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Sphingosine 1\u2010phosphate (S1P) signaling is needed for endothelial integrity and its decreased serum level is a predictor of clinical severity in COVID\u201019. In this clinical trial, the effect of Fingolimod, an agonist of S1P, was evaluated on patients with COVID\u201019. Forty patients with moderate to severe COVID\u201019 were enrolled and divided into two groups including (1) the control group (<jats:italic>n<\/jats:italic>\u00a0=\u200921) receiving the national standard regimen for COVID\u201019 patients and (2) the intervention group (<jats:italic>n<\/jats:italic>\u00a0=\u200919) that prescribed daily Fingolimod (0.5\u00a0mg) for 3\u2009days besides receiving the standard national regimen for COVID\u201019. The hospitalization period, re\u2010admission rate, intensive care unit (ICU) administration, need for mechanical ventilation, and mortality rate were assessed as primary outcomes in both groups. The results showed that re\u2010admission was significantly decreased in COVID\u201019 patients who received Fingolimod compared to the controls (<jats:italic>p<\/jats:italic>\u00a0=\u2009.04). In addition, the hemoglobin levels of the COVID\u201019 patients in the intervention group were increased compared to the controls (<jats:italic>p<\/jats:italic>\u00a0=\u2009.018). However, no significant differences were found regarding the intubation or mortality rate between the groups (<jats:italic>p<\/jats:italic>\u00a0&gt;\u2009.05). Fingolimod could significantly reduce the re\u2010admission rate after hospitalization with COVID\u201019. Fingolimod may not enhance patients' outcomes with moderate COVID\u201019. It is necessary to examine these findings in a larger cohort of patients with severe to critical COVID\u201019.<\/jats:p>","DOI":"10.1002\/prp2.1039","type":"journal-article","created":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T06:15:15Z","timestamp":1672035315000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The effect of Fingolimod on patients with moderate to severe <scp>COVID<\/scp>\u201019"],"prefix":"10.1002","volume":"11","author":[{"given":"Soheil","family":"Teymouri","sequence":"first","affiliation":[{"name":"Tuberculosis and Lung Disease Research Center Tabriz University of Medical Sciences  Tabriz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siamak","family":"Pourbayram Kaleybar","sequence":"additional","affiliation":[{"name":"Kidney Research Center Faculty of Medicine Tabriz University of Medical Sciences  Tabriz Iran"},{"name":"Student Research Committee Tabriz 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