ABSTRACT
The COVID-19 pandemic has had an unprecedented impact on the transportation sector, with changes expected to last for a long time. Following the reopening phases, increased use of private vehicles and continued avoidance of exposure to the infectious virus in public transportation exacerbated urban traffic and environmental problems. The paper aims to evaluate the impact of travel demand management strategies during the COVID-19 pandemic in Tehran, Iran. That city provided a unique case study because of its high COVID-19 contagion and death rates, traffic congestion, and lack of government restriction plans, which are common in developing countries. Four scenarios combining various travel demand management strategies were considered during the pandemic. The findings highlight the importance of considering the tradeoffs between different performance measures when selecting a suitable travel demand management strategy. Depending on the goals that decision-makers have set, the strategies may not be additive. While teleworking, e-learning, and rescheduling working hours all help reduce traffic congestion, the pricing strategy contributes significantly to meeting environmental and health goals. The findings also highlight the nonlinear pattern of change associated with each strategy.
ABSTRACT
Background and Objectives: Several studies have focused on the alterations of hematological parameters for a better un-derstanding of the COVID-19 pathogenesis and also their potential for predicting disease prognosis and severity. Although some evidence has indicated the prognostic values of thrombocytopenia, neutrophilia, and lymphopenia, there are conflicting results concerning the leukocyte and monocyte count. Materials and Methods: In this retrospective Double Centre study, we reviewed the results of WBC and monocyte counts of 1320 COVID-19 patients (243 of whom (18.4%) had severe disease) both on admission and within a 7-day follow-up. Results: We found that both the number of monocytes and the percentage of monocytosis were higher in the severe group;however, it was not statistically significant. On the other hand, we found that not only the mean number of WBCs was significantly higher in the severe cases also leukocytosis was a common finding in this group;indicating that an increased number of WBC may probably predict a poor prognosis. Also, the monocyte count was not affected by age;however, univariate analysis showed that the percentage of leukocytosis was significantly greater in the older group (>50) with an odds ratio of 1.71 (P: 0.003). Conclusion: Alteration of monocytes either on admission or within hospitalization would not provide valuable data about the prediction of COVID-19 prognosis. Although the rapidly evolving nature of COVID-19 is the major limitation of the present study, further investigations in the field of laboratory biomarkers will pave the way to manage patients with severe disease better.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) has a variety of symptoms and laboratory and radiologic features whose identification can help diagnose and manage patients with COVID-19 more effectively. Objectives: This study aimed to describe the epidemiological, clinical, and laboratory features of patients with COVID-19, compare clinical features of patients in the intensive care unit (ICU) with those of non-ICU admitted patients, and define mortality risk factors for this disease.
ABSTRACT
Background and Objectives: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first de-scribed during a pneumonia outbreak in Wuhan, has attracted tremendous attention in a short period of time as the death toll and the number of confirmed cases is growing unceasingly. Although molecular testing is the gold standard method of SARS-CoV-2 detection, the existence of the false-negative results presents a major limitation to this method. Materials and Methods: This retrospective Double-Centre study was conducted on 1320 COVID-19 patients recruited at Taleghani and Shohadae Tajrish Hospitals in Tehran, Iran. We analyzed the leukocyte, lymphocyte and neutrophil counts of hospitalized cases both on admission and at discharge. We also evaluated the alteration of these parameters within a sev-en-day follow-up. Results: Of the whole, 1077 (81.6%) neither were admitted to intensive care unit (ICU) nor experienced death, and were defined as the mild-moderate group. Of 243 severe cases, while 59 (24.3%) were admitted to ICU and cured with the intensive care services, 184 (75.7%) patients died of the disease, either with or without ICU admission. Calculation of neu-trophil-to-lymphocyte ratio (NLR) revealed that the mild-moderate cases had a lower ratio at discharge. On the other hand, the ratio was significantly higher in the death group as compared to the ICU group;highlighting the fact that patients with a higher degree of neutrophilia and a greater level of lymphopenia have a poor prognosis. Conclusion: We suggest that NLR greater than 6.5 may reflect the progression of the disease towards an unfavorable clinical outcome, with this notion that the ratios higher than 9 may strongly result in death.