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Background: COVID-19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis. Infected subjects are at high risk for coagulation diseases such as venous thromboembolism. Objectives: The aim of the present study was to investigate the consequences of delayed referral of patients with COVID-19 in Ilam.
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Background: Patients with cancer are potentially vulnerable to COVID-19 infection due to the immune-compromised state of cancer or its treatment complications. Objective(s): This study compared the COVID-19 mortality rate in cancer patients with and without a history of chemotherapy. Method(s): This registry-based cohort study launched from March 2020 to March 2021 contains 2350 records in which 64 COVID-19 patients with cancer were included, of which 27 patients underwent the chemotherapy plan within eight weeks before confirmed COVID-19. In addition, age and sex were matched in patients without a history of cancer as a control group. Two groups of cancer patients with and without a history of chemotherapy compared to the control group using cox proportional hazard regression models in Stata.10 software. Result(s): Patients with cancer had a higher hazard for in-hospital mortality from COVID-19 infection (adjusted HR;2.27, 95% CI: 1.25-4.13, P = 0.007) after adjusting for age, sex, body mass index (BMI), and co-morbidities. Our result showed no significant association between chemotherapy and control groups (adjusted HR;1.65, 95% CI: 0.60-4.56, P = 0.33). Conclusion(s): Patients with cancer faced a risk of mortality from COVID-19 two times higher than those without cancer. However, chemotherapy did not increase the mortality following COVID-19 infection. Copyright © 2022, Author(s).
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Background: COVID-19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis. Infected subjects are at high risk for coagulation diseases such as venous thromboembolism. Therefore, the present study was conducted to investigate the consequences of delayed referral of patients with Quaid-19 in Ilam. Methods: In this study, a present prospective study was performed in 2020 on the registry data of patients with COVID-19 disease in the infectious ward of Shahid Mostafa Khomeini Hospital in Ilam.. In this study, the effect of delay in hospitalization from the onset of the first symptom of the disease on death and intubation of patients in special and general wards in 2350 patients with COVID-19 was investigated. Delays in referrals were recorded by day and based on the biographies recorded in the patients' files. In this registry, only 96% of patients reported a delay of 1 to 60 days. The effect of the delay on mortality as well as the intubation rate were analyzed using logistic regression models in Stata software 12. Results: The average number of days of delay in referral according to different variables for deceased patients, requiring intubation and requiring hospitalization in the ICU is listed in Table 1. The results of univariate logistic regression analysis for the main causes of death due to COVID-19 disease according to hospitalization in ICU and general ward showed that the variables of age, sex, marital status, heart disease, blood pressure, diabetes, chronic lung disease, chronic disease Kidney, neurological disease, cancer and delayed referral were statistically significantly associated with death at the 5% error level. The chance of death for delayed referral in ICU patients is equal (OR ICU ADMISSION = 1.06;95% CI, 1.01 - 1.12;P value = 0.01) and in normal ward patients (OR = 0.88;95% CI, 0.79 - 0.97;P value = 0.01 was obtained. Conclusions: According to the results of the final regression model which were adjusted to other variables, in hospitalized patients, each day of delay in hospitalization meant a 0.08% increase in the odds of mortality rate and a 0.05% increase in the odds of intubation.
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Background & Objective: Individuals with opioid use disorder are a marginalized population in any society. They commonly have a weaker immune system, greater stress vulnerability, poorer health, more high-risk behaviors, and less access to healthcare services compared to the general population, which can expose them to a risk of severe COVID-19 complications. This study aimed to evaluate the effects of opioid use disorder on mortality in patients with SARS-CoV-2. Materials & Methods: This registry-based retrospective cohort study was conducted on 2362 consecutive inpatients with a confirmed diagnosis of SARS-CoV-2 between March 5, 2020 and March 21, 2021, presenting to a university hospital in Ilam in the southwest of Iran. Forty-five patients with opioid use disorder were identified in this study and matched to 100 patients without opium addiction. All patients with a history of opium addiction were included in the study group, and age-and sex-matched patients without opioid use disorder were randomly recruited as the controls. After adjusting for the effects of age and comorbidities, data were analyzed in STATA version 10, using logistic regression models. Results: The mortality of patients with opioid use disorder increased following COVID-19 (adjusted OR: 6.59;95% CI: 1.84–23.59;P=0.004). Hypertension (adjusted OR: 8.17;95% CI: 2.21–30.15;P=0.002) and advancing age (OR: 1.06;95% CI: 1.01–1.11;P=0.01) were significantly associated with increased COVID-19 mortality. Conclusion: Based on the present findings, opioid use disorder is a possible risk factor for mortality following COVID-19. The findings of the present study can be applied in the implementation of preventive measures and policies and prioritization of COVID-19 vaccination. However, further relevant research is recommended.
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On March 11, 2020, the World Health Organization declared the COVID-19 (coronavirus) outbreak a pandemic. In the following days, media reports showed that consumers increasingly stockpiled groceries and household supplies. Interestingly, behavioral data show that this stockpiling exhibited considerable heterogeneity across countries. Building on cultural dimension theory, the authors theorize that this heterogeneity can be explained by countries’ cultural values: consumer stockpiling after the World Health Organization's announcement was more pronounced in countries whose residents show high uncertainty avoidance, low long-term orientation, low indulgence, and high individualism. The authors confirm these propositions using global mobility data from Google matched with country-level data on cultural values, pandemic reaction policies, and other key variables. This research note thereby integrates the previously disconnected literature on cultural dimension theory and consumer stockpiling in general, as well as provides new and significant knowledge about cross-cultural consumer behavior in crises. Furthermore, the authors provide actionable insights for international policy makers and business managers who aim to predict or control consumer stockpiling in future global crises to enhance consumer well-being. © The Author(s) 2021.
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Background: COVID-19 disease is a new disease that is very important how informing the patient about it. This study was conducted with the aim of investigating the experiences of the nurses' staff on how to inform the patient to get infected with COVID-19. Methods: Twelve health care providers (8 nurses and 4 anesthesiologists) in an educational and medical center in the city of Ilam in From February to June 2020 participated in the study with purposeful sampling. Semi-structured interviews were used to collect data, and the study began with the open question, "Describe your experience of identifying the disease in patients with COVID-19". To analyze the data, the conventional qualitative content analysis was performed. Results: Participants in this study included 12 medical personnel, of which 7 (58.4%) were male and 5 (41.6%) were female. Based on the findings, 2 main themes and 7 sub-themes were extracted. The main themes extracted from this study include A) Passing the patient of the purgatory of COVID-19 diagnosis including four sub-themes: 1) Waiting for a diagnosis, 2) Announcing step by step the diagnosis, 3) giving information, 4) acceptance or resistance;B) Entering the important others to the purgatory of COVID-19 diagnosis including three sub-themes: 1) Entering the key family members, 2) Entering the physician, 3) Entering the relatives working as medical staff. Conclusion: Diagnosing the disease of COVID-19 is like a purgatory for patient and staff. To help the patient get through this purgatory, important others are introduced by the staff. Eventually the patient either accepts the disease or resists accepting it.
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Objectives: This study was conducted to evaluate the clinical features of 68 coronavirus 2019-infected cardiac cases on gender basis. Methodology: Clinical, laboratory and electrocardiographic data of 68 COVID-19 patients with pre-existing cardiovascular diseases, analyzed and compared by gender-wise. Results: Dry cough (78% of male, 80% females) and fever (62% of male, 75% females) were the most common symptoms. Out of these 97% of them needed O2 supplementation. O2 saturation in patients with O2 therapy was 85%;31% of men and 11% of women experienced intubation. The most common laboratory abnormalities, were neutrophilia, leukocytosis, lymphopenia, thrombocytopenia, decreased hemoglobin level, increased creatinine and urea, in men and women. Troponin level was different between male and female. Pneumonia was found in 86-87% patients. Approximately, Males and female, respectively53.10 and 52.8%, shown sinus tachycardia (ST arrythmia). PVC arrythmia was found in 2.9% of total patients. BBB arrythmia was found in 31.20% of males vs. 11.10% of females. The mean systole/diastole blood pressures respectively were 130±4/79.7 ±2 in males and 134±4/81±3 in females. Heart axis changes was identified in 43.8% and 27.8% of males and females respectively. Conclusion: Severity of symptoms and outcomes of COVID-19 in cardiac patients showed some differences between men and women which could be associated with differences in immune responses, respiratory tract properties, renin angiotensin system, sex hormones and lifestyle. However, more studies to categorize gender differences are required. © 2017 Pakistan Cardiac Society. All Rights Reserved.
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Cardiac arrhythmias are important causes of death among populations and are always responsible for a high percentage of mortality in hospitalized patients. The aim of this descriptive analytical study was to evaluate the frequency of arrhythmias in patients with coronavirus disease 2019 (COVID-19) in the Shahid Mostafa Khomeini Hospital of Ilam from March to August 2020. All the COVID-19 patients with a cardiac condition admitted to the intensive care unit were enrolled in the study by census. Electrocardiography (ECG) and Holter monitoring were used to diagnose arrhythmias. Data analysis was performed in Microsoft Excel using descriptive statistics (frequency and percentage). The total number of eligible patients was 45, of whom 26 (57.8%) were men and 19 (42.2%) were women. The mortality rate of arrhythmias among COVID-19 patients was 17.77% (8 out of 45 patients), and the recovery rate was 82.13% (37 out of 45 patients). Tachycardia and a lack of response to heart-rate-reducing drugs were observed in patients with COVID-19. Owing to an overlap between these symptoms and those of heart diseases, there is a need to further evaluate patients with arrhythmias. Although arrhythmias are not common in COVID-19 patients, they can be fatal and have a high mortality rate, which can be prevented by early detection.