ABSTRACT
Background: As a result of the COVID-19 pandemic, many vaccines were developed to counter the disease, including the vector-based Sputnik V vaccine. This study aims to identify the side effects of the Sputnik V COVID-19 vaccine in a medical center and compare the results with the previous reports. Methods: A questionnaire-based study was performed after the injection of the first and second doses of the vaccine to assess the side effects experienced by the participants. It was performed by reviewing similar previous studies. Results: Injection site pain, muscle pain, fever, fatigue, chills, and headache were the most common side effects of the vaccine. The incidence of major side effects decreased with age and was lower in men. In our study and others, the incidence of side effects was decreased in the second dose. In some studies, participants with a previous history of Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCOV-2) infection developed more side effects, especially injection site pain, muscle pain, and fatigue. Conclusion: Most studies agree with our reported results. Serious side effects of this vaccine are rare and may be considered tolerable in adults.
ABSTRACT
Background: As a result of the COVID-19 pandemic, many vaccines were developed to counter the disease, including the vector-based Sputnik V vaccine. This study aims to identify the side effects of the Sputnik V COVID-19 vaccine in a medical center and compare the results with the previous reports. Method(s): A questionnaire-based study was performed after the injection of the first and second doses of the vaccine to assess the side effects experienced by the participants. It was performed by reviewing similar previous studies. Result(s): Injection site pain, muscle pain, fever, fatigue, chills, and headache were the most common side effects of the vaccine. The incidence of major side effects decreased with age and was lower in men. In our study and others, the incidence of side effects was decreased in the second dose. In some studies, participants with a previous history of Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCOV-2) infection developed more side effects, especially injection site pain, muscle pain, and fatigue. Conclusion(s): Most studies agree with our reported results. Serious side effects of this vaccine are rare and may be considered tolerable in adults. Copyright © 2022 Shahid Beheshti University of Medical Sciences. All rights reserved.
ABSTRACT
Background: Due to uncontrolled lymphocyte reaction, the overproduction of cytokines in COVID-19 patients can cause sepsis-like symptoms, suggesting sepsis, cytokine release syndrome (CRS), and secondary hemophagocytic lymphohistiocytosis (sHLH). Since different therapeutic approaches are used for each diagnosis, differentiation is essential. This study aims to use H-score as a possible prognostic tool in COVID-19 patients. Method(s): A sample of 64 moderate and severe COVID-19 patients was enrolled in this study. Clinical and laboratory findings were assessed. H-score was initially calculated and reevaluated among severe cases 72 hours later and among moderate cases showing severe features of COVID-19. Result(s): Mortality of 31.3% was reported. Laboratory findings, including triglycerides (TG), ferritin, and aspartate aminotransferase (AST) showed significantly higher initial and follow-up laboratory assessment levels in severe cases than in moderate cases. Moreover, fibrinogen was significantly higher among severe cases than moderate cases at the initial assessment, but no significant difference was reported in the second fibrinogen assessment. Conclusion(s): In this study, H-score was useful as a predictive tool for the initial evaluation of severe cases of COVID-19. H-score is much lower in these patients than in non-COVID-19 HLH patients may be due to the different underlying immunologic pathophysiology of COVID-19;thus, each H-score criterion must be evaluated for sensitivity and specificity in COVID-19 patients. The H-score cut-offs, H-score may be useful for diagnosing immune overreaction and determining the need for more exclusive immunomodulatory treatments. Copyright © 2022 Shahid Beheshti University of Medical Sciences. All rights reserved.
ABSTRACT
In the pandemic era of coronavirus disease 2019 (COVID-19), vaccines have been developed and approved to control the pandemic that might reduce the COVID-19 mortality. Transplant recipients are among the high-risk groups and are more susceptible to COVID-19 infection. According to the available data about COVID-19 vaccines, some platform technologies include vector-based, inactivated, protein subunit, virus-like particles, mRNA, and DNA vaccines (1). There are several guidelines about vaccination in immunocompromised individuals for both non-live- and live vaccines. However, there are still limited evidence-based data about COVID-19 vaccines in the hematopoietic stem cell transplantation (HSCT), and establishing a proper recommendation for vaccination in these patients would be challenging (2, 3). Transplant recipients may have shown lesser responses to the vaccines compared with the general population, and it is unknown to what extent the vaccine is effective in this group of patients. Also, in many countries, the vaccination schedule is not adjustable by the patients or physicians, and selecting a particular time window for the best efficacy of immunization is impossible. In this regard, the main concern in the patients treated with immunosuppressive drugs is not worsening symptoms and disease following vaccination. The most critical issue is determining the best time for vaccination to increase its efficacy. Here are some considerations about vector-based, inactivated, and mRNA- nanoparticle vaccines, but most evidence is not based on the results of cohort or clinical trial studies. Before HSCT, patients could receive the COVID-19 vaccine if they are not already immunosuppressed. According to evidence about other inactivated vaccines, such as the influenza vaccine, the interval to start the conditioning regimen could be considered 2 - 4 weeks following the vaccination (4). In autologous HSCT patients, COVID-19 vaccination can be considered 1 - 3 months after transplantation if there has been a community outbreak. If acquiring or transmitting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was well controlled, vaccination could be withheld after six months of transplantation. In the current pandemic, COVID-19 vaccination in allogeneic HSCT patients could be considered at least three months after transplantation. If transmission of SARS-CoV-2 was controlled, vaccination could be withheld after six months of transplantation (4-6). Vaccination of patients with chronic graft versus host disease (cGVHD) receiving less than 20 mg/day prednisolone (or equivalent) for less than 2 weeks, can be considered similar to the HSCT recipients with no GVHD (5). Vaccines in HSCT recipients with active SARS-CoV-2 infection are not effective thus, receiving the vaccine is not recommended. If an HSCT recipient has received the COVID-19 vaccine before HSCT, re-vaccination after transplantation is suggested (6). The administration of the vaccine is considered when the immune system acquired functional competence. Transplant donation should not be delayed due to the vaccination of the donor to protect the patients in case the transplant is urgent (6). It was reported that recipients who have received anti-B cell antibodies might get the vaccine at 3 - 6 months after the administration and four weeks before the next course of B cell-depleting therapy. If this time window was not possible, vaccination can be regarded under B-cell depleting therapy, considering a suboptimal response to the vaccine (7). It should be noted that the effects of rituximab may last for six months or even a year. Also, the decision to order vaccines following the use of rituximab should be based on the level of immunoglobulins and CD19. There is no strong evidence for the short duration of vaccination following the use of rituximab (such as 3 to 6 months). However, despite the low efficacy of the vaccine in such conditions, it is recommended to get the vaccine whenever available. It is reasonable that recipients who have received therapy with antithy
ABSTRACT
Background: Returning symptomatic patients with a history of recovered COVID-19 with a new positive SARS CoV-2 PCR test after several weeks to months of a negative PCR result is challenging during the COVID-19 pandemic. Objectives: We aimed to determine such Iranian patients' clinical and laboratory characteristics and discuss possible reasons.
ABSTRACT
Background: With the emergence and spread of coronavirus disease 2019 (COVID-19) globally, health care systems have faced the biggest challenge in recent decades. Objectives: The present study aimed to identify risk factors associated with oropharyngeal candidiasis (OPC) in COVID-19 patients. Methods: The total number of confirmed COVID-19 patients was 218 (105 cases with OPC and 113 controls without OPC). The questionnaire used in this study consisted of demographic data, treatment strategy, clinical and laboratory data, and underlying diseases collected from the onset of clinical OPC until the end of hospitalization. Results: Pseudomembranous candidiasis (77/105, 73.3%) was the most prevalent form of OPC in case patients. The majority of the cases (58.1%) and controls (58.4%) were males. Increasing age (P = 0.03) and hospitalization length (P = 0.016) were significantly associated with OPC in COVID-19 patients. Diabetes (P = 0.003), solid tumor (P = 0.019), and hypertension (P = 0.000) were the most common underlying conditions. The use of dentures (P = 0.003) and poor oral hygiene (P = 0.000) were related to OPC in the case group. Therapy with chloroquine (P = 0.012), IVIG (P = 0.001), diuretics (P = 0.000), and corticosteroid pulse therapy (P = 0.000) were significantly associated with developing OPC in case patients. Conclusions: Old age, hospitalization length, poor oral hygiene, corticosteroids use, diabetes, solid tumor, and hypertension may predispose COVID-19 patients to develop OPC. © 2021, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) has been pandemic and has caused a great burden on almost all countries across the world. Different perspectives of this novel disease are poorly understood. This study sought to investigate the clinical and epidemiological characteristics of COVID-19 to efficiently assist the health system of Iran to conquer the outbreak. Materials and Methods: This retrospective observational study was performed on 394 patients with a diagnosis of COVID-19. The patients should have a history of hospitalization at Loghman-Hakim hospital, Tehran, Iran, for 10 weeks, beginning from the first official report of the disease in Iran. In the subsequent step, the baseline demographic and clinical and paraclinical information of the patients was documented. Finally, the patients were assessed if they had exhibited any morbidity or mortality. Results: The epidemiological examination of the COVID-19 population suggested a bell diagram pattern for the hospitalization rate, in which the 4th week of the study was the peak. The highest rate of secondary adverse events due to the virus was observed at the 6th and 7th weeks of the study course. On another note, clinical evaluations resulted in identifying specific abnormalities, such as bilateral opacity in chest computed tomography scans or low oxygen saturation in laboratory data. Conclusion: This study provides evidence concerning the clinical and epidemiological characteristics of COVID-19 in the first phase of the virus outbreak in Iran. Further studies comparing the disease features in the subsequent phases with findings of this study can pave the way for additional information in this regard.
ABSTRACT
Introduction: As diabetes is highly prevalent worldwide, understanding particular dimensions of COVID-19 infection in diabetic patients is of significant importance. Objectives: The present research aimed to evaluate the outcome of diabetic patients with COVID-19 infection, and the clinical and biochemical characteristics in survived and non-survived patients. Patients and Methods: The present single-center, cross-sectional study examined laboratory and clinical features of 160 patients with diabetes who had moderate to severe criteria. The obtained data were categorized as survived or non-survived patients and then we compared the clinical characteristics in two groups. Results: In this study, 160 diabetic patients (75 men and 85 women) admitted with moderate to severe Covid-19 were evaluated. The mean age of studied patients was 51-90 years old, with diabetes duration of 5 to 15 years. One hundred thirty-one patients (81.9%) survived, but twenty-nine patients (18.1%) did not survive. Regarding the comparison of symptoms, only the loss of consciousness on admission was higher in non- survived patients;however, a majority of the non-survivors have been admitted to ICU, 23(79.3%) and 26 (89.6%) needed invasive mechanical ventilation;in comparison to survived patients also had a shorter duration of hospital stay (5.5 +/- 5.1 versus 8.4 +/- 6.1days). Non-survivors more probably suffer from high blood pressure [23 (79.3%) patients versus 80 (61%) patients] and chronic kidney disease [20 (69%) patients versus 9 (6.9%) patients;P<0.001]. Glycated hemoglobin (HbA1c) of more than 9%, and high fasting blood sugar, severe inflammatory response, hepatic, renal, and coagulation impairment was higher in non-survived than those who survived. Conclusion: Multifactorial parameters result in the poor prognosis in diabetic patients;therefore, it is critical for identifying the key clinical, as well as laboratory characteristics of COVID-19 cases that lead to severe disease and increase the risk of death.
ABSTRACT
Coronavirus disease 2019 (COVID-19) caused a fatal pandemic worldwide. This review aims to discuss laboratory, molecular, and serological methods and their advantages and disadvantages over each other in COVID-19 diagnosis. Moreover, computed tomography (CT) scan, that is used on suspicion of COVID-19 pneumonia and for determining the severity and progression of the disease, is also discussed. Different CT features categorize the patients into low to high-risk groups. Here, we described three kinds of CT classification based on CT patterns within different time courses of the disease. Chest CT imaging should be considered for screening, evaluating, and following up COVID-19 due to its high sensitivity. Approximately, shortly after the onset of symptoms, viral load can be diagnosed by real-time PCR technique through bronchoalveolar lavage, nasopharyngeal and/or oropharyngeal swab sampling. Proper sampling may delineate the result of this test. Although RT-PCR assay is currently considered the gold standard test, false-negative results should be considered. Furthermore, a positive test may indicate the infection with SARS-CoV-2, but not necessarily the disease, and the person may be a carrier or other organs may be involved other than the lungs. In contrast to CT imaging, RT-PCR assay has poor sensitivity, but it helps the decision-making on hospitalization and isolation. The emergence of reliable serological tests has promoted the diagnosis, treatment process, chronic or carrier status of an individual, and epidemiological studies. In addition, an earlier and more accurate diagnosis will be provided for asymptomatic or susceptible individuals.