- oxygen saturation at admission ≤96%. - high temperature ≥100 deg f (≥37.5 deg c) not controlled on oral doses of acetaminophen. - known history of diabetes on oral medications or insulin. - il-6 levels ≥ 3times of laboratory reference range and / or significantly elevated levels of crp, serum ferritin or d-dimer. - lymphocyte / monocyte ratio ≤3 or neutrophil / lymphocyte ratio ≥5 or platelet count ≤150,000 cells per microliter - on any chronic medications for more than 4 weeks before randomization or active malignancy or having any co-morbidity that increases risk of rapid disease progression. - previously tested positive and recovered from covid-19

- oxygen saturation at admission ≤96%. - high temperature ≥100 deg f (≥37.5 deg c) not controlled on oral doses of acetaminophen. - known history of diabetes on oral medications or insulin. - il-6 levels ≥ 3times of laboratory reference range and / or significantly elevated levels of crp, serum ferritin or d-dimer. - lymphocyte / monocyte ratio ≤3 or neutrophil / lymphocyte ratio ≥5 or platelet count ≤150,000 cells per microliter - on any chronic medications for more than 4 weeks before randomization or active malignancy or having any co-morbidity that increases risk of rapid disease progression. - previously tested positive and recovered from covid-19