Search

Background: In this study, we assessed the prevalence of positive rapid detection test (RDT) among healthcare workers (HCWs) and evaluated the role of personal protective equipment (PPE) and knowledge of the pandemic., Methods: In a cross-sectional study conducted between August 2020 and October 2020 in a tertiary referral center (Tehran, Iran), we enrolled 117 physicians, nurses, and other HCWs (OHCWs)-aides, helpers, and medical waste handlers-regularly working in coronavirus disease 2019 (COVID-19) wards. The RDT kit was utilized to reveal recent infection; data on demographics, PPE use and availability, and knowledge of the pandemic was collected through pre-defined questionnaires., Results: Overall, 24.8% (95% CI: 16.8-32.7%) of HCWs had positive RDTs. The more PPE was available and used, the less the chance of positive RDT was (OR: 0.63 [0.44-0.91], P = 0.014 and 0.63 [0.41-0.96], P = 0.030). The same was true for the knowledge of prevention and adhering to preventive rules (OR: 0.44 [0.24-0.81], P = 0.008 and 0.47 [0.25-0.89], P = 0.020). OHCWs had the highest prevalence of positive RDT, while they had more shifts per month, less accessibility to PPE, and less knowledge of the pandemic than physicians., Conclusion: The findings of this study suggest that HCWs should have a thorough knowledge of the pandemic along with using PPE properly and rationally. Furthermore, adhering to preventive regulations plays a crucial role in HCWs' safety. It is also noteworthy that shifts should be arranged logically to manage exposures, with a special attention being paid to OHCWs., (2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons. org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: The clinical course of COVID-19 may vary significantly. The presence of comorbidities prolongs the recovery time. The recovery in patients with mild-to-moderate symptoms might take 10 days, while in those with a critical illness or immunocompromised status could take 15 days. Considering the lack of data about predictors that could affect the recovery time, we conducted this study to identify them., Methods: This cross-sectional study was implemented in the COVID-19 clinic of a teaching and referral university hospital in Tehran. Patients with the highly suggestive symptoms who had computed tomography (CT) imaging results with typical findings of COVID-19 or positive results of reverse transcriptase-polymerase chain reaction (RT-PCR) were enrolled in the study. Inpatient and outpatient COVID-19 participants were followed up by regular visits or phone calls, and the recovery period was recorded., Results: A total of 478 patients were enrolled. The mean age of patients was 54.11 ± 5.65 years, and 44.2% were female. The median time to recovery was 13.5 days (IQR: 9). Although in the bivariate analysis, multiple factors, including hypertension, fever, diabetes mellitus, gender, and admission location, significantly contributed to prolonging the recovery period, in multivariate analysis, only dyspnea had a significant association with this variable (p = 0.02, the adjusted OR of 2.05; 95% CI 1.12-3.75)., Conclusion: This study supports that dyspnea is a predictor of recovery time. It seems like optimal management of the comorbidities plays the most crucial role in recovery from COVID-19.

BACKGROUND AND OBJECTIVES: The outbreak of COVID-19 has created a global public health crisis. Little is known about the predisposing factors of this infection. The aim of this study was to explore an association between the serum vitamin D level, obesity, and underlying health conditions, as well as the vulnerability to COVID-19 in the Iranian population., Methods: We conducted a case-control study of 201 patients with coronavirus infection and 201 controls. Cases and controls were matched for age and gender. The study was carried out for 2 months (February 2020-April 2020) at Imam Khomeini Hospital Complex, Tehran, Iran. Serum 25(OH) vitamin D was measured using the enzyme-linked immunosorbent assay method. Information containing age, gender, clinical symptoms, body mass index, computed tomography scan findings, and underlying health conditions related to each participant were elicited from health records., Results: A significant negative correlation (p = .02) was observed between the serum vitamin D level and developing coronavirus infection. Also, the results showed that the COVID-19 cases were more likely to be overweight than the controls (p = .023). Diabetes mellitus, hypertension, and respiratory infections were found in 20.89%, 9.65%, and 6.96% of cases, respectively. These underlying health conditions were not significantly different between cases and controls (p = .81)., Conclusions: Vitamin D deficiency and obesity are two main predisposing factors associated with the vulnerability to coronavirus infection in the Iranian population., (© 2020 Wiley Periodicals LLC.)

Background and Objectives: To explore the prevalence and characteristics of secondary bacterial infections among patients suffering from mucormycosis following COVID-19 infection. Materials and Methods: We conducted a cross-sectional, retrospective analysis from March 2020 to April 2022 at Imam Khomeini Hospital Complex in Tehran. The study included patients with histopathologically confirmed mucormycosis and documented secondary bacterial infections. We extracted and analyzed data from hospital records using SPSS software, version 26. Results: The study comprised 27 patients, with a predominance of females (70.4%) and an average age of 56 years. The majority of these patients (63%) had pre-existing diabetes mellitus. The severity of their COVID-19 infections varied. Treatment regimens included immunosuppressive drugs and antibiotics. Rhinocerebral mucormycosis was the most common form observed. The predominant secondary infections involved the urinary tract, respiratory system, bloodstream (bacteremia), and soft tissues, with resistant strains of Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae being the most frequently identified microorganisms. Notably, cases of bacteremia and pneumonia exhibited a higher mortality rate. Ultimately, 55.6% of patients were discharged, while 44.4% succumbed to their infections. Conclusion: Patients recovering from COVID-19 with mucormycosis are significantly susceptible to secondary bacterial infections, particularly those with diabetes mellitus or those undergoing immunosuppressive therapy. Such infections compound the morbidity and mortality risks in this vulnerable patient cohort. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has led to the demand for finding effective antiviral agents. Preliminary experiments showed Umifenovir inhibit replication in vivo. There is limited data on the clinical efficacy of COVID-19-infected pneumonia. Therefore, we aimed to evaluate this medication based on clinical findings. Methods: The present study was designed to investigate the advantages and disadvantages of Umifenovir and compared to empirical treatments. For this purpose, multi-stage sampling was considered. 56 people who had mild-to-moderate symptoms without signs of pneumonia, were selected by accidental non-random sampling method and divided into two groups [(group A with Hydroxychloroquine (HCQ) and group B in combination with Umifenovir] by randomized block sampling (1:1). During the study, three patients left the case group. Their clinical signs and symptoms were evaluated on 3rd, 7th, and 14th day after taking these medicines in the disease course. The SPSS software was used for data analysis and the significance level was considered to be p<0.05. Results: On the seventh day after visiting the patients, there were statistically significant differences in recuperation dry cough (p=0.001), weakness (p=0.004), gastrointestinal symptoms (p=0.043) and shortness of breath (p=0.001) between the two groups so that group B patients (HCQ and Umifenovir) had a faster recovery. In patients treated with HCQ and Umifenovir compared to the control group, myalgia (p=0.03), gastrointestinal symptoms (p=0.047) and weakness (p=0.007) improved significantly earlier during the illness. Conclusion: Evaluation of the clinical findings in mild-to-moderate COVID-19 patients' symptoms was performed and it was shown that recuperation was faster in the group who received both HCQ and Umifenovir. [ABSTRACT FROM AUTHOR]

Background: There is a growing need for information regarding the recent coronavirus disease of 2019 (COVID-19). We present a comprehensive report of COVID-19 patients in Iran. Materials and Methods: One hundred hospitalized patients with COVID-19 were studied. Data on potential source of exposure, demographic, clinical, and paraclinical features, therapy outcome, and postdischarge follow-up were analyzed. Results: The median age of the patients was 58 years, and the majority of the patients (72.7%) were above 50 years of age. Fever was present in 45.2% of the patients on admission. The most common clinical symptoms were shortness of breath (74%) and cough (68%). Most patients had elevated C-reactive protein (92.3%), elevated erythrocyte sedimentation rate (82.9%), and lymphocytopenia (74.2%) on admission. Lower lobes of the lung were most commonly involved, and ground-glass opacity (81.8%) was the most frequent finding in computed tomography scans. The administration of hydroxychloroquine improved the clinical outcome of the patients. Lopinavir/ritonavir was efficacious at younger ages. Of the 70 discharged patients, 40% had symptom aggravation, 8.6% were readmitted to the hospital, and three patients (4.3%) died. Conclusion: This report demonstrates a heterogeneous nature of clinical manifestations in patients affected with COVID19. The most common presenting symptoms are nonspecific, so attention should be made on broader testing, especially in age groups with the greatest risk and younger individuals who can serve as carriers of the disease. Hydroxychloroquine and lopinavir/ritonavir (in younger age group) can be potential treatment options. Finally, patients discharged from the hospital should be followed up because of potential symptom aggravation. [ABSTRACT FROM AUTHOR]

No effective antiviral drugs and vaccines are available for the treatment of patients with severe coronavirus 2019 (COVID-19). Therefore, available, safe, and inexpensive drugs and supplements such as melatonin are among the proposed options for controlling inflammation. We did a randomized, single-blind study in Imam Khomeini Hospital between June 30, 2020, and August 5, 2020. Mild to moderate COVID-19 patients aged 25-65 years were eligible to enter the study based on chest CT scan, clinical symptoms, and physician diagnosis. The intervention group was prescribed 6 mg of oral melatonin for 2 weeks, which consumed half an hour before bedtime every night in low light conditions. Clinical symptoms and C-reactive protein (CRP) were measured before and after treatment in the melatonin received and control (regular medications) groups. Among screened patients with COVID-19, 14 patients were assigned to receive melatonin, and 17 patients were considered as controls. A significant difference (p=0.005) between CRP 1 and CRP 2 levels (before and after using melatonin) was found in the melatonin group while this difference (p=0.069) was not significant in the control group. Also, the percentage of recovery (based on symptoms) in patients who took melatonin was higher than that of patients in the control group (85.7% VS 47.1%). The result of this study confirmed the effectiveness of melatonin in mild to moderate outpatients with COVID-19. More clinical trials on elderly, diabetic, obese patients and severe cases are suggested in future studies. [ABSTRACT FROM AUTHOR]

• Clinical response occurred faster in the tocilizumab than methylprednisolone group. • Improvement rate of SpO2 and CRP were comparable between the groups. • 28-day mortality was not different among patents in the groups. • More patients in the tocilizumab group experienced sleep disturbances. • Methylprednisolone may be an alternative in the treatment of severe COVID-19. This study was designed to compare the efficacy and safety of methylprednisolone and tocilizumab in the treatment of patients with severe COVID-19. During a prospective cohort study, hospitalized patients with severe COVID-19 received intravenous methylprednisolone (250–500 mg daily up to three doses), weight-based tocilizumab (maximum 800 mg, one or two doses as daily interval) or dexamethasone (8 mg daily). The primary outcome was time to onset of clinical response. Secondary outcomes were improvement rate of oxygen saturation and CRP, need for ICU admission, duration of hospitalization and 28-day mortality. During study, adverse events of the treatments were recorded. Although the difference was not statistically significant (p = 0.090), clinical response occurred faster in the tocilizumab group than other groups (10 vs. 16 days). Clinical response was detected in 74.19%, 81.25%, and 60% of patients in the methylprednisolone, tocilizumab, and dexamethasone groups respectively (p = 0.238). Based on the Cox regression analysis and considering dexamethasone as the reference group, HR (95% CI) of clinical response was 1.08 (0.65–1.79) and 1.46 (0.89–2.39) in the methylprednisolone and tocilizumab groups respectively. Improvement rate of oxygen saturation and CRP was not significantly different between the groups (p = 0.791 and p = 0.372 respectively). Also need for ICU admission and 28-day mortality was comparable between the groups (p = 0.176 and p = 0.143 respectively). Compared with methylprednisolone, tocilizumab caused more sleep disturbances (p = 0.019). Other adverse events were comparable among patients in the groups. When or where access to tocilizumab is a problem, methylprednisolone may be considered as an alternative for the treatment of patients with severe COVID-19, [ABSTRACT FROM AUTHOR]