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Background During the ongoing COVID-19 pandemic, immunocompromised patients are at a higher risk of severe infection, since the immune system has an important role in defeating this disease. This study compares the severity of COVID-19 in patients taking methotrexate with the severity of their family members' illness as patients with normal immune system function. Methods A total of 35 participants, including 14 patients taking methotrexate and 21 patients with normal immune function, entered this study, and the indicators of COVID-19 severity were compared between these two groups. Results The case group, who were on methotrexate therapy, had significantly less severe COVID-19 based on their symptoms, including fever (p = 0.000) and cough and dyspnea (p = 0.01) as well as in terms of COVID-19 severity indicators such as pulmonary involvement (p = 0.001), ferritin level (p = 0.001), white blood cell count (p = 0.008) and CRP level (p = 0.006), compared to the control group. There was a significant correlation between taking methotrexate and lower severity in COVID-19 disease. Conclusion The present findings demonstrated that methotrexate does not predispose patients to severe COVID-19; on the contrary, patients taking methotrexate may experience a milder disease, possibly due to their reduced severe inflammatory reactions as a result of inhibited TNFα, lowered IL6, and increased T regulatory cells. According to these findings, methotrexate appears to be a suitable treatment option for patients who need immunosuppressive medications during the COVID-19 pandemic.

Chronic obstructive pulmonary disease (COPD) is an irreversible pulmonary obstruction. Respiratory exercise training by a feedback-based model besides the routine managements have been considered to perform.Eighty exacerbated COPD patients with informed consent were divided to the control group (n = 40) received the routine approach and the intervention group (n = 40) received a teach-back training method (TBTM) of respiratory exercise including diaphragmatic breathing (DB), pursed-lip breathing (PLB), and effective coughing (EC) plus routine approach. The clinical outcomes were evaluated by measurement of the FEV1/FVC ratio, the Borg scale of dyspnea (BSD), and the 6-minute walking test (6MWT) results at the baseline, just after TBTM, and next 3 months.FEV1/FVC ratio has been indicated the significant improvement followed by TBTM compare to the baseline (p 0.001). Moreover, the BSD scores in 3-month follow-up after TBTM were significantly lower compared to the baseline (6 ± 1.3 vs. 3.8 ± 0.78, p 0.001). Although a significant difference was reported in 6MWT distance between two groups after 3-month follow-up (p 0.001), there was no significant difference immediately after the TBTM (p = 0.992) that suggested a long-term effect of educational intervention on physical activity.Significant enhancement in the clinical variables can demonstrate the efficacy of the TBTM program in reducing COPD patients' symptoms.http//www.irct.ir.Unique identifier: IRCT20181024041449N5.