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Background and Purpose: Numerous comorbidities are involved in the severity of the new coronavirus disease 2019 (COVID-19). Hypothyroidism’s impact on COVID-19 is yet to be adequately understood. Thyroid disorders are thought to play a role in the development and progress of COVID-19. This study aimed to determine the frequency of hypothyroidism among COVID-19 patients in hospitalized patients. Materials and Methods: This retrospective cross-sectional study was conducted at a tertiary hospital in Tehran City, Iran. Demographic information and other specified data related to our research, mainly comorbidities, were collected using a structured questionnaire from electronic patient health records. A total of 493 medical records of COVID-19 patients were used for this study according to the inclusion criteria. Subsequently, the data were analyzed with SPSS, version 25, using descriptive and analytic statistics. Results: The prevalence of hypothyroidism was 13.2% (n=65) in hospitalized COVID-19 patients. This was higher (13.4% vs 2.3%) compared with the prevalence of hypothyroidism in the general Iranian population. Overall, in patients with hypothyroidism, about 21 patients (32.3%) expired, of whom 14 patients (66.7%) were female, and 7 (33.3%) were male. In these patients, no statistically significant difference was observed between the expired and discharged groups (Adjusted Odds Ratio: 1.04; 95% CI 0.59-1.83; P=0.87). As a result, hypothyroidism was not linked to an increased risk of death. Conclusion: Hypothyroidism in hospitalized COVID-19 patients appears to be low. However, it seems more prevalent in the female gender but without significant adverse effects on the risk of mortality from this disease.

Objective: Understanding the minimum infective dose is significant for risk assessment in the performance of suitable infection control strategies in healthcare centers. However, the literature lacks strong evidence regarding this value for severe acute respiratory syndrome coronavirus 2. Therefore, the aim of this study was to investigate the minimum infectious dose of coronavirus disease 2019. Methods: We searched the databases of PubMed, Scopus, Web of Science, and Cochrane and retrieved all the relevant literature by 25 July 2021. The records were downloaded into the EndNote software and underwent title/abstract and full-text screenings. A summary of included studies was organized into tables for further analysis, interpretation, and drafting of the results. Results: Nineteen studies including the laboratory data on human and animal hosts were selected based on the eligibility criteria. All the literature reported on the infective dose, particularly in humans. The main methods for measurement of infection were through tissue culture infectious dose (TCID50) and counting plaque-forming units. The range of minimum infective was 1.26–7 × 10 6.25 PFU. Conclusion: In this study, we have presented a range of minimum infective doses in humans and various animal species. Such numbers can possibly vary between the individuals based on numerous demographic, immunologic, or other factors.

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.

Abstract Background and Aims Scientists and healthcare workers have expressed their concerns on the impacts of the COVID‐19 pandemic on vaccination coverage in children and adolescents. Therefore, we aimed to systematically review the studies addressing this issue worldwide. Methods We conducted a systematic search of relevant studies using the keywords on databases of PubMed, Web of Science, and Cochrane on May 22, 2021. The identified records were imported into EndNote software and underwent a two‐phase screening process consisting of title/abstract and full‐text screenings against inclusion criteria. The data of the included studies were summarized into a table and the findings were analyzed in a systematic approach. Results From 26 eligible studies, 21 studies demonstrated decreased vaccination rates in the children during the COVID‐19 pandemic, while three studies found increased or no significant changes only in influenza vaccination. The two remaining studies from Brazil and Sweden also showed no significant changes in vaccination rates in the children during the pandemic. Conclusion Most of the reports worldwide reported a decline or delay in vaccination at the time of the COVID‐19 pandemic. A sustained catch‐up program seems to be necessary, especially in low‐income countries, to avoid any vaccine dose missing. Facilitating the vaccination process is recommended, such as decreasing the waiting time for vaccination at the health center, addressing the fear and concerns related to COVID infection for parents, and enhancing vaccine availability, and promoting access in remote areas. Countries should ensure proper vaccination to prevent future pandemics related to vaccine‐preventable diseases.

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.

Objective: The coronavirus disease 2019 (COVID-19) has become a global pandemic. Timely and effective predictors of survival and death rates are crucial for improving the management of COVID-19 patients. In this study, we evaluated the predictors of mortality based on the demographics, comorbidities, clinical characteristics, laboratory findings, and vital signs of 500 patients with COVID-19 admitted at Imam Khomeini Hospital Complex, the biggest hospital in Tehran, Iran. Methods: Five hundred hospitalized laboratory-confirmed COVID-19 patients were included in this study. Subsequently, electronic medical records, including patient demographics, clinical manifestation, comorbidities, and laboratory test results were collected and analyzed. They were divided into two groups: expired and discharged. Demographics, clinical, and laboratory data were compared among the two groups. The related factors with death in the patients were determined using univariate and multivariate logistic regression approaches. Results: Among the 500 hospitalized patients, most patients were male (66.4% versus 33.6%). The expired group had more patients ⩾70 years of age compared with the discharged group (32.9% versus 16.3%, respectively). Almost 66% of the expired patients were hospitalized for ⩾5 days which was higher than the discharge group (26.9%). Patients with a history of opium use in the expired group were significantly higher compared to the discharged group (14.8% versus 8.6%, p = 0.04) as well as a history of cancer (15.5% versus 4.7%, p

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. [ABSTRACT FROM AUTHOR]

Bartonella is an infrequent yet important pathogen in immunocompromised patients. Bartonella infections can cause serious morbidity and mortality in people living with human immunodeficiency virus (PLWH), particularly those with advanced immunosuppression. The prevalence of clinically evident Bartonella infections among PLWH is relatively low. Here, we reported a bacillary angiomatosis (BA) case in a homeless HIV-positive patient. A 31-year-old man with acquired immunodeficiency syndrome (AIDS) and advanced immunosuppression, who had discontinued antiretroviral therapy (ART) one year ago, referred to the hospital. At the admission, he had nausea, vomiting, anorexia, weight loss, occasional sputum cough, subjective fevers, and multiple skin lesions. Lesions' biopsies were non-diagnostic for routine bacterial, tuberculosis, and fungal infection. However, the diagnosis of Bartonella quintana was confirmed by serum polymerase chain reaction (PCR). After receiving a long course of antibiotic therapy, skin lesions resolved. The patient had a favorable outcome with supportive care and continuation of ART and doxycycline. While easily treated, an infection due to Bartonella may be clinically unrecognized, if skin lesions are absent or overlooked, and microbiologically unrecognized, if appropriate protocols are not followed. Because the fever caused by Bartonella infection is easily treated, it is essential that suspected clinical signs of Bartonella infection in immunocompromised hosts should be reported to the microbiology laboratory. Bartonella quintana infection can result in a broad range of often non-specific clinical manifestations; therefore, patients must be evaluated for suspected bacteremia, and clinical wariness is required for diagnosis. [ABSTRACT FROM AUTHOR]

Gingival enlargement is caused by various factors such as inflammation, medications and malignant diseases. Acute leukemic enlargement is commonly seen in children. If prompt diagnosis is not made properly and treated early, it may result in significant morbidity and mortality. Gingival enlargement is seldom seen in adult patients with acute lymphoblastic leukemia. This case report presents an interesting rare case of gingival enlargement in an adult patient with acute lymphoblastic leukemia and management of the disease. [ABSTRACT FROM AUTHOR]