygenation index (pao2/fio2) ≤300 mmhg, and/or lung infiltrates \>50% within 24-48 h.

inclusion criteria: 1. patients with pcr-confirmed covid-19 2. minimal age:18 years 3. agree to participate in the trial with written informed consent 4. moderate or severe covid-19 at the time of enrollment . a. definition of moderate disease (according to siddiqi et al): moderate covid-19 is defined as disease with fever, respiratory symptoms (dry cough, chest distress, or shortness of breath after activities), and pulmonary imaging findings, and at least one of the following findings: i) abnormal coagulation parameters: * d-dimer \>1 µg/ml (normal \<0.5 µg/ml) * prothrombin time (\>13.6 second) or international normalized ratio (inr) ≥1.8 * thrombocyte count \<100x 10\^3/ml ii) increased pro-inflammatory markers: * c-reactive protein (crp) ≥26.9 mg/l * procalcitonin ≥0.5 ng/ml, * lymphocyte count \<1.5x 10\^9/l) or neutrophil/lymphocyte ratio (nlr) \>3.3 iii) presence of risk factors or comorbidities: * age \>65 years * type 1 diabetes mellitus or type 2 diabetes mellitus (with any of the following: fasting blood glucose ≥126 mg/dl, 2-h plasma glucose ≥200 mg/dl, or random plasma glucose ≥200 mg/dl, plus hba1c \>6.5%) * chronic kidney disease (creatinine \>2.0 mg/dl) or with routine hemodialysis * chronic liver disease with signs of liver cirrhosis; child-turcotte-pugh (ctp) class a (score 5-6) or class b (score 7-9) or higher; or model for end-stage liver disease (meld) score \<39 * heart failure (new york health association \[nyha\] class i or ii) * bronchial asthma, chronic obstructive pulmonary disease (copd), or pulmonary tuberculosis * cancer (particularly patients with chemotherapy or immunotherapy) * immunocompromised conditions, including hiv/aids, post-organ transplantation, or judged by attending physician (preferable after specialist consultation) * long-term corticosteroid use * autoimmune disease * sequential organ failure assessment \[sofa\] score ≥5.65 * body mass index (bmi) ≥35 kg/m2 b. definition of severe covid-19 (according to siddiqi et al): severe covid-19 is defined as disease with a respiratory rate ≥30 breaths/min, oxygen saturation \<90% or oxygenation index (pao2/fio2) ≤300 mmhg, and/or lung infiltrates \>50% within 24-48 h.

inclusion criteria: patients with pcr-confirmed covid-19 minimal age:18 years agree to participate in the trial with written informed consent moderate or severe covid-19 at the time of enrollment . a. definition of moderate disease (according to siddiqi et al): moderate covid-19 is defined as disease with fever, respiratory symptoms (dry cough, chest distress, or shortness of breath after activities), and pulmonary imaging findings, and at least one of the following findings: i) abnormal coagulation parameters: d-dimer >1 µg/ml (normal <0.5 µg/ml) prothrombin time (>13.6 second) or international normalized ratio (inr) ≥1.8 thrombocyte count <100x 10^3/ml ii) increased pro-inflammatory markers: c-reactive protein (crp) ≥26.9 mg/l procalcitonin ≥0.5 ng/ml, lymphocyte count <1.5x 10^9/l) or neutrophil/lymphocyte ratio (nlr) >3.3 iii) presence of risk factors or comorbidities: age >65 years type 1 diabetes mellitus or type 2 diabetes mellitus (with any of the following: fasting blood glucose ≥126 mg/dl, 2-h plasma glucose ≥200 mg/dl, or random plasma glucose ≥200 mg/dl, plus hba1c >6.5%) chronic kidney disease (creatinine >2.0 mg/dl) or with routine hemodialysis chronic liver disease with signs of liver cirrhosis; child-turcotte-pugh (ctp) class a (score 5-6) or class b (score 7-9) or higher; or model for end-stage liver disease (meld) score <39 heart failure (new york health association [nyha] class i or ii) bronchial asthma, chronic obstructive pulmonary disease (copd), or pulmonary tuberculosis cancer (particularly patients with chemotherapy or immunotherapy) immunocompromised conditions, including hiv/aids, post-organ transplantation, or judged by attending physician (preferable after specialist consultation) long-term corticosteroid use autoimmune disease sequential organ failure assessment [sofa] score ≥5.65 body mass index (bmi) ≥35 kg/m2 b. definition of severe covid-19 (according to siddiqi et al): severe covid-19 is defined as disease with a respiratory rate ≥30 breaths/min, oxygen saturation <90% or oxygenation index (pao2/fio2) ≤300 mmhg, and/or lung infiltrates >50% within 24-48 h.

inclusion criteria: patients with pcr-confirmed covid-19 minimal age:18 years agree to participate in the trial with written informed consent moderate or severe covid-19 at the time of enrollment . a. definition of moderate disease (according to siddiqi et al): moderate covid-19 is defined as disease with fever, respiratory symptoms (dry cough, chest distress, or shortness of breath after activities), and pulmonary imaging findings, and at least one of the following findings: i) abnormal coagulation parameters: d-dimer >1 µg/ml (normal <0.5 µg/ml) prothrombin time (>13.6 second) or international normalized ratio (inr) ≥1.8 thrombocyte count <100x 10^3/ml ii) increased pro-inflammatory markers: c-reactive protein (crp) ≥26.9 mg/l procalcitonin ≥0.5 ng/ml, lymphocyte count <1.5x 10^9/l) or neutrophil/lymphocyte ratio (nlr) >3.3 iii) presence of risk factors or comorbidities: age >65 years type 1 diabetes mellitus or type 2 diabetes mellitus (with any of the following: fasting blood glucose ≥126 mg/dl, 2-h plasma glucose ≥200 mg/dl, or random plasma glucose ≥200 mg/dl, plus hba1c >6.5%) chronic kidney disease (creatinine >2.0 mg/dl) or with routine hemodialysis chronic liver disease with signs of liver cirrhosis; child-turcotte-pugh (ctp) class a (score 5-6) or class b (score 7-9) or higher; or model for end-stage liver disease (meld) score <39 heart failure (new york health association [nyha] class i or ii) bronchial asthma, chronic obstructive pulmonary disease (copd), or pulmonary tuberculosis cancer (particularly patients with chemotherapy or immunotherapy) immunocompromised conditions, including hiv/aids, post-organ transplantation, or judged by attending physician (preferable after specialist consultation) long-term corticosteroid use autoimmune disease sequential organ failure assessment [sofa] score ≥5.65 body mass index (bmi) ≥35 kg/m2 b. definition of severe covid-19 (according to siddiqi et al): severe covid-19 is defined as disease with a respiratory rate ≥30 breaths/min, oxygen saturation <90% or oxygenation index (pao2/fio2) ≤300 mmhg, and/or lung infiltrates >50% within 24-48 h.

inclusion criteria: 1. patients with pcr-confirmed covid-19 2. minimal age:18 years 3. agree to participate in the trial with written informed consent 4. moderate or severe covid-19 at the time of enrollment . a. definition of moderate disease (according to siddiqi et al): moderate covid-19 is defined as disease with fever, respiratory symptoms (dry cough, chest distress, or shortness of breath after activities), and pulmonary imaging findings, and at least one of the following findings: i) abnormal coagulation parameters: - d-dimer >1 µg/ml (normal <0.5 µg/ml) - prothrombin time (>13.6 second) or international normalized ratio (inr) ≥1.8 - thrombocyte count <100x 10^3/ml ii) increased pro-inflammatory markers: - c-reactive protein (crp) ≥26.9 mg/l - procalcitonin ≥0.5 ng/ml, - lymphocyte count <1.5x 10^9/l) or neutrophil/lymphocyte ratio (nlr) >3.3 iii) presence of risk factors or comorbidities: - age >65 years - type 1 diabetes mellitus or type 2 diabetes mellitus (with any of the following: fasting blood glucose ≥126 mg/dl, 2-h plasma glucose ≥200 mg/dl, or random plasma glucose ≥200 mg/dl, plus hba1c >6.5%) - chronic kidney disease (creatinine >2.0 mg/dl) or with routine hemodialysis - chronic liver disease with signs of liver cirrhosis; child-turcotte-pugh (ctp) class a (score 5-6) or class b (score 7-9) or higher; or model for end-stage liver disease (meld) score <39 - heart failure (new york health association [nyha] class i or ii) - bronchial asthma, chronic obstructive pulmonary disease (copd), or pulmonary tuberculosis - cancer (particularly patients with chemotherapy or immunotherapy) - immunocompromised conditions, including hiv/aids, post-organ transplantation, or judged by attending physician (preferable after specialist consultation) - long-term corticosteroid use - autoimmune disease - sequential organ failure assessment [sofa] score ≥5.65 - body mass index (bmi) ≥35 kg/m2 b. definition of severe covid-19 (according to siddiqi et al): severe covid-19 is defined as disease with a respiratory rate ≥30 breaths/min, oxygen saturation <90% or oxygenation index (pao2/fio2) ≤300 mmhg, and/or lung infiltrates >50% within 24-48 h.

inclusion criteria: 1. patients with pcr-confirmed covid-19 2. minimal age:18 years 3. agree to participate in the trial with written informed consent 4. moderate or severe covid-19 at the time of enrollment . a. definition of moderate disease (according to siddiqi et al): moderate covid-19 is defined as disease with fever, respiratory symptoms (dry cough, chest distress, or shortness of breath after activities), and pulmonary imaging findings, and at least one of the following findings: i) abnormal coagulation parameters: - d-dimer >1 µg/ml (normal <0.5 µg/ml) - prothrombin time (>13.6 second) or international normalized ratio (inr) ≥1.8 - thrombocyte count <100x 10^3/ml ii) increased pro-inflammatory markers: - c-reactive protein (crp) ≥26.9 mg/l - procalcitonin ≥0.5 ng/ml, - lymphocyte count <1.5x 10^9/l) or neutrophil/lymphocyte ratio (nlr) >3.3 iii) presence of risk factors or comorbidities: - age >65 years - type 1 diabetes mellitus or type 2 diabetes mellitus (with any of the following: fasting blood glucose ≥126 mg/dl, 2-h plasma glucose ≥200 mg/dl, or random plasma glucose ≥200 mg/dl, plus hba1c >6.5%) - chronic kidney disease (creatinine >2.0 mg/dl) or with routine hemodialysis - chronic liver disease with signs of liver cirrhosis; child-turcotte-pugh (ctp) class a (score 5-6) or class b (score 7-9) or higher; or model for end-stage liver disease (meld) score <39 - heart failure (new york health association [nyha] class i or ii) - bronchial asthma, chronic obstructive pulmonary disease (copd), or pulmonary tuberculosis - cancer (particularly patients with chemotherapy or immunotherapy) - immunocompromised conditions, including hiv/aids, post-organ transplantation, or judged by attending physician (preferable after specialist consultation) - long-term corticosteroid use - autoimmune disease - sequential organ failure assessment [sofa] score ≥5.65 - body mass index (bmi) ≥35 kg/m2 b. definition of severe covid-19 (according to siddiqi et al): severe covid-19 is defined as disease with a respiratory rate ≥30 breaths/min, oxygen saturation <90% or oxygenation index (pao2/fio2) ≤300 mmhg, and/or lung infiltrates >50% within 24-48 h.