Safety and Effectiveness of SeptimebTM in Patients with COVID-19 Referred to a Teaching and Referral Hospital: An Uncontrolled Clinical Trial Study (Phase II)

Background: We conducted this study to determine the safety and evidence of effectiveness of SeptimebTM among patients with COVID-19. Methods: An uncontrolled phase II clinical trial with SeptimebTM was implemented in Imam Khomeini Hospital as a before-and-after trial during May to October 2020. Considering the inclusion and exclusion criteria, 33 patients with COVID-19 were treated using SeptimebTM. The patients received the anti-inflammatory drug 150 mg /10 ml /IV infusion SeptimebTM on the first day and then 300 mg /20 ml / IV infusion from the second day onwards for at least 2 days and up to 13 days based on the improvement of clinical symptoms and laboratory findings in addition to treatment which were selected according to the national protocol. The patients were then evaluated for the treatment efficacy and side effects. Adherence to treatment, clinical observations, and side effects were recorded before and after the treatment. Results: The herbal drug SeptimebTM was injected in phase two of an uncontrolled clinical trial on 33 patients with COVID-19 in Imam Khomeini Hospital in Tehran as a before-and-after trial. The number of new cases admitted to the Intensive Care Unit (ICU) and the new need to Non-Invasive Ventilation (NIV) ecreased compared to before the treatment. Also, blood oxygen saturation and platelet count increased. Conversely, CRP, ESR, and ferritin levels decreased (p<0.05). Besides, SeptimebTM did not show any serious side effects except recurrent thrombophlebitis during the treatment. Conclusion: We found some evidence regarding the efficacy of this drug and its low amount of short term side effects. The investigators recommend conducting the third phase of the clinical trial. Copyright 2023, Journal of Iranian Medical Council.

Artificial Intelligence in COVID-19 Management: A Systematic Review

With the development of modern technologies in the field of healthcare, the use of Artificial Intelligence (AI) in disease management is increasing. AI methods may assist healthcare providers in the COVID-19 era. The current study aimed to observe the efficacy and importance of AI for managing the COVID-19 pandemic. An organized search was conducted, utilizing PubMed, Web of Science, Scopus, Embase, and Cochrane up to September 2022. Studies were considered qualified for inclusion if they met the inclusion criterion. We conducted review according to the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA) guidelines. There were 52 documents that met the eligibility criteria to be included in the review. The most common item using AI during the COVID-19 era was predictive models to foretell pneumonia and mortality risks in people with COVID-19 based on medical and experimental parameters. COVID-19 mortality was related to being male and elderly based on the Artificial Neural Network (ANN) and Convolutional Neural Network (CNN) logistic regression analysis of demographics, clinical data, and laboratory tests of hospitalized COVID-19 patients. AI can predict, diagnose and model COVID-19 by using techniques such as support vector machines, decision trees, and neural networks. It is suggested that future research should deal with the design and development of AI-based tools for the management of chronic diseases such as COVID-19. © 2023 Samaneh Mohammadi, SeyedAhmad SeyedAlinaghi, Mohammad Heydari, Zahra Pashaei, Pegah Mirzapour, Amirali Karimi, Amir Masoud Afsahi, Peyman Mirghaderi, Parsa Mohammadi, Ghazal Arjmand, Yasna Soleimani, Ayein Azarnoush, Hengameh Mojdeganlou, Mohsen Dashti, Hadiseh Azadi Cheshmekabodi, Sanaz Varshochi, Mohammad Mehrtak, Ahmadreza Shamsabadi, Esmaeil Mehraeen, and Daniel Hackett. This open-access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.

Investigation of Effective Drugs in the Treatment of Patients with COVID-19

Background: Due to the lack of definitive treatments for corona disease and the use of various medications in protocols around the world, it is necessary to conduct more epidemiological studies exploring the effect of different available therapeutic regimes;therefore, the present study aimed to explore the current effective drugs for the treatment of hospitalized COVID-19 patients. Methods: The present study is a descriptive-analytical study that was conducted between August and September of 2021 at Khalkhal University of Medical Sciences. A convenient sampling method was employed to retrieve the data from the available hospital records, including 252 documents from COVID-19 hospitalized patients. A researcher-made checklist was used to record the data. Data were analyzed using SPSS 26 software. Results: The findings showed that Hypertension and Hypotension (n=47,18.7%) are the most common underlying diseases in the study sample. The most therapeutic regimen was the combination of Remdesivir and Dexametason (n=137,54.4%) in hospitalized COVID-19 patients. There are a variety of organ involvements and presentations to the COVID-19;however, most patients experience a mild-to-moderate, self-limited disease;even though, the disease could progress to more fatal cases and lead to death. Conclusion: The main pathology exists in the lungs which are caused by an inappropriate immune response that leads to a severe inflammatory response. Therefore, antiviral and anti-inflammatory drugs are currently the first-line therapy for hospitalized patients. Copyright 2023, Journal of Iranian Medical Council.

Factors associated with covid-19 morbidity and mortality: A narrative review

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been declared as a pandemic on March 11th 2020 by the WHO. Morbidity and mortality of COVID-19 has been shown to be high among patients with underlying diseases. In this narrative review, searching a number of electronic databases (PubMed, Google Scholar, Scopus, and Science Direct), 127 related articles written in English were retrieved and of which 73 articles related to risk factors affecting morbidity and mortality of COVID-19 were extracted and summarized. Factors such as old age, male gender and working in health setting were associated with higher morbidity and mortality. Hypertension was the most frequent reported condition among those with severe disease. It also appeared to increase the mortality and duration of hospitalization. Diabetes, respiratory chronic illnesses (COPD, asthma), impaired liver and renal function, and malignancies were also mentioned as the risk factors for severe disease, longer hospitalization, poor prognosis and outcome. Some laboratory findings such as elevated D-dimer, CRP, and LDH as well as severe lymphopenia were associated with severity, mortality and poor outcomes in hospitalized patients. All in all, a considerable number of comorbidities and biomarkers are associated with severity and presentations of COVID-19 disease, affecting its morbidity and mortality rates. © 2020, Journal of Iranian Medical Council.