Exploring the underlying factors of COVID-19 vaccination hesitancy in Ahvaz, Iran: a comprehensive cross-sectional study.

Purpose: Around 70% of the Iranian population had received two doses of coronavirus disease 2019 (COVID-19) vaccines by the end of 2021. In this study, we evaluated the reasons for vaccination refusal among people in Ahvaz, Iran. Materials and Methods: In this cross-sectional study, 800 participants (400 vaccinated and 400 unvaccinated) were recruited. A demographic questionnaire was completed through interviews. The unvaccinated participants were asked about the reasons for their refusal. The Shapiro-Wilk test, independent t-test, chi-square test, and logistic regression were used for analyzing data. Results: Older people were 1.018 times more likely to refrain from vaccination (95% confidence interval [CI], 1.001-1.039; p=043). People who were manual workers as well as those who were unemployed/housewives were 0.288 and 0.423 times less likely to receive vaccination, respectively. Those with high school education and married women were 0.319 and 0.280 times less likely to receive vaccination, respectively (95% CI, 198-0.515; p<0.001; 95% CI, 0.186-0.422; p<0.001). Participants who had hypertension or suffered from neurological disorders were more likely to receive the vaccination. Finally, people affected with severe COVID-19 infection were 3.157 times more likely to get vaccinated (95% CI, 1.672-5.961; p<0.001). Conclusion: The results of this study showed that lower level of education and older age were contributed to reluctance for vaccination, while having chronic diseases or being already infected with severe COVID-19 infection were associated with more acceptance of vaccination.

Prevalence of self-medication during COVID-19 pandemic: A systematic review and meta-analysis.

Background: The COVID-19 pandemic and restrictions on travel and quarantine measures made people turn to self-medication (SM) to control the symptoms of their diseases. Different studies were conducted worldwide on different populations, and their results were different. Therefore, this global systematic review and meta-analysis was conducted to estimate the pooled prevalence of self-medication. Methods: In this systematic review and meta-analysis, databases of Scopus, PubMed, Embase, and Web of Science were searched without a time limit. All eligible observational articles that reported self-medication during the COVID-19 pandemic were analyzed. Heterogeneity among the studies was assessed using Cochran's Q test and I2 statistics. A random-effects model was used to estimate the pooled prevalence of self-medication. The methodological quality of the articles was evaluated with the Newcastle-Ottawa Scale. Results: Fifty-six eligible studies were reviewed. The pooled prevalence of self-medication was 48.6% (95% CI: 42.8-54.3). The highest and lowest prevalence of self-medication was in Asia (53%; 95% CI: 45-61) and Europe (40.8%; 95% CI: 35-46.8). Also, the highest and lowest prevalence of self-medication was related to students (54.5; 95% CI: 40.8-68.3) and healthcare workers (32.5%; 16-49). The prevalence of self-medication in the general population (48.8%; 40.6-57) and in patients with COVID-19 (41.7%; 25.5-58). The prevalence of self-medication was higher in studies that collected data in 2021 than in 2020 (51.2 vs. 48%). Publication bias was not significant (p = 0.320). Conclusion: During the COVID-19 pandemic, self-medication was highly prevalent, so nearly half of the people self-medicated. Therefore, it seems necessary to provide public education to control the consequences of self-medication.

Severe SARS-CoV-2 infection in a 32-week pregnant woman treated with Remdesivir-Dexamethasone combination therapy: A case report.

This study shows that remdesivir and dexamethasone combination therapy can be considered as a suitable treatment choice for pregnant women infected with COVID-19. It is worth mentioning that more studies are required to evaluate the efficacy and side effects of remdesivir monotherapy and its combination with dexamethasone during pregnancy.

The therapeutic efficacy of quercetin in combination with antiviral drugs in hospitalized COVID-19 patients: A randomized controlled trial.

In this study, the therapeutic efficacy of quercetin in combination with remdesivir and favipiravir, were evaluated in severe hospitalized COVID-19 patients. Our main objective was to assess the ability of quercetin for preventing the progression of the disease into critical phase, and reducing the levels of inflammatory markers related to SARS-Cov-2 pathogenesis. Through an open-label clinical trial, 60 severe cases were randomly divided into control and intervention groups. During a 7-day period, patients in the control group received antivirals, i.e., remdesivir or favipiravir, while the intervention group was treated with 1000 mg of quercetin daily in addition to the antiviral drugs. According to the results, taking quercetin was significantly associated with partial earlier discharge and reduced serum levels of ALP, q-CRP, and LDH in the intervention group. Furthermore, although the values were in normal range, the statistical outputs showed significant increase in hemoglobin level and respiratory rate in patients who were taking quercetin. Based on our observations, quercetin is safe and effective in lowering the serum levels of ALP, q-CRP, and LDH as critical markers involved in COVID-19 severity. However, according to the non-significant borderline results in comparing the mortality, the ICU-admission rate, and the duration of ICU-admission, further studies can be helpful to compensate the limitations of our study and clarify the therapeutic potential of quercetin in COVID-19 treatments.

Prevalence of SARS-CoV-2 in Patients with Severe Pneumonia in Khuzestan Province, Iran.

The emergence of a highly pathogenic virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) accounts for severe pneumonia throughout the world. More than 7 million world population have been infected with SARS-CoV-2, and the number of deaths is increasing every day. This study aimed to evaluate the frequency of SARS-CoV-2 in hospitalized patients with an acute respiratory infection (ARI). During an outbreak of the SARS-CoV-2, the nasopharyngeal and oropharyngeal swabs were collected from 909 hospitalized patients with severe pneumonia, including 517 (56.9%) males and 392 (43.1%) females. All the collected samples were from different cities of Khuzestan province from 19 February to- 27 March 2020. The RNA was extracted from samples and subjected to real-time polymerase chain reaction (PCR) tests for the detection of the SARS-CoV-2. Simultaneously, the computerized tomography (CT) scan was tested for the presence of ground-glass opacity in the lung among the patients. Of the total number of 909 specimens, 328 (36.08%) cases, including 185 (20.35%) females and 143 (15.73%) males, were positive for the SARS-CoV-2 while, 581 (63.9%) cases, including 374 (41.14%) males and 207 (22.77%) were negative for the SARS-CoV-2 by real-time PCR (p=0.001).Four hundred sixteen (45.76%) cases were positive for ground-glass opacity in the lung by CT scan, while 328/909 (36.08%) trials proved positive for SARS-CoV-2 by the real-time PCR (p=0.003).  In this study, 36.08% of patients were positive for SARS-CoV-2. Although the results of positive cases by CT scan showed higher than real-time PCR, screening the SARS-COV-2 with a real-time PCR method is the first line of choice.