ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) has turned into a global public health crisis since the end of 2019. It may thus take years to develop new drugs, so evaluating the existing ones can play a key role in suppressing or even mitigating the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Objective(s): This study reflected on the effects of ivermectin (IVM) and metronidazole (MTR) vs. standard treatment protocols on symptoms, humoral immune responses, and outcomes of COVID-19 in hospitalized patients. Method(s): This triple-blinded randomized controlled trial (RCT) of IVM and MTR vs. standard treatment protocols was conducted from February 2021 to May 2021. A total number of 107 participants were accordingly selected from all patients infected with SARS-CoV-2 and positive results for SARS-CoV-2 based on the reverse transcription-polymerase chain reaction (RT-PCR) or the computerized tomography (CT) scan results at three teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. In this RCT, several indicators, including some vital signs, biomedical parameter, length of hospital stay (LOS), and death, were considered the outcomes. Result(s): A total number of 107 patients were recruited in this study. The results revealed that 10 patients (10.4%) expired during hospitalization. The mortality rate in IVM group (4.5%) was lower compared with MTZ (15.8%) and standard treatment (11.8%) (P = 169). After five days, the mean differences of lymphocyte and neutrophil counts differed significantly between groups (P = 0.020 and P = 0.029, respectively). But, other outcomes did not differ (P > 0.05). Conclusion(s): Based on this RCT, neither IVM nor MTZ could significantly affect COVID-19 patients' recovery patterns compared with the standard treatment protocols. Hence, more studies are needed to test diverse combinations of immunological response trigger-ing and anti-inflammatory drugs. Moreover, including and relying on IVM in clinical guidelines for COVID-19 should be cautioned and based on more evidence. Copyright © 2022 Author(s).
ABSTRACT
Introduction: There is little information on the symptoms, clinical characteristics, and outcomes of patients with Multiple Sclerosis (MS) who have the novel coronavirus disease 2019 (COVID-19) illness, especially for those admitted to the hospital. Objectives: Very little is currently known about the effects of COVID-19 on people with MS and vice versa. Aims: The purpose of this study was to determine the symptoms, clinical characteristics, and hospital outcomes of MS patients admitted to the hospital due to COVID-19. Methods: The current study is a multicenter case-control study that took place in Fars Province, Iran, from February 19 to November 20, 2020. All consecutive patients with a confirmed COVID-19 diagnosis were included, and all individuals with a history of MS were selected from the database. We also included two control groups with matching age and sex (patients with no history of an underlying disease and patients with a history of underlying disease). Results: From 38000 hospital admitted COVID-19 patients in the database, 25 had MS. Diabetes was the most common underlying disease in both MS patients and control groups, 11.5 % and 39.7 %, respectively. Fever and cough were the most common symptoms in MS patients. However, respiratory distress and low arterial oxygen saturation (<93%) were the most common symptoms in both control groups. Multivariate regression analysis revealed that the risk of loss of smell in MS patients was approximately 5 times (OR: 4.95 CI: 1.04-23.58 P=.04) and loss of taste 13 times (OR: 12.9 CI: 1.12-147.9 P=.04) higher than total control groups. There is no statistically significant difference in clinical outcome between MS patients and control groups, including ICU admission, the need for intubation, and in-hospital death. Conclusions: While the risk of loss of smell and loss of taste was higher in MS patients, hospital outcomes indices were not different.
ABSTRACT
Objectives: The first case of 2019 novel coronavirus disease (COVID-19) was reported in Iran in February 2020. Here, we report the epidemiological and clinical characteristics of patients with COVID-19 and factors associated with mortality in these patients. Methods: A retrospective cohort study was conducted from February 22, 2020, to March 24, 2020, in Golestan Hospital in Kerman-shah, Iran. Demographic data including underlying diseases and clinical data including the presenting symptoms, chest computed tomography (CT) scan, reverse transcription polymerase chain reaction (RT-PCR) test results, and outcomes were extracted from electronic medical records. Simple and multiple logistic regression methods were used to explore the factors associated with mor-tality. Results: Of 245 patients admitted with COVID-19, 155 (63.30%) were male. The mean age of the subjects was 54.68 ± 19.21. Forty-five (18.48%) patients had underlying diseases. Common symptoms were dyspnea (n = 137;55.9%), cough (n = 93;38.0%), and fever (n = 78;31.8%). All patients had pneumonia with abnormal findings on chest CT scan (100%), and RT-PCR test results were positive in 87 (35.50%) patients. Of the total admitted cases, 38 (15.5%) patients died during hospitalization. An old age (OR = 1.09;95% CI: 1.02 to 1.06), history of heart disease (OR = 5.07;95% CI: 1.46 to 17.58), hypertension (OR = 5.82;95% CI: 1.13 to 30.04), smoking (OR = 11.44;95% CI: 1.01 to 29.53), history of at least one underlying disease (OR = 3.31;95%CI: 1.54 to 7.09), and symptoms of decreased consciousness at the time of admission (OR = 24.23;95% CI: 2.62 to 223.39) were associated with mortality. Also, the symptoms of cough (OR = 0.383;95% CI: 0.17 to 0.88) and fever (OR = 0.278;95% CI: 0.10 to 0.74) had a negative association with mortality. Conclusions: In the current study, factors including old age, smoking, symptoms of decreased consciousness, and underlying diseases such as heart disease, hypertension, and history of at least one underlying disease were associated with mortality. Factors associated with mortality should be considered so that we can better manage patients with COVID-19.