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Abstract Introduction The COVID-19 epidemic and various control and mitigation measures to combat the widespread outbreak of the disease may affect other parts of health care systems. There is a concern that the COVID-19 pandemic could disrupt HIV services. Therefore, this study aimed to systematically evaluate the effect of the COVID-19 pandemic on service delivery and treatment outcomes in people with HIV. Methods In this study, a systematic search was conducted using the keywords in the online databases including Scopus, PubMed, Web of Science, and Cochrane databases. The retrieved articles underwent a two-step title/abstract and full-text review process, and the eligible papers were selected and included in the qualitative synthesis. Result We selected 16 studies out of 529 retrieved records that met the inclusion criteria for this review. Study populations of the selected studies were either HIV-positive patients or HIV clinics and healthcare providers. Most studies were focused on adhering to and obtaining medication and attending clinical appointments and their decrement during the pandemic. Other aspects of HIV care (alternative healthcare settings, viral suppression, psychological care, etc.) were discussed to a lesser extent by the included studies. Conclusion Interruption in in-person visits and medical follow-up services, loss of adherence to treatment, and subsequent increase in mortality due to the COVID-19 pandemic complications in PLHIV have led to growing concerns. Other challenges were psychological disorders such as anxiety and depression, an increase in substance abuse, and a rise in experienced stigma and discrimination. However, the use of telemedicine in some countries helps to alleviate the situation to some extent and is recommended in similar settings in the future.

Introduction: Several clinical manifestations have been discovered for COVID-19 since the emergence of SARS-CoV-2, which can be classified into early, medium, and long-term complications. However, late complications can be present after recovery from acute COVID-19 illness. The present study aims to comprehensively review the available evidence of late complications related to COVID-19. Method: A search was conducted, using keywords, through electronic databases, which included Scopus, Web of Science, PubMed, and Embase up to August 29, 2022. Study selection was performed according to a strict inclusion and exclusion criteria. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist was followed, and studies were appraised using the National Institute of Health (NIH) quality assessment and risk of bias tool. Results: In total, 50 studies were included, and nine distinct COVID-19 late complication categories were identified. A review of these studies revealed that neurologic and psychiatric (n=41), respiratory (n=27), musculoskeletal and rheumatologic (n=22), cardiovascular (n=9), and hepatic and gastrointestinal (n=6) complications were the most prevalent complications of long COVID-19. Conclusion: Almost all human body systems are affected by late complications of COVID-19 with different severity and prevalence. Fatigue and some other neuropsychiatric symptoms are the most common late complications among long COVID-19 patients. Respiratory symptoms including dyspnea (during exercise), cough, and chest tightness were the next most prevalent long-term complications of COVID-19. Since these complications are persistent and late, being aware of the signs and symptoms is essential for the healthcare providers and patients.

Abstract Background and Aims Alteration in humans' gut microbiota was reported in patients infected with severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2). The gut and upper respiratory tract (URT) microbiota harbor a dynamic and complex population of microorganisms and have strong interaction with host immune system homeostasis. However, our knowledge about microbiota and its association with SARS‐CoV‐2 is still limited. We aimed to systematically review the effects of gut microbiota on the SARS‐CoV‐2 infection and its severity and the impact that SARS‐CoV‐2 could have on the gut microbiota. Methods We searched the keywords in the online databases of Web of Science, Scopus, PubMed, and Cochrane on December 31, 2021. After duplicate removal, we performed the screening process in two stages; title/abstract and then full‐text screening. The data of the eligible studies were extracted into a pre‐designed word table. This study adhered to the PRISMA checklist and Newcastle−Ottawa Scale Bias Assessment tool. Results Sixty‐three publications were included in this review. Our study shows that among COVID‐19 patients, particularly moderate to severe cases, the gut and lung microbiota was different compared to healthy individuals. In addition, the severity, and viral load of COVID‐19 disease would probably also be influenced by the gut, and lung microbiota's composition. Conclusion Our study concludes that there was a significant difference in the composition of the URT, and gut microbiota in COVID‐19 patients compared to the general healthy individuals, with an increase in opportunistic pathogens. Further, research is needed to investigate the probable bidirectional association of COVID‐19 and human microbiome.

Introduction COVID-19 vaccines emerged as a worldwide hope to contain the pandemic. However, many people ‎are still hesitant to receive these vaccines. We aimed to systematically review the public knowledge, perception, and acceptability of COVID-19 vaccines in the Middle East and North Africa (MENA) countries and the predictors of vaccine acceptability in this region. Methods We systematically searched databases of PubMed, Scopus, Web of Science, and Cochrane and retrieved ‎all relevant studies by 5 August 2021. Results There was a considerable variation in the COVID-19 vaccine acceptance ‎rates, from 12% in a study from Israel to 83.3% in Kuwait, although two other studies from Israel mentioned 75% ‎and 82.2% acceptability rates. Concerns about the side effects and safety of the vaccine were the main reasons for ‎the lack of acceptability of taking the vaccine, which was reported in 19 studies. ‎ Conclusion Several factors, such as age, gender, education level, and comorbidities, ‎are worthy of attention as they could expand vaccine coverage in the target population.‎

Abstract Introduction C‐reactive protein (CRP) and cytokines levels could alter in patients with coronavirus disease (COVID‐19) due to the inflammatory response caused by the virus. This analysis aimed to assess the relationship between the CRP levels and the levels of various cytokines in COVID‐19 patients. Materials and Methods We searched the databases of PubMed, Cochrane, and Web of Science for relevant articles on May 29th, 2021. Applying the inclusion/exclusion criteria, the retrieved records underwent two‐phase screenings; first, a title/abstract screening process, and then, a full‐text screening to find the eligible studies. Data for study variables were extracted, including the CRP levels and the levels of all reported cytokines. A strong and significant relationship between Interleukins and CRP was defined as: p ≤ 0.05, 0.7 ≤ r ≤ 1. Results In this study, 103 studies were included for systematic review and correlation analysis. The aggregate mean and SD of study variables were calculated and reported. The correlation between Interleukins and CRP was measured using correlation coefficient (r). It appeared that interleukin (IL)‐10 has a moderate and significant relationship with CRP (p ≤ 0.05, r = 0.472). IL‐10 predicted almost 10% of CRP changes. Conclusion This correlation analysis suggests IL‐10 is moderately correlated with CRP levels in patients with COVID‐19 infection. A better understanding of the pro‐inflammatory markers could contribute to the implementation of therapeutic and preventive approaches. More prospective studies are suggested to explore the relationship between CRP and cytokines as potential markers for the early identification of COVID‐19 progression and severity.

Abstract Introduction Since the outbreak of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) began, necessary measures to prevent virus transmission and reduce mortality have been implemented, including mandatory public use of masks, regular hand-sanitizing and hand-washing, social distancing, avoidance of crowds, remote work, and cancellation of public events. During and after the introduction of COVID-19 lockout, we performed a systematic review of available published literature to investigate the incidence of seasonal influenza and other respiratory viral infections. Methods PubMed, Embase, Web of Science, Scopus, Science Direct, Google Scholar, Research Gate, and the World Health Organization databases and websites were systematically searched for original studies concerning the impact of COVID-19 prevention means and measures on other common respiratory infectious diseases during the pandemic published by March 2021. Results The findings showed that the adherence to health protocols to prevent COVID-19 could help to reduce the incidence of other infectious diseases such as influenza, pneumonia, and Mycobacterium tuberculosis. Conclusion The implemented prevention measures and protocols might have reduced the incidence of influenza and some other common respiratory infections. However, controversies exist on this matter and future large population-based studies might provide further information to address these controversies.

Introduction: Rare serious complications have been documented after COVID-19 vaccination as clinical research proceeded and new target populations, such as children and ‎pregnant women, were included. In this study, we attempted to review the literature relevant to ‎pregnancy complications and maternal outcomes of COVID-19 immunization in pregnant women. ‎ Methods: We searched the databases of PubMed, Scopus, Cochrane, and Web of Science on 31 August 2022. The records were downloaded and underwent a two-step screening; 1) title/abstract and then 2) full-text screening to identify the eligible studies. We included English original studies that evaluated the adverse effects of COVID-19 vaccines during pregnancy. Information such as the type of ‎study, geographical location, type of vaccine injected, gestational age, maternal underlying diseases, and ‎complications following the vaccination were extracted into pre-designed tables. Results: According to the findings of included studies, in most of them vaccination had a positive impact and no negative effects were observed. Also, no medical history was reported in 11 articles, and pregnant women had no underlying diseases. Some serious adverse events were reported after ‎vaccination, including miscarriage, paresthesia, uterine contraction, vaginal bleeding, preterm birth, major ‎congenital anomalies, intrauterine growth restriction, and seizure. ‎ Conclusion: Because of limited data availability and the cross-sectional design of most studies, we could neither infer ‎causation between vaccines and incidence of adverse effects nor comment with certainty about any ‎possible adverse outcome of COVID-19 vaccines in vaccinated pregnant women. Consequently, more longitudinal and experimental studies are needed to define the exact adverse effects of COVID-19 vaccines in pregnant women.

Introduction: Controversies existed regarding the duration of COVID-19 vaccines’ protection and whether receiving the usual vaccine doses would be sufficient for long-term immunity. Therefore, we aimed to systematically review the studies regarding the COVID-19 vaccines’ protection three months after getting fully vaccinated and assess the need for vaccine booster doses. Methods: The relevant literature was searched using a combination of keywords on the online databases of PubMed, Scopus, Web of Science, and Cochrane on September 17th, 2021. The records were downloaded and the duplicates were removed. Then, the records were evaluated in a two-step process, consisting of title/abstract and full-text screening processes, and the eligible records were selected for the qualitative synthesis. We only included original studies that evaluated the efficacy and immunity of COVID-19 vaccines three months after full vaccination. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement to ensure the reliability of results. Results: Out of the 797 retrieved records, 12 studies were included, 10 on mRNA-based vaccines and two on inactivated vaccines. The majority of included studies observed acceptable antibody titers in most of the participants even after 6 months; however,it appeared that the titers could also decrease in a considerable portion of people. Due to the reduction in antibody titers and vaccine protection, several studies suggested administering the booster dose, especially for older patients and those with underlying conditions, such as patients with immunodeficiencies. Conclusion: Studies indicated that vaccine immunity decreases over time, making people more susceptible to contracting the disease. Besides, new variants are emerging, and the omicron variant is continuing to spread and escape from the immune system, indicating the importance of a booster dose.

Abstract Introduction Coronavirus Disease-2019 (SARS-CoV-2) started its devastating trajectory into a global pandemic in Wuhan, China, in December 2019. Ever since, several variants of SARS-CoV-2 have been identified. In the present review, we aimed to characterize the different variants of SARS-CoV-2 and explore the related morbidity and mortality. Methods A systematic review including the current evidence related to different variants of SARS-CoV-2 and the related morbidity and mortality was conducted through a systematic search utilizing the keywords in the online databases including Scopus, PubMed, Web of Science, and Science Direct; we retrieved all related papers and reports published in English from December 2019 to September 2020. Results A review of identified articles has shown three main genomic variants, including type A, type B, and type C. we also identified three clades including S, V, and G. Studies have demonstrated that the C14408T and A23403G alterations in the Nsp12 and S proteins are the most prominent alterations in the world, leading to life-threatening mutations.The spike D614G amino acid change has become the most common variant since December 2019. From missense mutations found from Gujarat SARS-CoV-2 genomes, C28854T, deleterious mutation in the nucleocapsid (N) gene was significantly associated with patients' mortality. The other significant deleterious variant (G25563T) is found in patients located in Orf3a and has a potential role in viral pathogenesis. Conclusion Overall, researchers identified several SARS-CoV-2 variants changing clinical manifestations and increasing the transmissibility, morbidity, and mortality of COVID-19. This should be considered in current practice and interventions to combat the pandemic and prevent related morbidity and mortality.

Abstract Background and Aims The outbreak of coronavirus disease 2019 (COVID‐19) over the past year has affected public health worldwide. During pregnancy, the maternal immune system and inflammatory responses are widely suppressed. Pregnancy‐related immune system suppression could make the mother vulnerable to infectious diseases like SARS‐COV‐2. However, current data suggest little to no possibility of COVID‐19 transmission in pregnant women to the fetus during pregnancy or childbirth. This systematic review focused on the possible complications of COVID‐19 infection in the fetus and newborn babies including the possibility and evidence of vertical transmission by reviewing articles published during the first year of the COVID‐19 pandemic. Methods We conducted a systematic search using keywords on PubMed, Embase, and Scopus databases. The studies followed a title/abstract and a full‐text screening process, and the eligible articles were included in the study. Results In total, 238 published papers were identified using a systematic search strategy (44 articles met the inclusion criteria and were included in the final review). In all studies, a total of 2375 women with signs and symptoms of COVID‐19, who were in the second and third trimester of pregnancy, were assessed mild to moderate pneumonia was one of the most common symptoms. Seventy‐three percent of the women did not present any comorbidity, 19% had a fever, 17% had to cough as the most frequent clinical signs and symptoms, 7.5% had pulmonary changes with chest scans, 8% had increased C reactive protein, and 9.4% had decreased lymphocytes (lymphocytopenia). A total of 2716 newborns and fetal were assessed; the delivery method of 1725 of them was reported, 913 (53%) through C‐section delivery, and 812 through normal vaginal delivery (47%). Of total newborns, 13 died (five died along with the mother), and 1965 were tested for SARS‐CoV‐2:118 tested positive. In a study, vertical transmission in seven cases was reported in total of 145 cases assessed. Conclusion It appeared that most pregnant COVID patients were mildly ill, and there is currently no convincing evidence to support the vertical transmission of COVID‐19 disease. Therefore, neonates do not represent any additional risk for adverse outcomes neither during the prenatal period nor after birth.

Abstract Introduction Several reports previously described mucormycosis co‐infection in patients with COVID‐19. As mucormycosis and COVID‐19 co‐infection might adversely affect patients' outcomes, we aimed to systematically review the related evidence and the subsequent outcomes. Methods We conducted a systematic review of relevant articles searching the keywords in the online databases of PubMed, Scopus, Embase, Cochrane, and Web of Science. All the records from the start of the pandemic until June 12th, 2021 underwent title/abstract and then full‐text screening process, and the eligible studies were included. We did not include any language or time restrictions for the included studies. Results We found 31 eligible studies reporting 144 total cases of COVID‐19 and mucormycosis co‐infection. The nose, cranial sinuses, and orbital cavity were the most commonly involved organs, although the cerebrum, lungs, and heart were also involved in the studies. Pre‐existing diabetes mellitus (DM), as well as corticosteroid use, were the most commonly identified risk factors, but other underlying conditions and immunomodulatory drug use were also present in several cases. Aspergillus was the most commonly reported micro‐organism that caused further co‐infections in patients with concurrent COVID‐19 and mucormycosis. As most of the studies were case reports, no reliable estimate of the mortality rate could be made, but overall, 33.6% of the studied cases died. Conclusion Early diagnosis of mucormycosis co‐infection in COVID‐19 patients and selecting the right treatment plan could be a challenge for physicians. Patients with underlying co‐morbidities, immunocompromised patients, and those receiving corticosteroids are at higher risk of developing mucormycosis co‐infection and it is crucial to have an eye examination for early signs and symptoms suggesting a fungal infection in these patients.

Abstract Introduction Patients with COVID‐19 may present different viral loads levels. However, the relationship between viral load and disease severity in COVID‐19 is still unknown. Therefore, this study aimed to systematically review the association between SARS‐CoV‐2 viral load and COVID‐19 severity. Methods The relevant studies using the keywords of “COVID‐19” and “viral load” were searched in the databases of PubMed, Scopus, Google Scholar, and Web of Science. A two‐step title/abstract screening process was carried out and the eligible studies were included in the study. Results Thirty‐four studies were included from the initial 1015 records. The vast majority of studies have utilized real‐time reverse transcription‐polymerase chain reaction of the nasopharyngeal/respiratory swabs to report viral load. Viral loads were commonly reported either as cycle threshold (Ct) or log10 RNA copies/ml. Conclusion The results were inconclusive about the relationship between COVID‐19 severity and viral load, as a similar number of studies either approved or opposed this hypothesis. However, the studies denote the direct relationship between older age and higher SARS‐CoV‐2 viral load, which is a known risk factor for COVID‐19 mortality. The higher viral load in older patients may serve as a mechanism for any possible relationships between COVID‐19 viral load and disease severity. There was a positive correlation between SARS‐CoV‐2 viral load and its transmissibility. Nonetheless, further studies are recommended to precisely characterize this matter.