ABSTRACT
The outbreak of a novel coronavirus in Wuhan, China, in December 2019 led to a global crisis and a critical threat to the health of millions of people worldwide. Existing research indicates that besides typical respiratory symptoms and signs of COVID-19, gastrointestinal manifestations are also caused by coronavirus disease 2019 (COVID-19) and the main intention of this article is to compare the gastrointestinal disorders seen in patients infected by the virus as well as study the possible and logical mechanisms that may lead to these situations. The high rate of contagion of the virus and the number of current patients reveal the importance of this research and all other studies related to this subject.
ABSTRACT
Background: When an epidemic occurs, resources, including hospital beds, are severely limited and not all patients can be treated;so, hospital bed rationing is inevitable. Therefore, the aim of this study is to provide a method for evaluating and prioritizing patients with COVID-19 for admission to the intensive care unit. Methods: This was a descriptive-survey study in terms of data collection method conducted in the summer of 2021. Following the formation of an expert panel with 4 specialists, a three-stage approach to evaluating and prioritizing COVID-19 patients was adopted by combining multi-criteria decision analysis methods. In the first stage, effective criteria and sub-criteria for patients' prioritization were identified by a panel of experts and related studies, and the hierarchy of criteria was drawn. In the second stage, the Fuzzy best-worst method was used to determine the weight of criteria and sub-criteria. Finally, in the third stage, a combined compromise solution method was performed to prioritize 10 patients in need of COVID-19 and the most critical patient was selected. Results: According to the experts, among the 15 criteria studied, respiratory rate, PaO2/FiO2, impaired consciousness, mean arterial pressure and age were identified as 5 of the most important criteria in prioritizing COVID-19 patients for intensive care unit admission. In addition, 10 COVID-19 patients referred to Shohadaye Pakdasht Hospital were evaluated and prioritized with the proposed approach. Conclusion: The proposed method can be used as a useful tool in the evaluation of COVID-19 patients for admission to the intensive care unit and to support the vital decisions of physicians.
ABSTRACT
Background: To find different variables involved in the hospitalization of patients referred to the respiratory Emergency Room (ER) at the time of COVID-19 pandemic. Methods: A questionnaire was designed to determine different hypothetical factors involved in the hospitalization of 3481 patients during the COVID-19 pandemic. Results: This study suggests that the following factors/variables are involved in the hospitalization of patients: age, respiratory distress, duration of symptoms, cough, 5-day-prolonged fever, diabetes mellitus, respiratory diseases, renal conditions, history of chemotherapy, saturation of blood oxygen, sore throat, and fever. Conclusion: We found that through having an insight towards what may and may not be involved in the severity of the novel coronavirus infection, one might be able to decide if a patient could potentially benefit from hospitalization. Copyright 2022, Journal of Iranian Medical Council. All rights reserved.
ABSTRACT
Introduction: Since the start of COVID-19 pandemic in December 2019, until mid-April 2020 the total number of cases worldwide exceeded two millions and the death toll exceeded 130000 cases. Objective: The current study conducted to explore the clinical and epidemiological characteristics of COVID-19 patients, fatality of this disease and its mortality risk factors in major hospitals affiliated with Tehran University of Medical Sciences (TUMS). Methods: The data were collected in four major teaching hospitals affiliated with TUMS for all the patients that were admitted between Feb 19th and Apr 15th 2020 and were diagnosed as COVID-19 using reverse transcription polymerase chain reaction (RT-PCR), clinical diagnosis and/or lung computed tomography (CT) scan. The case fatality rate of the disease was estimated by age, sex, symptoms, comorbidities, and type of diagnosis. Logistic regression model was used to examine the associations between different factors and in-hospital deaths. Results: By Apr 15th 2020, a total of 4377 patients were admitted with COVID-19 diagnosis in four selected hospitals and 496 (11.3%) of these patients died in hospital. The case fatality rate of this disease was 28.8% in the ≥80-year age group, which was the highest compared to the other age groups. The case fatality rates were 12.5% and 9.8% among men and women, respectively. The results of multiple logistic regression on the outcome of death indicated that age, sex, cough, myalgia, reduced consciousness at arrival and past history of cancer were significantly associated with in-hospital death. Adjusting the effect of other variables, for each 10-year increase in age, the odds of death due to COVID-19 was 1.61 times greater (adjusted OR 1.61, 95% CI: 1.51 to 1.72, p<0.001). Conclusions: Older age, the male gender, past history of comorbidities (particularly cancer) and reduced consciousness at arrival are among the factors that can significantly increase the odds of in-hospital death in COVID 19 patients. These factors might be helpful in detecting and managing patients with poorer prognosis. © 2021 Tehran University of Medical Sciences.
ABSTRACT
In December 2019, the emergence of a novel coronavirus, which rapidly turned into a pandemic that posed a public health threat of global concern and has had a huge impact on the health of millions of people around the world. Existing evidence indicates relatively low incidence and mild severity of coronavirus disease 2019 (COVID-19) in children compared with adults; although the precise underlying reasons for such disparity remain obscure. The article provides general information about COVID-19 and epidemiological data of the disease in children, its clinical manifestations and multisystem inflammatory syndrome in children. The main aim of this article is to explore the reasons given for the mildness of the disease in pediatric patients. Several theories related to immunosenescence, vaccination and trained immunity, co-infection, angiotensin-converting enzyme-2 maturation and expression, viral exposure, overall health and smoking have been proposed in recent literature. However, due to the novelty of this virus and the lack of information about it, these reasons are not conclusive; however, these points are considered as possible reasons for the low prevalence and mildness of the disease in pediatric patients.