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Introduction: It seems that Multiple sclerosis (MS) patients are at the higher risk for COVID-19 implications due to the use of immunomodulatory or immunosuppressive treatments. Obesity as a risk factor may lead to more adverse consequences. Relationship between obesity and COVID-19 risk and outcome in Iranian MS patients still remains unclear. We aimed to investigate the impact of BMI as a modifiable risk factors on the risk and outcomes of COVID-19 in Iranian patients with MS. Material(s) and Method(s): A cross-sectional study was conducted in the Sina hospital, Tehran, Iran. MS patients were asked to complete an online questionnaire in the google form format. Demographic information, clinical data consisting of MS disease-related factors, COVID-19-related factors, and anthropometric information were collected. In total, 492 patients were filled the questionnaire. BMI was categorized considering WHO's standard classification as underweight (BMI<18.5), normal weight (BMI>=18.5 and <25), overweight (BMI>=25 and <30), obesity type I (BMI>=30 and <35), and obesity type II (BMI>=35) (3). Result(s): The mean age was 36.7+/-8.2 and 395(80.3%) of them were women. 350(71.1%) of participants were suffered from RRMS. The most received MS drugs was Rituximab (36.0%). The mean BMI was 24.3+/-4.5 kg/m2. 234(47.6%) participants reported COVID-19 infection during the pandemic. 465(94.5%) of them were two doses vaccinated and 15(3%) of them were one-dose vaccinated. The odds ratio of COVID-19 infection was significantly 4.41 times more than the normal group in the type 2 obesity category (OR:5.41;95%CI:1.00-29.09) in the fully adjusted regression model. COVID-19 severity was significantly different in BMI groups (P:0.02), So that 11(8.6%) patients in normal weight group and 4(50%) of patients in type II obesity group were hospitalized due to COVID-19 infection. Respiratory symptoms (P:0.05) and gastrointestinal symptoms (P<0.01) were more prevalent among types I and II of obesity. On the other hand, no one in the obesity type I and II reported COVID-19 infection without any symptoms (P:0.04). Conclusion(s): The results of current study support that obesity could play a key role in susceptibility to COVID-19 infection and symptoms severity in MS patients. One of the issues that emerge from these findings is recommended that neurologists pay more attention on patients' BMI during this pandemic.Copyright © 2022
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In this chapter, the epidemic diseases, their impact on the future of cities, and the causes of these problems for cities are examined. Additionally, efforts will be made to address these challenges and problems, a response that can make future cities livable and sustainable, despite population growth, increasing environmental problems, increasing urban management challenges, epidemic diseases and pandemics such as COVID-19 and other challenges and problems. This chapter will also discuss the steps taken in the field of smart transformation and smart cities and the necessity for cities to move toward smart transformation. © 2023 by Amin Faraji, Amin Gharibi and Azadeh Azimi. All rights reserved.
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Background. Coronavirus Disease 2019 (COVID-19) is associated with an increased incidence of pulmonary embolism (PE). Both conditions increase hospital complications and mortality, especially when exhibited concurrently. Unfortunately, both conditions may present similarly, and physicians often have a difficult time finding clinical indicators to suggest pursuing further evaluation of a PE during a COVID-19 infection. Methods. Using a multi-center facility database, we conducted a retrospective analysis of 3,675 COVID-19 patients at Methodist Health System from March 2020 to December 2020. COVID-19 infection was determined via molecular PCR testing and PE was determined by computed tomography (CT) scan with angiography. Patient demographics and laboratory values were determined by a manual review of patient charts. Chi-Square test was used to analyze observed variables. Odds ratios were calculated for variables with a statistically significant difference (p < 0.05). Results. Of the 3,675 patients diagnosed with COVID-19, 150 (4.1%) were diagnosed with PE. Elevated D-dimer level had a statistically significant association with increased rate of PE (OR 0.1988, 95% CI 0.0727 - 0.5438, p < 0.001). Factors such as elevated C-reactive protein (p = 0.61), IL-6 (p = 0.26), smoking history (p = 0.70), age over 65 (p=0.54), BMI over 25 (p = 0.42), and history of chronic kidney disease (p = 0.16) did not show a significant association with PE incidence. Of note, patients with PE during admission were seen to have an increased incidence of intubation (OR 0.40, 95% CI 0.2660 - 0.6029, p < 0.001). Conclusion. Our study suggests that COVID-19 patients with elevated D-dimer have higher odds of having a PE. This study also suggests that COVID-19 patients that develop a PE during hospitalization are more likely to require intubation.
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Background: Now that the majority of the population has been immunized with two-dose vaccines, debates over the third booster dose have been raised. We studied the viewpoint of cases with multiple sclerosis (MS) on this matter. Method(s): In a cross-sectional study, a google form containing questions about participants' characteristics, the history of coronavirus disease 2019 (COVID-19) infection and vaccination, and opinions on the third dose was designed. Result(s): Of 1067 responders, only 16 (1.5%) were not vaccinated at all. The most used vaccine type was Sinopharm BBIBP COVID-19 vaccine (BBIBP-CorV) (n = 1002, 93.9%). Generally, 58 (5.4%) cases were hospitalized due to COVID-19. Of those with full vaccination, 134 (13.3%) got COVID-19 infection after the second dose. Only 13 participants (1%) did not agree with the third dose, while 564 (53.0%) believed that a booster dose was needed. Of all, 488 (45.7%) declared that they did not have a final idea and would follow the instructions by the experts. A significant association was found between not receiving the first two doses and not believing in the third dose (P = 0.001). 692 patients declared their reasoning for the importance of the third dose. All the cases who thought the administered vaccine was not efficient enough had received Sinopharm BBIBP-CorV. Those who got infected after full vaccination were more uncertain about the efficacy of the vaccine [odds ratio (OR): 2.6, 95% confidence interval (CI): 1.6-4.2]. Conclusion(s): It seems that the majority of the Iranian patients with MS expect the authorities to administer a third booster dose, especially if scientifically validated. Copyright © 2022 Iranian Neurological Association, and Tehran University of Medical Sciences Published by Tehran University of Medical Sciences.
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Introduction and Objectives: The pivotal role of chest computed tomographic (CT) to diagnosis and prognosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. This study was conducted to assess the CT features in confirmed cases with COVID-19. Materials and Methods: Retrospectively, initial chest CT data of 363 confirmed cases with COVID-19 were reviewed. All subjects were stratified into three groups based on patients' clinical outcomes; non-critical group (n=194), critical group (n=65), and death group (n=104). The detailed of CT findings were collected from patients' medical records and then evaluated for each group. In addition, multinomial logistic regression was used to analyze risk factors according to CT findings in three groups of patients with COVID-19. Results: Compared with the non-critical group, mixed ground-glass opacities (GGO) and consolidation lesion, pleural effusion lesion, presence of diffuse opacity in cases, more than 2 lobes involved and opacity scores were significantly higher in the critical and death groups (P<0.05). Having more mixed GGO with consolidation, pleural effusion, lack of pure GGO, more diffuse opacity, involvement of more than 2 lobes and high opacity score identified as independent risk factors of critical and death groups. Conclusion: CT images of non-critical, critical and death groups with COVID-19 had definite characteristics. CT examination plays a vital role in managing the current COVID-19 outbreak, for early detection of COVID-19 pneumonia. In addition, initial CT findings may be useful to stratify patients, which have a potentially important utility in the current global medical situation.
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COVID-19, which is caused by the SARS-Cov-2, begins with early symptoms of fever, cough, shortness of breath, myalgia, and fatigue, affecting the lungs with pneumonia and causing acute respiratory distress syndrome (ARDS). Also, the onset of the disease may with rapid progression, lead to organ dysfunction, such as acute kidney or liver damage, and even death in severe cases. Many scientific efforts are underway around the world to identify the appropriate treatment for this disease. Curcumin is a natural polyphenolic compound, which could be a potential treatment option for patients with Covid-19. In this study, we review some of the possible effects of curcumin, such as inhibiting virus entry into the cell, inhibiting virus replication and viral protease, as well as modulating some intracellular messenger pathways. To comprehensive literature review, information from an internet search of English language databases PubMed, Scopus, Web of Science and ScienceDirect as well as Persian language databases such as SID using related keywords based on MESH such as COVID-19, SARS-COV-2, Curcumin and curcuminoid between January 2020 and January 2021 were collected. This review provides some possible effects of curcumin and its mechanisms for the treatment of COVID-19.
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Background and Aim: COVID-19 as a pandemic disease caused many deaths across the world and imposed considerable pressure on health care systems as well as healthcare providers. This study was conducted to clarify the elements and dimensions of experiences among nurses when caring for COVID-19 patients. Methods: This qualitative study was performed using the content analysis method in 16 nursing staffs that were responsible for caring for patients with COVID-19 selected by purposive sampling in April 2020. Deep semi-structured interviews in experimentation format was used to collect data. All interviews were recorded and typed in the MAXQDA software and then analyzed by eight steps including writing interviews, determining the semantic units, text coding, matching codes with text, categorizing and developing categories, reviewing the categories, identifying the subthemes and reporting the findings. Results: Overall, 223 codes were extracted from the interviews and after the integration of similarities three key themes including personal protection, structural protection and safety problems were obtained indicating participants' experiences on self-protection when. Conclusion: Themes such as personal protection, structural protection and safety problems are the most important concerns raised when nurses caring for COVID-19 patients and should be considered when planning to protect nursing health. © 2020 Baqiyatallah University of Medical Sciences. All rights reserved.