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Background and aim: Health care workers (HCWs), mostly frontliners, are encountering numerous physical and psychosocial stressors, and even managing some conflicts over the course of the novel coronavirus disease 2019 (COVID-19). In this respect, the present study was to investigate the prevalence rate of occupational burnout (OB) in such workers during this pandemic. Materials and methods: This cross-sectional study was conducted between April 6 and May 30, 2020, via an online survey in 31 provinces of Iran, on HCWs selected based on convenience sampling method. For data collection, a socio-demographic information form and the Maslach Burnout Inventory (MBI) was utilized. Descriptive statistics, Chi-square test, and multivariate regression analysis were also applied to test the research hypotheses. Results: In total, 7626 HCWs participated in the present study. Accordingly, 73.2 and 26.8% of the workers were female and male, respectively. As well, 57.8% of the respondents were nurses and 14.4% of the cases were clinicians. Moreover, 44.8% of the participants had thus far worked in isolation wards and 40.3% of these individuals reported working for 4–8 hours with COVID-19 patients. The prevalence rate of OB was 18.3%. Besides, 34.2, 48.7, and 56.1% of the respondents had severe levels of emotional exhaustion (EE), higher depersonalization (DP), and decreased sense of personal accomplishment (PA), respectively. Besides, the HCWs at the age range of 20 to 30, having female gender, no children, and a bachelor's degree, and working in isolation wards showed the higher levels of OB with reference to the Chi-square test results (p < 0.001). Accordingly, the statistical test outcomes demonstrated that a history of physical illnesses (p = 0.001) and psychiatric disorders (p = 0.044) could be the best predictor of OB throughout the first peak of the COVID-19 pandemic. Conclusion: Regarding the high prevalence rate of OB among the HCWs and the remaining COVID-19 journey in Iran, health care managers are recommended to orient the required management and coping strategies toward improving mental health in these individuals. [ABSTRACT FROM AUTHOR]

Aim: The main purpose of this study was to assess the levels of anxiety, depression, and stress among healthcare providers in Iran. Methods: This descriptive cross‐sectional survey was performed on healthcare providers selected through the convenience sampling method from April 6 to May 19, 2020, during the COVID‐19 pandemic. To this end, a self‐report web‐based questionnaire made up of a sociodemographic characteristics information form, Depression, Anxiety, and Stress Scale (DASS), and Corona Disease Anxiety Scale (CDAS) was distributed. Descriptive statistics, chi‐square test (χ2), and univariate and multivariate logistic regression models were accordingly practiced to analyze the data using the Statistical Package for Social Sciences (SPSS) software. Results: Of 1343 healthcare providers, 45.8% and 73.0% had moderate physical and psychological anxiety symptoms, respectively. The logistic regression model similarly demonstrated that anxiety caused by COVID‐19 was significantly correlated with the age ranges of 41‐50 (P =.007) and 51‐60 (P =.014) years as well as male participants (P <.001). In addition, the prevalence rates of depression and stress were, respectively, reported by 35.1% and 27.8%. There was correspondingly a significant relationship between depression and age as well as stress and gender. Conclusions: It seems that healthcare managers need to focus more attention on psychological aspects in healthcare providers during this pandemic and plan to teach them about coping strategies. [ABSTRACT FROM AUTHOR]

Objectives: The present study was conducted to assess 3(HCWs) during the COVID‐19 pandemic. Methods: A total number of 7626 HCWs were included in this web‐based cross‐sectional study, via the convenience sampling technique. To collect the required data, the sociodemographic characteristics information form, the Depression Anxiety Stress Scale‐21 (DASS‐21), and the Corona Disease Anxiety Scale (CDAS) were also employed. In addition, data analysis was performed using the SPSS Statistics software (ver. 24), as well as descriptive statistics, Chi‐square test (χ2), and univariate/multivariate logistic regression models. Results: The CDAS results revealed that 47.9% and 70.5% of the HCWs had experienced moderate levels of physical and psychological anxiety, respectively. Based on the DASS results, 44.8%, 43%, and 34.8% of the HCWs had been subjected to depression, anxiety, and stress symptoms during the COVID‐19 pandemic, respectively. The logistic regression models correspondingly showed that depression among the HCWs was significantly correlated with risk factors, such as the age groups of 20–30 years (p =.001), 31–40 years (p =.006), female HCWs (p>.001), history of physical illnesses (p =.004), and history of psychiatric disorders (p>.001). Moreover, factors including the age groups of 20–30 years (p <.001), 31–40 years (p <.001), 41–50 years (p <.001), female HCWs (p>.001), history of physical illnesses (p <.001), and history of psychiatric disorders (p>.001) were assumed as significant predictors of anxiety in these individuals. Besides, factors such as the age groups of 20–30 years (p =.002), 31–40 years (p =.004), female HCWs (p>.001), occupation (p =.016), history of physical illnesses (p <.001), and history of psychiatric disorders (p>.001) could significantly predict the prevalence rate of stress in the HCWs in times of this crisis. Conclusion: Given the importance of mental health status among HCWs during the COVID‐19 pandemic, health administrators and policymakers of the Ministry of Health and Medical Education in Iran are suggested to provide psychological screening and supportive care programs for HCWs with the aim of enhancing their mental health and successful coping with critical circumstances. [ABSTRACT FROM AUTHOR]

• Excessive inflammation leads to lung damage in complicated COVID-19 patients. • Tocilizumab, an IL-6 inhibitor, was added to the standard treatment in this study. • Comparably low mortality rate (6.98%) was observed in severe patients. • Benefits of tocilizumab were less considerable in patients with critical disease. • Appropriate timing is important in the administration of tocilizumab for COVID-19. Potential therapeutic approaches in coronavirus disease 2019 (COVID-19) comprise antiviral and immunomodulatory agents; however, no immunomodulator drug has been approved. This multicenter, prospective, open-label, uncontrolled study aimed to assess the use of subcutaneous tocilizumab in adult patients with severe and critical COVID-19. Tocilizumab was added to the standard care of therapy at a dose of 324 mg (<100 kg bodyweight) or 486 mg (≥100 kg bodyweight). The study endpoints were all-cause mortality rate, changes in oxygen-support level, oxygen saturation, body temperature, respiratory rate, and laboratory variables during the study, and drug safety. Of 126 patients enrolled, 86 had severe and 40 had critical disease. Most patients were male (63.49%) and aged below 65 (78.57%). By day 14 of the study, 4.65% (4/86) of severe patients and 50.00% (20/40) of critical patients died. By the end, 6.98% (6/86) of severe patients and 60.00% (24/40) of critical patients died. Outcomes concerning three additional endpoints (oral temperature, oxygen saturation, and respiratory rate) were significantly improved as early as three days after tocilizumab administration in both groups of subjects, more considerably in severe patients. Significant improvement in the required level of oxygenation was reported in severe patients seven days after tocilizumab administration. No tocilizumab-related serious adverse event occurred in this study. Subcutaneous tocilizumab might improve some clinical parameters and reduce the risk of death in COVID-19 patients, particularly if used in the early stages of respiratory failure. [ABSTRACT FROM AUTHOR]