Intention to get Vaccinated against COVID-19 in Iranian Hospital Staff: Application of the Theory of Planned Behavior.

Background: This study aimed to identify the predictors of the intention to receive the COVID-19 vaccine among Iranian health care workers (HCWs) based on the Theory of Planned Behavior (TPB). Methods: The study was a descriptive cross-sectional study that was conducted on 473 personnel working in hospitals of Hamadan, in May 2021 and before COVID-19 vaccination on hospital staff. The multi-stage sampling method was used for choosing participants. The survey included socio-demographic, questions related to TPB dimensions, and intention to receive a COVID-19 vaccine. Qualitative and quantitative data analyses were performed using the Chi-square test and T-test, respectively. Predictors of COVID-19 vaccination intention were determined using the logistic regression model. Results: Seventy percent of 361 eligible respondents stated their willingness to receive COVID-19 vaccine. The participants with the intention to receive COVID-19 vaccine had higher scores of attitude (7.25 ± 3.92 vs. 4.40 ± 5.14) and norm (3.04 ± 2.92 vs. -0.5 ± 3.18) (P < 0.001). Having an underlying disease and being married were significantly associated with the intention to receive COVID-19 vaccine (P < 0.05). Higher attitude and norm scores as a construct of the TPB were associated with an increase in intention to receive COVID-19 vaccine. Conclusions: The results of this study showed that the vaccination intention was affected by social, demographic, health, and behavioral features, such as age, marital status, underlying diseases, subjective norms, and attitude. Therefore, age groups below 50, single people, and those with no underlying diseases were eligible to be the target of interventional programs.

Predictors of COVID-19 related death in elderly patients hospitalized due to COVID-19 infection: a cross-sectional study in the west of Iran

Aim Identifying risk factors associated with mortality in elderly patients hospitalized with COVID-19 can be helpful in managing the disease in this age group. Therefore, the aim of this study was to determine the risk factors of death in elderly patients hospitalized with COVID-19 in Hamadan in 2020. Subject and methods This cross-sectional study was performed on the medical records of 1694 patients aged 60 years and older who were diagnosed with COVID-19 disease between March and August 2020 and were admitted to Shahid Beheshti and Sina Hospitals. A researcher-made checklist included demographic information, clinical information, laboratory results, type of procedures performed for the patient in the hospital, and the number of hospitalization days. Results The results showed that 30% of the elderly patients died due to COVID-19 complications. The results of adapted logistic regression showed that the variables of gender, age, inpatient ward and laboratory indices of albumin, hemoglobin, ESR, and LDH were the main predictors of COVID-19 related death in elderly patients (p < 0.05). Conclusion The rate of COVID-19 related death in the hospitalized elderly patients is remarkable. The death rate increased among male patients, age older than 75 years, hospitalization in the ICU, increased ESR and HDR levels, and decreased albumin and hemoglobin.

Predictors of COVID-19 related death in elderly patients hospitalized due to COVID-19 infection: a cross-sectional study in the west of Iran.

Aim: Identifying risk factors associated with mortality in elderly patients hospitalized with COVID-19 can be helpful in managing the disease in this age group. Therefore, the aim of this study was to determine the risk factors of death in elderly patients hospitalized with COVID-19 in Hamadan in 2020. Subject and methods: This cross-sectional study was performed on the medical records of 1694 patients aged 60 years and older who were diagnosed with COVID-19 disease between March and August 2020 and were admitted to Shahid Beheshti and Sina Hospitals. A researcher-made checklist included demographic information, clinical information, laboratory results, type of procedures performed for the patient in the hospital, and the number of hospitalization days. Results: The results showed that 30% of the elderly patients died due to COVID-19 complications. The results of adapted logistic regression showed that the variables of gender, age, inpatient ward and laboratory indices of albumin, hemoglobin, ESR, and LDH were the main predictors of COVID-19 related death in elderly patients (p < 0.05). Conclusion: The rate of COVID-19 related death in the hospitalized elderly patients is remarkable. The death rate increased among male patients, age older than 75 years, hospitalization in the ICU, increased ESR and HDR levels, and decreased albumin and hemoglobin.

The clinical manifestations and outcomes in neonates infected with COVID-19 in the West of Iran

Introduction: So far, no study has been conducted in Iran on the effect of COVID-19 on neonates. Therefore, the present cross-sectional study has been evaluated to determine the clinical manifestations and outcomes in neonates infected with COVID-19 in the west of Iran. Materials and Methods: The present cross-sectional study was conducted among neonates infected with COVID-19 in six provinces of Hamadan, Kermanshah, Kurdistan, Ilam, Zanjan and Lorestan, located in the west of Iran, from 1 March to 1 July 2020. In these neonates, the polymerase chain reaction test was positive. The data were collected by a checklist and were analysed using SPSS Statistics Software. Result: During the study period, 16 neonates infected with COVID-19 were identified including Kurdistan Province with five cases, Hamadan Province four cases, Kermanshah with three cases, and Lorestan and Zanjan provinces with two cases. Neonate gender of them had equal distribution. Two (15.38%) of them needed CPR after delivery. The delivery method for 9 (56.25%) was vaginal, and one of them died during the study period. The medical care used for these neonates was as follows: 87.5% were hospitalized in the intensive care unit and antibiotics were used for 68.75%. 12.5% underwent COVID-19-specific treatment, and for 25%, a ventilator was used. The laboratory findings in neonates infected with COVID-19 showed that in 18.75%, blood urea nitrogen has increased. 46.15% of neonates reported lymphocytopenia. The blood haematocrit and haemoglobin decreased by 31.35% and 56.25%, respectively. Conclusion: The coronavirus disease 2019 has occurred among neonates, but they seemed to have a milder disease course and better prognosis than adults. Findings showed that there is a possibility of vertical intrauterine transmission from pregnant mothers to newborns. [ FROM AUTHOR]

Covid-19 Preventive Behaviors in Iranian People: Applying Health Belief Model

Covid-19 disease, as a common infectious disease, has caused infection and death. Preventive behaviors are among the most important essential strategies of the Covid-19 disease prevention and control program. The health belief model (HBM) is one of the models that have been used to investigate the effective motivational factors and ultimately the protective behavior of the individual. Therefore, this study was conducted to define the factors related with Covid-19 protection behaviors among patients referred to comprehensive health service centers in Tuyserkan city using the HBM. A total of 800 patients referred to the comprehensive health service centers of Tuyserkan city during November 2021 were selected as the statistical population of this descriptive-analytical study. Clients were selected by multi-stage cluster random sampling from 21 comprehensive health service centers and health bases and then entered the study through simple random sampling. Data collection was online and based on a questionnaire. The questionnaire consisted of two parts: demographic information and HBM structure. The analysis was performed using SPSS24 software after data collection. The mean age of the subjects was 48.80 years and the income of the majority of the subjects was low (86.5%). People who washed their hands frequently kept a social distance, avoided losing others, used masks and gloves were 54.2%, 72.5%, 79.8%, 53.9%, 7.9% respectively. The results showed that with one unit increase in self-efficacy score and practice guide, the average behavior score increased by 0.27 and 0.31. The results show that the importance of prevention of Covid-19 infection among the population is necessary due to the high prevalence of infection and mortality. It seems that in intervention and prevention programs, the factors of prevention of Covid-19 transmission should be fully identified and proper interventions should be planned and implemented based on affective factors.

Effect of Convalescent Plasma Therapy on Clinical Improvement of COVID-19 Patients: A Randomized Clinical Trial.

Background: Due to the critical condition of COVID-19, it is necessary to evaluate the efficacy of administrating convalescent plasma to COVID-19 patients. Therefore, we decided to design a clinical trial to investigate the effect of convalescent plasma of patients recovered from COVID-19 on the treatment outcome of COVID-19-infected patients. Materials and Methods: In this parallel randomized controlled clinical trial, patients in the intervention group received standard treatment plus convalescent plasma of patients recovered from COVID-19. We allocated 60 patients to each treatment group through balanced block randomization. Then, COVID-19 outcomes, vital signs, and biochemical parameters were compared between the two treatment groups by the independent t test and ANCOVA. Results: The mean age (SD) of the patients in the intervention and standard treatment groups was 52.84 (15.77) and 55.15 (14.34) years, respectively. Although patients in the intervention group reported more hospitalization days (11.45±5.86 vs. 10.42±6.79), death rates (26.67% vs. 18.13%), ICU admission (45 vs. 41.67%), and ARDS (11.67% vs. 3.33%), these differences were not statistically significant (P>0.05). Moreover, the two groups were homogenous in vital signs and biochemical parameters before and after treatment (P>0.05). Conclusion: The present study indicated that convalescent plasma therapy has no significant effect on the survival, hospitalization, and ICU admission of COVID-19 patients.

Identification of Risk Factors for COVID-19-related Death using Machine Learning Methods.

Background: Unknown cases of pneumonia appeared in late 2019 in Wuhan, China. Following the worldwide spread of the disease, the World Health Organization declared it a pandemic on March 11, 2020. The total number of infected people worldwide as of December 16, 2020, was more than 74 million, more than one million and six hundred thousand of whom died from Coronavirus Disease 2019 (COVID-19). This study aimed to identify the risk factors for the mortality of COVID-19 in Hamadan, west of Iran. Materials and Methods: This cross-sectional study used the information of all patients with COVID-19 admitted to Shahid Beheshti and Sina hospitals in Hamadan during January 2020-November 2020. Logistic regression model, decision tree, and random forest were used to assess risk factors for death due to COVID-19. Results: This study was conducted on 1853 people with COVID-19. Blood urea nitrogen change, SPO2 at admission, the duration of hospitalization, age, neutrophil count, lymphocyte count, number of breaths, complete blood count, systolic blood pressure, hemoglobin, and sodium were effective predictors in both methods of decision tree and random forest. Conclusion: The risk factors identified in the present study may serve as surrogate indicators to identify the risk of death due to COVID-19. The proper model to predict COVID-19-related mortality is random forest based on sensitivity.

Which patients bring the most costs for hospital? A study on the cost determinants among COVID-19 patients in Iran.

BACKGROUND: Accurate information on the cost determinants in the COVID-19 patients could provide policymakers a valuable planning tool for dealing with the future COVID-19 crises especially in the health systems with limited resources. OBJECTIVES: This study aimed to determine the factors affecting direct medical cost of COVID-19 patients in Hamadan, the west of Iran. METHODS: This study considered 909 confirmed COVID-19 patients with positive real-time reverse-transcriptase polymerase-chain-reaction test which were hospitalized from 1 March to 31 January 2021 in Farshchian (Sina) hospital in Hamadan, Iran. A checklist was utilized to assess the relationship of demographic characteristics, clinical presentation, medical laboratory findings and the length of hospitalization to the direct hospitalization costs in two groups of patients (patients with hospitalization ≤ 9 days and > 9 days). Statistical analysis was performed using chi-square, median test and multivariable quantile regression model at 0.05 significance levels with Stata 14 software program. RESULTS: The median cost of hospitalization in patients was totally 134.48 dollars (Range: 19.19-2397.54) and respectively 95.87 (Range: 19.19-856.63) and 507.30 dollars (Range: 68.94-2397.54) in patients with hospitalization ≤ 9 days and > 9 days. The adjusted estimates presented that in patients with 9 or less hospitalization days history of cardiovascular disease, wheezing pulmonary lung, SPO2 lower than 90%, positive CRP, LDH higher than 942 U/L, NA lower than 136 mEq/L, lymphosite lower than 20% and patients with ICU experience had significantly positive relationship to the median of cost. Moreover, in patients with more than 9 hospitalization days, history of cardiovascular disease and ICU experience was statistically positive association and age older than 60 years and WBC lower than 4.5 mg/dL had statistically negative relationship to the median of hospitalization cost. CONCLUSION: As the length of hospital stay, which can be associated with the severity of the disease, increases, health systems become more vulnerable in terms of resource utilization, which in turn can challenge their responsiveness and readiness to meet the specialized treatment needs of individuals.

Predictors of COVID-19 Mortality in Hemodialysis Patients, Hamadan Province, Iran

Background: Identification of the predictors of coronavirus disease 2019 (COVID-19)-related death in hemodialysis patients plays a key role in the management of these patients. In this regard, the present study aimed to evaluate the predictors of death among COVID-19 infected hemodialysis patients in Hamadan province, Iran. Study design: A cross-sectional study. Methods: This cross-sectional study investigated 50 COVID-19 infected hemodialysis patients who were confirmed by polymerase chain reaction (PCR) test and referred to hemodialysis wards of hospitals located in Hamadan province, Iran, from March 2019 and January 2020. In order to compare the demographic characteristics and clinical variables between survived and deceased patients, the independent student t test and chi-square test were applied. Results: Out of 50 confirmed COVID-19 hemodialysis patients, 27 (54%) cases were male, 38 (76%) subjects were urban residents, and 4 (8%) individuals were smokers. A significant relationship was observed between patients’ gender, age, acute respiratory distress syndrome (ARDS) status, and body mass index (BMI) with the treatment outcome (P<0.05). A significantly higher level of serum albumin was observed in the survived patients (3.49±0.37 vs. 3.17±0.42, P = 0.030). Moreover, in terms of lactate dehydrogenase (LDH) level, a significantly higher level of LDH was observed in the patients who died (1471.1±1484.89 vs. 670.86±268.85, P = 0.005). Conclusions: It can be concluded that some demographic characteristics of the patients, including age, gender, ARDS status, BMI, co-morbidities, and laboratory signs and symptoms are associated with disease outcomes in COVID-19 infected hemodialysis patients. Therefore, awareness about the predictors of death in these patients can help make better and direct clinical decisions and inform health officials about the risk of COVID-19 mortality among hemodialysis patients.

Care burden, coping styles and involvement in care in mothers of autistic children in pandemic of COVID-19.

AIM: The aim of the present study was to investigate the burden of care, coping styles and involvement in the care of mothers of autistic children in the pandemic of COVID-19 in Iranian society. DESIGN: A cross-sectional study. METHODS: A total of 134 mothers completed questionnaires online. Data were analysed by descriptive statistics (frequency, percentage, mean and standard deviation) and independent t-test, ANOVA and multiple linear regressions. The significance level was considered p < .05. RESULT: Findings of the study found that burden of care has a strong and direct correlation with involvement in care (p < .001, r = .78) and strongly and indirectly correlated with coping styles (p < .001, r = -.82). Variables of coping styles, involvement in care, mothers' occupation and number of children, age and functional level of autism can predict 81.27% of the variance in care burden in these mothers.

Predictors of COVID-19 Mortality in Hemodialysis Patients, Hamadan Province, Iran.

BACKGROUND: Identification of the predictors of coronavirus disease 2019 (COVID-19)-related death in hemodialysis patients plays a key role in the management of these patients. In this regard, the present study aimed to evaluate the predictors of death among COVID-19 infected hemodialysis patients in Hamadan province, Iran. STUDY DESIGN: A cross-sectional study. METHODS: This cross-sectional study investigated 50 COVID-19 infected hemodialysis patients who were confirmed by polymerase chain reaction (PCR) test and referred to hemodialysis wards of hospitals located in Hamadan province, Iran, from March 2019 and January 2020. In order to compare the demographic characteristics and clinical variables between survived and deceased patients, the independent student t test and chi-square test were applied. RESULTS: Out of 50 confirmed COVID-19 hemodialysis patients, 27 (54%) cases were male, 38 (76%) subjects were urban residents, and 4 (8%) individuals were smokers. A significant relationship was observed between patients' gender, age, acute respiratory distress syndrome (ARDS) status, and body mass index (BMI) with the treatment outcome (P < 0.05). A significantly higher level of serum albumin was observed in the survived patients (3.49 ±â€…0.37 vs. 3.17 ±â€…0.42, P =  0.030). Moreover, in terms of lactate dehydrogenase (LDH) level, a significantly higher level of LDH was observed in the patients who died (1471.1 ±â€…1484.89 vs. 670.86 ±â€…268.85, P =  0.005). CONCLUSIONS: It can be concluded that some demographic characteristics of the patients, including age, gender, ARDS status, BMI, co-morbidities, and laboratory signs and symptoms are associated with disease outcomes in COVID-19 infected hemodialysis patients. Therefore, awareness about the predictors of death in these patients can help make better and direct clinical decisions and inform health officials about the risk of COVID-19 mortality among hemodialysis patients.

Healthcare professionals' families' perception of life during COVID-19 in Iran: a qualitative study.

BACKGROUND: The families of healthcare professionals are one of the most vulnerable groups whose lives have been severely damaged by the COVID-19 pandemic. So far, the experiences and perceptions of these individuals have not been explored. The present study aims to investigate the experiences and perceptions of the family members of the healthcare professionals during COVID-19. METHODS: The present study is a qualitative research with a phenomenological design. The participants were 25 family members of healthcare professionals which were selected from the medical centres in Iran via purposeful sampling from August 2021 to October 2021. The sampling was kept on until the data became saturated. To collect data, individual semi-structured interviews were conducted online. The Colaizzi approach was used to analyse the data collected. RESULTS: The findings of the study emerged as two main themes: psychological tension with five categories (indescribable fear and worry, longing to see their loved ones, patient stone, bitter farewell, fear of the future) and dignity with four categories (acclamation, appreciation, feeling proud, spiritual growth). CONCLUSION: During the COVID-19 pandemic, the family members of healthcare professionals have experienced dignity combined with the degrees of psychological tension which were beyond the experiences of the majority of people in the society, but similar to the psychological tension experienced by the families of COVID-19 victims. The families of healthcare workers are continuously anxious about the safety of their loved ones who are responsible to obtain the treatment of COVID-19 patients, which potentially jeopardizes their physical and psychological well-being. Therefore, the appreciation and support of people in the community of the family members of healthcare professionals have increased their tolerance. Healthcare providers can successfully promote the health of healthcare professionals' families by providing comprehensive assistance to healthcare personnel and their families.

Burnout and Mental Health of COVID-19 Frontline Healthcare Workers: Results from an Online Survey

Objective: The COVID-19 pandemic has been prolonged and healthcare workers have become exhausted. The purpose of this study was to investigate burnout and its relationship with mental health in COVID-19 frontline healthcare workers. Method: This cross-sectional study was carried out in all hospitals where patients with COVID-19 were admitted in Hamedan, Iran. With the census method and considering the inclusion criteria, 924 COVID-19 frontline healthcare workers participated in this study. Data were collected using a web-based survey consisting of demographic characteristics, GHQ-28, and Maslach Burnout Inventory. Statistical analysis was performed using Stata 14. Results: The results showed that the main cause of concern and stress in employees was that it was not clear how long this situation would continue. The results regarding burnout and mental health showed that 29.33% of participants were high in emotional exhaustion (EE), 10.93% were high in depersonalization (DP), 34.31% were low in personal accomplishment (PA), 50.4% had physical symptoms, 50.2% had anxiety and insomnia symptoms, 62.2% had social dysfunction and 17.5% had depression symptoms. The results of the multivariate logistic regression showed that EE had the greatest role in reducing mental health of employees with OR = 6.92 for moderate EE and OR = 39.42 for high EE (P < 0.001). Conclusion: COVID-19 frontline healthcare workers are at risk for burnout and poor mental health. Health policies should be implemented to help reduce burnout in healthcare workers. Also, person-directed and organizational-directed interventions to rejuvenate these employees seem necessary. [ FROM AUTHOR] Copyright of Iranian Journal of Psychiatry is the property of Tehran University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The effect of underlying diabetes disease on clinical outcome and survival in patients with Covid-19: a propensity score matching study.

PURPOSE: Coronavirus increases mortality rate in people with underlying disease. The purpose of the present research was to compare the clinical outcomes in Covid-19 patients with and without underlying diabetes disease using propensity score matching. METHODS: A matched case-control study was conducted on 459 diabetic patients with Covid-19 (case group) and 459 non-diabetic patients with Covid-19 (control group). Matching in two groups was performed using propensity score matching method. The effect of covariates on the clinical outcome of the patients (recovery-death) was assessed using logistic regression and the associations of factors with the patients' survival were determined using Cox proportional hazards regression model. Data were analyzed using R software. RESULTS: The mean (standard deviation) age of patients in the case and control groups were 65.77 (12.2) and 65.8 (12.24), respectively. 196 patients (43%) in the case group, and 249 patients (54%) in the control group were male (with P-value < 0.05). The logistic regression model showed that the variables of age, level of blood oxygen (SpO2), ICU admission, length of hospitalization, cancer and diabetes affected patients' death. Furthermore, the resuts of the Cox regression showed that the variables of age, level of blood oxygen (SpO2), ICU admission,cancer and diabetes were related to survival of the patients. It was found that diabetes was significantly associated with mortality from COVID-19 with odds ratio of 2.88 (95% CI: 1.80-4.69; P < 0.01) and hazard ratio of 1.45 (95% CI: 1.01-2.03; P = 0.05). CONCLUSION: The underlying diabetes significantly increases the mortality among patients with Covid-19, so special care should be taken for this high risk group if they develop Covid-19.

Management of Dental School During the COVID-19 Pandemic: Application of Intervention Mapping.

Background: Coronavirus Diesease-2019 (COVID-19) outbreak has led to the suspension of the activities of dental schools. Therefore, reorganizing clinical settings and supporting services as quickly as possible has received much attention to reopen dental schools. The present study aimed to evaluate the applicability of the Intervention Mapping (IM) approach for designing, implementing, and evaluating an intervention program to prevent and control COVID-19 in dental schools. Methods: Following the IM protocol, six steps were completed in the planning and development of an intervention, targeting, and management of Dental School during the COVID-19 pandemic. Results: The information obtained from the needs assessment revealed that the COVID-19 outbreak prevention was associated with the use of personal protective equipment by all target groups, infection control measures taken in the environment, preparation of the environment and equipment, changes in the treatment plan according to the COVID-19 pandemic, changing the admission process of patients, and reduction of attendance of target groups in the school are linked with. In this study, determinant factors affecting the COVID-19 prevention at the individual level were identified based on the Protection Motivation Theory (PMT). In this program, various methods, such as presentation of information, modeling role, and persuasion measures, were utilized and the practical programs included educational films and group discussions implemented. Conclusions: Our findings indicated that intervention in dental environments on the basis of the IM process can develop a comprehensive and structured program in the dental school and hence can reduce the risk of the COVID-19 infection.

The effect of underlying diabetes disease on clinical outcome and survival in patients with Covid-19: a propensity score matching study

Purpose Coronavirus increases mortality rate in people with underlying disease. The purpose of the present research was to compare the clinical outcomes in Covid-19 patients with and without underlying diabetes disease using propensity score matching. Methods A matched case–control study was conducted on 459 diabetic patients with Covid-19 (case group) and 459 non-diabetic patients with Covid-19 (control group). Matching in two groups was performed using propensity score matching method. The effect of covariates on the clinical outcome of the patients (recovery-death) was assessed using logistic regression and the associations of factors with the patients' survival were determined using Cox proportional hazards regression model. Data were analyzed using R software. Results The mean (standard deviation) age of patients in the case and control groups were 65.77 (12.2) and 65.8 (12.24), respectively. 196 patients (43%) in the case group, and 249 patients (54%) in the control group were male (with P-value < 0.05). The logistic regression model showed that the variables of age, level of blood oxygen (SpO2), ICU admission, length of hospitalization, cancer and diabetes affected patients' death. Furthermore, the resuts of the Cox regression showed that the variables of age, level of blood oxygen (SpO2), ICU admission,cancer and diabetes were related to survival of the patients. It was found that diabetes was significantly associated with mortality from COVID-19 with odds ratio of 2.88 (95% CI: 1.80–4.69;P < 0.01) and hazard ratio of 1.45 (95% CI: 1.01–2.03;P = 0.05). Conclusion The underlying diabetes significantly increases the mortality among patients with Covid-19, so special care should be taken for this high risk group if they develop Covid-19.

Assessment of mask-wearing adherence and social distancing compliance in public places in Hamadan, Iran, during the COVID-19 pandemic.

BACKGROUND: The determination of the rate of social distancing compliance and mask-wearing adherence is essential to address the health aspects of COVID-19. The present study aimed to estimate the adherence to mask-wearing and maintaining the social distancing in public places in Hamadan, western Iran, during the COVID-19 pandemic. STUDY DESIGN: The present study was conducted based on a cross-sectional design. METHODS: The current study included 72 images from 12 areas in Hamadan as clusters in January 2021. The images were extracted from the traffic control center of Hamadan Municipality. The mean of social distancing and percentage of mask-wearing in all clusters were obtained based on cluster sampling. RESULTS: In this research, the majority of people(68%) of people in public places were men and 32% women. The mean±SD of social distancing in all public places in Hamadan was obtained at 65.27 ±73.37 cm (95% CI: 38.48-92.08). The percentage of men who wore masks correctly was higher than that of women (57% vs. 51%). Moreover, mask-wearing adherence was not recognizable in about 34% of people in the images (28% of men versus 48% of women). Among the people whose images were recognizable, all the women were wearing masks, while about 13% of men were not (P<0.05). CONCLUSION: As evidenced by the obtained results, the mean social distance in Hamadan was much lower than the standard value (1.5-2 meters) even at the time of restrictions. Although more than half of people wore masks in public places, it was much less than that in developed countries. Therefore, people should pay more attention to health advice regarding mask-wearing and maintaining social distance.

Identifying the Risk Factors for Mortality in Patients with Cancer and COVID-19 in Hamadan, the West of Iran.

PURPOSE: Since cancer patients are at higher risk of COVID-19, the present study was conducted to investigate the epidemiology of these patients and identify the affecting risk factors on their mortality. METHODS: The present retrospective cohort study was conducted on 66 hospitalized patients with cancer and COVID-19 in Hamadan in 2020. In the present study, demographic, clinical, and laboratory information and patients' outcome were collected through a checklist and its impact on death was assessed. Data were analyzed in SPSS-24 software and the significance level of the tests was considered at 5%. RESULTS: The mean (standard deviation (SD)) age of patients was 61.6 (13.5) years. Forty patients (60.6%) were male. Twenty and five patients (37.9%) died at the end of study. The results of logistic regression model revealed that the nausea, mechanical ventilation, admission to ICU, and length of hospital stay in the ward had a significant impact on the odds of death among cancer patients with COVID-19 (p < 0.05). CONCLUSION: Owing to high mortality rate in cancer patients with COVID-19 and due to underlying diseases and more severe clinical symptoms than other patients with coronavirus, these patients need intensive care and specific treatments. However, screening these patients and early identifying and vaccinating of them can reduce the mortality rate in these patients.

Predictors of death in patients with COVID-19: A cross-sectional study in West of Iran.

Background: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a newly identified coronavirus. Our knowledge about the survival rate and prognostic factors of the disease is not established well. The purpose of this study was to evaluate the predictors of COVID-19 mortality in Hamadan province in western Iran. Methods: In this study, we included all laboratory-confirmed COVID-19 cases with known treatment outcomes in Hamadan province, Iran, between 20, 2020, to May 10, 2020. Demographic, clinical, laboratory data, and treatment outcomes were obtained from computerized medical records and compared between survived cases and patients with death outcomes. Univariable and multivariable logistic regression models were used to determine the predictors of death. Results: From 749 investigated patients, 77 patients (10.28%) died during the treatment. The Mean age of patients was 53.97±19.04 years. Multivariable logistic regression showed that males had 2.07 (95% CI: 1.73, 2.54) fold higher odds of death. Those with 60 years old and more had 6.49 (95% CI: 4.53, 7.93) fold higher odds of death. Patients with an underlying disease had 7.14 (95% CI: 6.94, 7.38) fold higher odds of death, and patients who were hospitalized in the ICU ward had 2.24 (95% CI: 1.75, 2.90) times higher odds of COVID-19 related mortality. Conclusion: The potential predictors of death in COVID-19 cases, including the male gender, older age, and having an underlying disease could help physicians to identify patients with poor prognoses at an early stage and better management of them.