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6. Durable functional limitation in patients with coronavirus disease-2019 admitted to intensive care and the effect of intermediate-dose vs standard-dose anticoagulation on functional outcomes

Author

Sadeghipour, Parham, Talasaz, Azita H., Barco, Stefano, Bakhshandeh, Hooman, Rashidi, Farid, Rafiee, Farnaz, Rezaeifar, Parisa, Jamalkhani, Sepehr, Matin, Samira, Baghizadeh, Elahe, Tahamtan, Ouria, Sharif-Kashani, Babak, Beigmohammadi, Mohammad Taghi, Farrokhpour, Mohsen, Sezavar, Seyed Hashem, Payandemehr, Pooya, Dabbagh, Ali, Moghadam, Keivan Gohari, Jimenez, David, Monreal, Manuel, Maleki, Majid, Siegerink, Bob, Spatz, Erica S., Piazza, Gregory, Parikh, Sahil A., Kirtane, Ajay J., Van Tassell, Benjamin W., Lip, Gregory Y.H., Goldhaber, Samuel Z., Klok, Frederikus A., Krumholz, Harlan M., and Bikdeli, Behnood

Published
2022
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12. Comparison Between Two Methods of Patient-Controlled Analgesia Through Intravenous and Thoracic Epidural to Control Pain and Complications After Surgery in Esophageal Cancer Patients: A Randomized Controlled Trial

Author

Maghsoudloo, Maziar, primary, Abbassi, Sina, additional, Samadi, Shahram, additional, Beigmohammadi, Mohammad Taghi, additional, Hajipour, Asghar, additional, Atashgahi, Mahboubeh, additional, Abbassi, Siavash, additional, Badrzadeh, Fariba, additional, and Nabavian, Omid, additional

Published
2023
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13. Effects of nebulized hypertonic saline on inflammatory mediators in patients with severe COVID-19 pneumonia: A double-blinded randomized controlled trial

Author

Beigmohammadi, Mohammad-Taghi, primary, Amoozadeh, Laya, additional, Naghibi, Nikoosadat, additional, Eslami, Babak, additional, Fattah Ghazi, Samrand, additional, Javaherian, Mohammad, additional, Khajeh-Azad, Mohammad-Amin, additional, Tabatabaei, Bahram, additional, Abdollahi, Alireza, additional, and Nazar, Elham, additional

Published
2023
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14. Nutritional status of patients hospitalized in the intensive care unit: A comprehensive report from Iranian hospitals, 2018

Author

Javid Mishamandani, Zeinab, Norouzy, Abdolreza, Hashemian, Seyed Mohammadreza, Khoundabi, Batoul, Rezaeisadrabadi, Mohammad, Safarian, Mohammad, Nematy, Mohsen, Pournik, Omid, Jamialahmadi, Tannaz, Shadnoush, Mahdi, Moghaddam, Omid Moradi, Zand, Farid, Beigmohammadi, Mohammad Taghi, Khoshfetrat, Masoum, Shafiei, Elham, and Sedaghat, Alireza

Published
2019
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15. Abstract 416: Atorvastatin Versus Placebo In Icu Patients With Covid19: Ninety-day Results Of The INSPIRATION-S Trial

Author

Talasaz, Azita, primary, Sadeghipour, Parham, additional, Sharif-Kashani, Babak, additional, Rashidi, Farid, additional, Beigmohammadi, Mohammad Taghi, additional, Gohari Moghadam, Keivan, additional, Rezaian, Somayeh, additional, Dabbagh, Ali, additional, Sezavar, Seyed Hashem, additional, Piazza, Gregory, additional, Farrokhpour, Mohsen, additional, Bakhshandeh, Hooman, additional, Abedini, Atefeh, additional, Aliannejad, Rasoul, additional, Riahi, Taghi, additional, Yadollahzadeh, Mehdi, additional, Lookzadeh, Somayeh, additional, rezaeifar, parisa, additional, Matin, Samira, additional, Tahamtan, Ouria, additional, Mohammadi, Keyhan, additional, Zoghi, Elnaz, additional, Hosseini, Hossein, additional, Mousavian, Seyed Masoud, additional, Abri, Homa, additional, Sadeghipour, Pardis, additional, baghizadeh, elahe, additional, Rafiee, Farnaz, additional, jamalkhani, sepehr, additional, Aghakouchakzadeh, Maryam, additional, Eslami, Vahid, additional, Payandemehr, Pooya, additional, Jimenez, David, additional, Sethi, Sanjum, additional, Parikh, Sahil A, additional, Monreal, Manuel, additional, maleki, majid, additional, Sadeghian, Saeed, additional, Barco, Stefano, additional, Siegerink, Bob, additional, Kirtane, Ajay J, additional, Van Tassell, Benjamin W, additional, Stone, Gregg, additional, Klok, Erik, additional, Lip, Gregory, additional, Goldhaber, Samuel, additional, Krumholz, Harlan M, additional, and Bikdeli, Behnood, additional

Published
2023
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16. Abstract 260: Machine Learning To Identify Heterogeneity Of Treatment Effect Of Intermediate-dose Vs Standard-dose Prophylactic Anticoagulation In The Inspiration Trial

Author

Bikdeli, Behnood, primary, Spicer, Alexandra, additional, Bakhshandeh, Hooman, additional, Talasaz, Azita, additional, Rashidi, Farid, additional, Sharif-Kashani, Babak, additional, Beigmohammadi, Mohammad Taghi, additional, Farrokhpour, Mohsen, additional, Sezavar, Seyed Hashem, additional, Payandemehr, Pooya, additional, Dabbagh, Ali, additional, Gohari Moghadam, Keivan, additional, Eslami, Vahid, additional, Sinha, Pratik, additional, Goldhaber, Samuel, additional, Piazza, Gregory, additional, Krumholz, Harlan M, additional, Sadeghipour, Parham, additional, and Churpek, Matthew M, additional

Published
2023
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19. Atorvastatin versus Placebo in ICU Patients with COVID-19: Ninety-day Results of the INSPIRATION-S Trial

Author

Talasaz, Azita H., additional, Sadeghipour, Parham, additional, Bakhshandeh, Hooman, additional, Sharif-Kashani, Babak, additional, Rashidi, Farid, additional, Beigmohammadi, Mohammad Taghi, additional, Moghadam, Keivan Gohari, additional, Rezaian, Somaye, additional, Dabbagh, Ali, additional, Sezavar, Seyed Hashem, additional, Farrokhpour, Mohsen, additional, Abedini, Atefeh, additional, Aliannejad, Rasoul, additional, Riahi, Taghi, additional, Yadollahzadeh, Mahdi, additional, Lookzadeh, Somayeh, additional, Rezaeifar, Parisa, additional, Matin, Samira, additional, Tahamtan, Ouria, additional, Mohammadi, Keyhan, additional, Zoghi, Elnaz, additional, Rahmani, Hamid, additional, Hosseini, Seyed Hossein, additional, Mousavian, Seyed Masoud, additional, Abri, Homa, additional, Sadeghipour, Pardis, additional, Baghizadeh, Elahe, additional, Rafiee, Farnaz, additional, Jamalkhani, Sepehr, additional, Amin, Ahmad, additional, Mohebbi, Bahram, additional, Parhizgar, Seyed Ehsan, additional, Soleimanzadeh, Mahshid, additional, Aghakouchakzadeh, Maryam, additional, Eslami, Vahid, additional, Payandemehr, Pooya, additional, Khalili, Hossein, additional, Talakoob, Hamed, additional, Tojari, Taranom, additional, Shafaghi, Shadi, additional, Tabrizi, Sanaz, additional, Kakavand, Hessam, additional, Kashefizadeh, Alireza, additional, Najafi, Atabak, additional, Jimenez, David, additional, Gupta, Aakriti, additional, Madhavan, Mahesh V., additional, Sethi, Sanjum S., additional, Parikh, Sahil A., additional, Monreal, Manuel, additional, Hadavand, Naser, additional, Hajighasemi, Alireza, additional, Ansarin, Khalil, additional, Maleki, Majid, additional, Sadeghian, Saeed, additional, Barco, Stefano, additional, Siegerink, Bob, additional, Spatz, Erica S., additional, Piazza, Gregory, additional, Kirtane, Ajay J., additional, Tassell, Benjamin W. Van, additional, Lip, Gregory Y. H., additional, Klok, Frederikus A., additional, Goldhaber, Samuel Z., additional, Stone, Gregg W., additional, Krumholz, Harlan M., additional, and Bikdeli, Behnood, additional

Published
2023
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21. Immunophenotyping characteristics of COVID‐19 patients: Peripheral blood CD8+ HLA‐DR+ T cells as a biomarker for mortality outcome

Author

Mirsharif, Ensie Sadat, primary, Chenary, Maryam Rajabnia, additional, Bozorgmehr, Mahmood, additional, Mohammadi, Saeed, additional, Hashemi, Seyed Mahmoud, additional, Ardestani, Susan Kabudanian, additional, Beigmohammadi, Mohammad‐Taghi, additional, Abdollahi, Alireza, additional, Sadeghipour, Alireza, additional, Kariminia, Amina, additional, Tuserkani, Fatemeh, additional, and Ghazanfari, Tooba, additional

Published
2022
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25. Immunophenotyping characteristics of COVID‐19 patients: Peripheral blood CD8+ HLA‐DR+ T cells as a biomarker for mortality outcome.

Author

Mirsharif, Ensie Sadat, Chenary, Maryam Rajabnia, Bozorgmehr, Mahmood, Mohammadi, Saeed, Hashemi, Seyed Mahmoud, Ardestani, Susan Kabudanian, Beigmohammadi, Mohammad‐Taghi, Abdollahi, Alireza, Sadeghipour, Alireza, Kariminia, Amina, Tuserkani, Fatemeh, and Ghazanfari, Tooba

Subjects
T cells, COVID-19, POSTMORTEM changes, LYMPHOCYTE subsets, CD8 antigen, CORONARY care units
Abstract

Introduction: The goal of this study was to identify biomarker(s) to assign risk of mortality in COVID‐19 patients to improve intensive care unit (ICU) and coronary care unit management. A total of 100 confirmed COVID‐19 patients admitted at Imam Khomeini Hospital in Tehran, were compared to 70 control subjects. Peripheral blood leukocyte was studied using staining reagents included CD3, CD4, CD8, HLA‐DR, CD19, CD16, and CD56. The immunophenotyping analysis was evaluated using the FACSCalibur instrument. To investigate the cell density of lung infiltrating T cells, postmortem slides of needle necropsies taken from the lung tissue of 3 critical patients were evaluated by immunohistochemistry staining. The number of lymphocyte subpopulations was significantly lower in COVID‐19 patients than in the control group. Regarding the disease severity, the absolute count of T, NK, and HLA‐DR+ T cells were significantly reduced in severe patients compared to the moderate ones. The critical patients had a significantly lower count of CD8‐HLA‐DR+ T cells than the moderate cases. Regarding the disease mortality, based on univariate analysis, the count of HLA‐DR+ T, CD8− HLA‐DR+ T, and CD8+ HLA‐DR+ T cells was associated with mortality in COVID‐19 patients. Receiver operating characteristic curve analysis showed the count of CD8+ HLA‐DR+ T cells is the best candidate as a biomarker for mortality outcome. Furthermore, pulmonary infiltration of T cells in the lung tissue showed only slight infiltrations of CD3+ T cells, with an equal percentage of CD4+ and CD8+ T cell subpopulation in the lung tissue. These findings suggest that close monitoring of the value of CD8+ HLA‐DR+ T cells in COVID‐19 patients may be helpful to identify high‐risk patients. However, further studies with larger sample size are needed. [ABSTRACT FROM AUTHOR]

Published
2023
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27. The role of saliva PCR assay in the diagnosis of COVID-19

Author

Abdollahi, Alireza, primary, Salarvand, Samaneh, additional, Ghalehtaki, Reza, additional, Jafarzadeh, Bita, additional, Beigmohammadi, Mohammad Taghi, additional, Ghiasvand, Fereshteh, additional, Shakoori, Abbas, additional, Khoshnevis, Hoda, additional, Arabzadeh, Mohammad, additional, Nateghi, Saeed, additional, and Mehrtash, Vahid, additional

Published
2022
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28. Effects of Melatonin and Propolis Supplementation on Inflammation, Oxidative Stress, and Clinical Outcomes in Patients with Primary Pneumosepsis: A Randomized Controlled Clinical Trial

Author

Pahlavani, Naseh, primary, Malekahmadi, Mahsa, additional, Sedaghat, Alireza, additional, Rostami, Amirabbas, additional, Alkadir, Ola Kamal A., additional, Taifi, Ahmed, additional, Ranjbar, Golnaz, additional, Sahebkar, AmirHossein, additional, Abdelbasset, Walid Kamal, additional, Beigmohammadi, Mohammad Taghi, additional, Mir, Mahdieh, additional, Bagheri Moghaddam, Ahmad, additional, Tabesh, Hamed, additional, Sadeghi, Omid, additional, Gholizadeh Navashenaq, Jamshid, additional, Firouzi, Safieh, additional, Fathi Najafi, Mohsen, additional, Safarian, Mohammad, additional, and Ghayour-Mobarhan, Majid, additional

Published
2022
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32. Intermediate-Dose versus Standard-Dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to the Intensive Care Unit: 90-Day Results from the INSPIRATION Randomized Trial

Author

Bikdeli, Behnood, primary, Talasaz, Azita H., primary, Rashidi, Farid, additional, Bakhshandeh, Hooman, additional, Rafiee, Farnaz, additional, Rezaeifar, Parisa, additional, Baghizadeh, Elahe, additional, Matin, Samira, additional, Jamalkhani, Sepehr, additional, Tahamtan, Ouria, additional, Sharif-Kashani, Babak, additional, Beigmohammadi, Mohammad Taghi, additional, Farrokhpour, Mohsen, additional, Sezavar, Seyed Hashem, additional, Payandemehr, Pooya, additional, Dabbagh, Ali, additional, Moghadam, Keivan Gohari, additional, Khalili, Hossein, additional, Yadollahzadeh, Mahdi, additional, Riahi, Taghi, additional, Abedini, Atefeh, additional, Lookzadeh, Somayeh, additional, Rahmani, Hamid, additional, Zoghi, Elnaz, additional, Mohammadi, Keyhan, additional, Sadeghipour, Pardis, additional, Abri, Homa, additional, Tabrizi, Sanaz, additional, Mousavian, Seyed Masoud, additional, Shahmirzaei, Shaghayegh, additional, Amin, Ahmad, additional, Mohebbi, Bahram, additional, Parhizgar, Seyed Ehsan, additional, Aliannejad, Rasoul, additional, Eslami, Vahid, additional, Kashefizadeh, Alireza, additional, Dobesh, Paul P., additional, Kakavand, Hessam, additional, Hosseini, Seyed Hossein, additional, Shafaghi, Shadi, additional, Ghazi, Samrand Fattah, additional, Najafi, Atabak, additional, Jimenez, David, additional, Gupta, Aakriti, additional, Madhavan, Mahesh V., additional, Sethi, Sanjum S., additional, Parikh, Sahil A., additional, Monreal, Manuel, additional, Hadavand, Naser, additional, Hajighasemi, Alireza, additional, Maleki, Majid, additional, Sadeghian, Saeed, additional, Piazza, Gregory, additional, Kirtane, Ajay J., additional, Van Tassell, Benjamin W., additional, Stone, Gregg W., additional, Lip, Gregory Y. H., additional, Krumholz, Harlan M., additional, Goldhaber, Samuel Z., additional, and Sadeghipour, Parham, additional

Published
2021
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34. Interpretation of Hematological, Biochemical, and Immunological Findings of COVID-19 Disease: Biomarkers Associated with Severity and Mortality

Author

Ghazanfari, Tooba, primary, Salehi, Mohammad Reza, additional, Namaki, Saeed, additional, Arabkheradmand, Jalil, additional, Rostamian, Abdolrahman, additional, Rajabnia Chenary, Maryam, additional, Ghaffarpour, Sara, additional, Kaboudanian Ardestani, Sussan, additional, Edalatifard, Maryam, additional, Naghizadeh, Mohammad Mehdi, additional, Mohammadi, Saeed, additional, Mahloujirad, Maryam, additional, Izadi, Alireza, additional, Ghanaati, Hossein, additional, Beigmohammadi, Mohammad Taghi, additional, Vodjgani, Mohammad, additional, Shirazi, Bentolhoda Mohammad, additional, Mirsharif, Ensie Sadat, additional, Abdollahi, Alireza, additional, Mohammadi, Mostafa, additional, Emadi Kouchak, Hamid, additional, Dehghan Manshadi, Seyed Ali, additional, Saber Zamani, Mohammad, additional, Mahmoodi Aliabadi, Maedeh, additional, Jamali, Davoud, additional, Khajavirad, Nasim, additional, Mohseni Majd, Ali Mohammad, additional, Nasiri, Zahra, additional, and Faghihzadeh, Soghrat, additional

Published
2021
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35. Nutritional adequacy in critically ill patients: Result of PNSI study

Author

Javid, Zeinab, primary, Shadnoush, Mahdi, additional, Khadem-Rezaiyan, Majid, additional, Mohammad Zadeh Honarvar, Niyaz, additional, Sedaghat, Alireza, additional, Hashemian, Seyed Mohammadreza, additional, Ardehali, Seyed Hossein, additional, Nematy, Mohsen, additional, Pournik, Omid, additional, Beigmohammadi, Mohammad Taghi, additional, Safarian, Mohammad, additional, Moradi Moghaddam, Omid, additional, Khoshfetrat, Masoum, additional, Zand, Farid, additional, Mohammad Alizadeh, Afshin, additional, Kosari Monfared, Mahboube, additional, Mazaheri Eftekhar, Fatemeh, additional, Mohamadi Narab, Maryam, additional, Taheri, Arefe Sadat, additional, Babakhani, Khatereh, additional, Foroutan, Behnam, additional, Jamialahmadi, Tannaz, additional, Jabbarzadeh Gangeh, Bahareh, additional, Meshkani, Mehrnoush, additional, Kimiaee, Fahime, additional, and Norouzy, Abdolreza, additional

Published
2021
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37. Intermediate versus standard-dose prophylactic anticoagulation and statin therapy versus placebo in critically-ill patients with COVID-19: Rationale and design of the INSPIRATION/INSPIRATION-S studies

Author

Bikdeli, Behnood, primary, Talasaz, Azita H., additional, Rashidi, Farid, additional, Sharif-Kashani, Babak, additional, Farrokhpour, Mohsen, additional, Bakhshandeh, Hooman, additional, Sezavar, Hashem, additional, Dabbagh, Ali, additional, Beigmohammadi, Mohammad Taghi, additional, Payandemehr, Pooya, additional, Yadollahzadeh, Mahdi, additional, Riahi, Taghi, additional, Khalili, Hossein, additional, Jamalkhani, Sepehr, additional, Rezaeifar, Parisa, additional, Abedini, Atefeh, additional, Lookzadeh, Somayeh, additional, Shahmirzaei, Shaghayegh, additional, Tahamtan, Ouria, additional, Matin, Samira, additional, Amin, Ahmad, additional, Parhizgar, Seyed Ehsan, additional, Jimenez, David, additional, Gupta, Aakriti, additional, Madhavan, Mahesh V., additional, Parikh, Sahil A., additional, Monreal, Manuel, additional, Hadavand, Naser, additional, Hajighasemi, Alireza, additional, Maleki, Majid, additional, Sadeghian, Saeed, additional, Mohebbi, Bahram, additional, Piazza, Gregory, additional, Kirtane, Ajay J., additional, Lip, Gregory Y.H., additional, Krumholz, Harlan M., additional, Goldhaber, Samuel Z., additional, and Sadeghipour, Parham, additional

Published
2020
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38. Clinical Characteristics and Outcomes of 905 COVID-19 Patients Admitted to Imam Khomeini Hospital Complex in the Capital City of Tehran, Iran

Author

Allameh, Seyed Farshad, primary, Nemati, Saeed, additional, Ghalehtaki, Reza, additional, Mohammadnejad, Esmaeil, additional, Aghili, Seyed Mojtaba, additional, Khajavirad, Nasim, additional, Beigmohammadi, Mohammad-Taghi, additional, Salehi, Mohammadreza, additional, Mirfazaelian, Hadi, additional, Edalatifard, Maryam, additional, Kazemizadeh, Hossein, additional, Dehghan Manshadi, Seyed Ali, additional, Hasannezhad, Maliheh, additional, Amoozadeh, Laya, additional, Radnia, Masoud, additional, Khatami, Seyedeh Rana, additional, Nahvijou, Azin, additional, Seyyedsalehi, Monireh Sadat, additional, Rashidian, Laleh, additional, Ayoobi Yazdi, Niloofar, additional, Nasiri Toosi, Mohsen, additional, Sadeghniiat-Haghighi, Khosro, additional, Jafarian, Ali, additional, Yunesian, Masud, additional, and Zendehdel, Kazem, additional

Published
2020
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39. The effect of Vitamin C and Zn supplementation on the immune system and clinical outcomes in COVID-19 patients

Author

Firouzi, Safieh, Pahlavani, Naseh, Navashenaq, Jamshid Gholizadeh, Clayton, Zachary Stephen, Beigmohammadi, Mohammad Taghi, and Malekahmadi, Mahsa

Abstract

SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2) is the most dangerous form of the coronavirus, which causes COVID-19. In patients with severe COVID-19, the immune system becomes markedly overactive. There is evidence that supplementation with select micronutrients may play a role in maintaining immune system function in this patient population. Throughout the COVID-19 pandemic, significant emphasis has been placed on the importance of supplementing critical micronutrients such as Vitamin C and Zinc (Zn) due to their immunomodulatory effects. Viral infections, like COVID-19, increase physiological demand for these micronutrients. Therefore, the purpose of this review was to provide comprehensive information regarding the potential effectiveness of Vitamin C and Zn supplementation during viral infection and specifically COVID-19. This review demonstrated a relation between Vitamin C and Zn deficiency and a reduction in the innate immune response, which can ultimately make patients with COVID-19 more vulnerable to viral infection. As such, adequate intake of Vitamin C and Zn, as an adjunctive therapeutic approach with any necessary pharmacological treatment(s), may be necessary to mitigate the adverse physiological effects of COVID-19. To truly clarify the role of Vitamin C and Zn supplementation in the management of COVID-19, we must wait for the results of ongoing randomized controlled trials. The toxicity of Vitamin C and Zn should also be considered to prevent over-supplementation. Over-supplementation of Vitamin C can lead to oxalate toxicity, while increased Zn intake can reduce immune system function. In summary, Vitamin C and Zn supplementation may be useful in mitigating COVID-19 symptomology.

Published
2022
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40. Intermediate-Dose versus Standard-Dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to the Intensive Care Unit: 90-Day Results from the INSPIRATION Randomized Trial.

Author

Bikdeli, Behnood, Talasaz, Azita H., Rashidi, Farid, Bakhshandeh, Hooman, Rafiee, Farnaz, Rezaeifar, Parisa, Baghizadeh, Elahe, Matin, Samira, Jamalkhani, Sepehr, Tahamtan, Ouria, Sharif-Kashani, Babak, Beigmohammadi, Mohammad Taghi, Farrokhpour, Mohsen, Sezavar, Seyed Hashem, Payandemehr, Pooya, Dabbagh, Ali, Moghadam, Keivan Gohari, Khalili, Hossein, Yadollahzadeh, Mahdi, and Riahi, Taghi

Published
2022
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43. Ventilator-associated Pneumonia: Multidrug Resistant Acinetobacter vs. Extended Spectrum Beta Lactamase-producing Klebsiella

Author

Salehi, Mohammadreza, primary, Jafari, Sirous, additional, Ghafouri, Lida, additional, Malekafzali Ardakani, Hossein, additional, Abdollahi, Alireza, additional, Beigmohammadi, Mohammad Taghi, additional, Dehghan Manshadi, Seyed Ali, additional, Feizabadi, Mohammad Mehdi, additional, Ramezani, Masoud, additional, Abtahi, Hamidreza, additional, and Seifi, Arash, additional

Published
2020
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45. Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial.

Author

Sadeghipour, Parham, Talasaz, Azita H., Rashidi, Farid, Sharif-Kashani, Babak, Beigmohammadi, Mohammad Taghi, Farrokhpour, Mohsen, Sezavar, Seyed Hashem, Payandemehr, Pooya, Dabbagh, Ali, Moghadam, Keivan Gohari, Jamalkhani, Sepehr, Khalili, Hossein, Yadollahzadeh, Mahdi, Riahi, Taghi, Rezaeifar, Parisa, Tahamtan, Ouria, Matin, Samira, Abedini, Atefeh, Lookzadeh, Somayeh, and Rahmani, Hamid

Subjects
ANTICOAGULANTS, COVID-19, INTENSIVE care patients, THROMBOSIS, FIBRINOLYTIC agents, STATINS (Cardiovascular agents), EXTRACORPOREAL membrane oxygenation, THROMBOCYTOPENIA
Abstract

Importance: Thrombotic events are commonly reported in critically ill patients with COVID-19. Limited data exist to guide the intensity of antithrombotic prophylaxis.Objective: To evaluate the effects of intermediate-dose vs standard-dose prophylactic anticoagulation among patients with COVID-19 admitted to the intensive care unit (ICU).Design, Setting, and Participants: Multicenter randomized trial with a 2 × 2 factorial design performed in 10 academic centers in Iran comparing intermediate-dose vs standard-dose prophylactic anticoagulation (first hypothesis) and statin therapy vs matching placebo (second hypothesis; not reported in this article) among adult patients admitted to the ICU with COVID-19. Patients were recruited between July 29, 2020, and November 19, 2020. The final follow-up date for the 30-day primary outcome was December 19, 2020.Interventions: Intermediate-dose (enoxaparin, 1 mg/kg daily) (n = 276) vs standard prophylactic anticoagulation (enoxaparin, 40 mg daily) (n = 286), with modification according to body weight and creatinine clearance. The assigned treatments were planned to be continued until completion of 30-day follow-up.Main Outcomes and Measures: The primary efficacy outcome was a composite of venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days, assessed in randomized patients who met the eligibility criteria and received at least 1 dose of the assigned treatment. Prespecified safety outcomes included major bleeding according to the Bleeding Academic Research Consortium (type 3 or 5 definition), powered for noninferiority (a noninferiority margin of 1.8 based on odds ratio), and severe thrombocytopenia (platelet count <20 ×103/µL). All outcomes were blindly adjudicated.Results: Among 600 randomized patients, 562 (93.7%) were included in the primary analysis (median [interquartile range] age, 62 [50-71] years; 237 [42.2%] women). The primary efficacy outcome occurred in 126 patients (45.7%) in the intermediate-dose group and 126 patients (44.1%) in the standard-dose prophylaxis group (absolute risk difference, 1.5% [95% CI, -6.6% to 9.8%]; odds ratio, 1.06 [95% CI, 0.76-1.48]; P = .70). Major bleeding occurred in 7 patients (2.5%) in the intermediate-dose group and 4 patients (1.4%) in the standard-dose prophylaxis group (risk difference, 1.1% [1-sided 97.5% CI, -∞ to 3.4%]; odds ratio, 1.83 [1-sided 97.5% CI, 0.00-5.93]), not meeting the noninferiority criteria (P for noninferiority >.99). Severe thrombocytopenia occurred only in patients assigned to the intermediate-dose group (6 vs 0 patients; risk difference, 2.2% [95% CI, 0.4%-3.8%]; P = .01).Conclusions and Relevance: Among patients admitted to the ICU with COVID-19, intermediate-dose prophylactic anticoagulation, compared with standard-dose prophylactic anticoagulation, did not result in a significant difference in the primary outcome of a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days. These results do not support the routine empirical use of intermediate-dose prophylactic anticoagulation in unselected patients admitted to the ICU with COVID-19.Trial Registration: ClinicalTrials.gov Identifier: NCT04486508. [ABSTRACT FROM AUTHOR]

Published
2021
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46. Pathological Findings of Postmortem Biopsies From Lung, Heart, and Liver of 7 Deceased COVID-19 Patients.

Author

Beigmohammadi, Mohammad Taghi, Jahanbin, Behnaz, Safaei, Masoomeh, Amoozadeh, Laya, Khoshavi, Meysam, Mehrtash, Vahid, Jafarzadeh, Bita, and Abdollahi, Alireza

Subjects
*COVID-19, *AUTOPSY, *SARS-CoV-2, *CORE needle biopsy, *HEPATIC portal system, *MYOCARDIUM
Abstract

Background. A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been affecting almost all nations around the world. Most infected patients who have been admitted to intensive care units show SARS signs. In this study, we aimed to achieve a better understanding of pathological alterations that take place during the novel coronavirus infection in most presumed affected organs. Methods. We performed postmortem core needle biopsies from lung, heart, and liver on 7 deceased patients who had died of coronavirus disease 2019. Prepared tissue sections were observed by 2 expert pathologists. Results. Diffuse alveolar damage was the main pathologic finding in the lung tissue samples. Patients with hospitalization durations of more than 10 days showed evidence of organization. Multinucleated cells in alveolar spaces and alveolar walls, atypical enlarged cells, accumulation of macrophages in alveolar spaces, and congestion of vascular channels were the other histopathologic alteration of the lung. None of our heart biopsy samples met the criteria for myocarditis. Liver biopsies showed congestion, micro- and macro-vesicular changes, and minimal to mild portal inflammation, in the majority of cases. Conclusions. Similar to the previous coronavirus infection in 2003, the main pathologic finding in the lung was diffuse alveolar damage with a pattern of organization in prolonged cases. The SARS-CoV-2 infection does not cause myocarditis, and the ischemia of myocardium is the most probable justification of the observed pathologic changes in the heart. Liver tissue sections mostly showed nonspecific findings; however, ischemia of the liver can be identified in some cases. [ABSTRACT FROM AUTHOR]

Published
2021
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47. Effect of Magnesium Loading Dose on Insulin Resistance in Patients With Stress-Induced Hyperglycemia: A Randomized Clinical Trial.

Author

Heidary, Zinat, Khalili, Hossein, Mohammadi, Mostafa, Beigmohammadi, Mohammad-Taghi, and Abdollahi, Alireza

Subjects
CONFIDENCE intervals, CRITICALLY ill, HOMEOSTASIS, HYPERGLYCEMIA, INSULIN resistance, INTRAVENOUS therapy, MAGNESIUM, PATIENTS, PHYSIOLOGIC salines, STATISTICAL sampling, PSYCHOLOGICAL stress, RANDOMIZED controlled trials, TREATMENT effectiveness, ADIPONECTIN, DESCRIPTIVE statistics
Abstract

Objectives: There is currently no evidence that whether magnesium supplementation would improve stress-induced hyperglycemia (SIH) in critically ill patients. In this study, effects of magnesium loading dose on insulin resistance (IR) indices were evaluated in critically ill patients without diabetes having SIH. Methods: Seventy critically ill patients with SIH were assigned to receive a loading dose of magnesium (7.5 g of magnesium sulfate in 500 mL normal saline as intravenous infusion over an 8-hour period) or placebo. Changes in baseline of serum and intracellular magnesium and serum adiponectin (AD) levels, homeostasis model assessment of IR (HOMA-IR), and HOMA-AD ratio were assessed in this study. Results: Serum and intracellular magnesium levels increased significantly in patients in the magnesium group (P <.001). At day 3, there were significant differences between the magnesium group and the placebo group in the mean changes from baseline in the HOMA (between-group difference: −0.11; 95% confidence interval [CI]: −0.19 to −0.01; P =.02), the AD (between-group difference: 0.94; 95% CI: 0.41-1.48; P =.04), and the HOMA-AD ratio (between-group difference: −0.03; 95% CI: −0.04 to −0.01; P <.001). Conclusion: In the present study, a single-loading dose of intravenous magnesium improved IR indices in critically ill patients with SIH. [ABSTRACT FROM AUTHOR]

Published
2020
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