Evaluation of epidemiology, clinical features, prognosis, diagnosis and treatment outcomes of patients with COVID-19 in West Azerbaijan Province.

BACKGROUND: COVID-19 is considered a widespread concern in global public health. Diagnoses of COVID-19 in some cases are necessary because of severe prognosis. In this study, epidemiologies, clinical and demographic characteristics of patients with COVID-19 were studied in Taleghani Hospital, Urmia, Iran. METHODS: This descriptive-analytical cross-sectional study was carried out on 215 patients with COVID-19 during March and April 2020. Approved COVID-19 case was considered as a person with a positive respiratory sample performed by at least one of two RT-PCR methods or genetic sequencing. ANOVA repeated measure, independent t-test and logistic regression were done. A P < .05 was considered significant. RESULTS: The mean age of patients was 50.93 ± 17.92 years. Regarding gender, there were 91 females (42.3%) and 124 males (57.7%). The mean hospital stay, the temperature at admission, and onset of symptoms were 4.91 ± 3.68 days, 37.40 ± 0.96°C and 5.88 ± 4.80 days, respectively. Close contact with suspected people was found in 10.2% of patients. Additionally, 44 patients (20.5%) were smokers. Shortness of breath and cough were found in 62.8% and 49.3% of patients. Diabetes mellitus and hypertension were the most common comorbidities of patients. Regarding lung involvement, 33 patients (33%) were normal, most of the patients (n = 71) had 5%-25% involvement in their lung and a minority of patients (n = 13) had a severe condition of 50%-75% lung involvement. The association between smoking and mortality was tested using chi-square showing no significant difference (X2 :2.959, P = .085). There was no significant difference between AST, ALT, ALP, total, direct Bilirubin, lung involvement and suffering from fever (P > .05). High Spo2 can increase the chance of recovery by 24% with each unit reduction. Kidney involvement increases the chance of death by about 80% (95% CI: 0.104-0.013). The odds ratio of spo2 for recovery of COVID-19 was 1.24 (95% CI: 1.014-1.528; P = .037). Kaletra with odds ratio of 31.960 had the most highest effect on recovery following COVID-19 (P = .043). CONCLUSION: COVID-19 involves different organs of the body with different severity. In the meantime, smoking was not a risk factor for the virus or associated with severe manifestations of the disease. Patients with high creatinine and CPK, pulmonary involvement above 25%, and hypoxemia had a higher mortality rate. Increase of Spo2 by 1% can improve the patients by 24%. The results indicated that Kaletra had the most highest effect on improvement following COVID-19.

Effect of guided imagery on anxiety, muscle pain, and vital signs in patients with COVID-19: A randomized controlled trial.

BACKGROUND: COVID-19 can lead to anxiety due to its high mortality rate. Patients with COVID-19 may suffer from muscle pain. This study aimed to determine the effect of guided imagery on anxiety, muscle pain, and vital signs in patients with COVID-19. METHODS: 110 patients with COVID-19 were recruited and randomly assigned to two control and intervention groups. Data were collected using the Spielberger Anxiety Inventory, the McGill Pain Questionnaire, and the Visual Analogue Scale. The intervention group received ten training sessions of guided imagery. RESULTS: The results indicated a significant difference in the mean scores of state (t = -3.829, p < .001), trait anxiety (t = -2.946, p = .004), pain quality (t = -4.223, p < .001), pain intensity (t = -3.068, p = .003), and heart rate, systolic blood pressure, and oxygen saturation (p < .001) between the two groups after the intervention. CONCLUSIONS: Guided imagery as a cost-effective method of complementary medicine is recommended to manage anxiety and pain in patients with COVID-19.

Correction to: The use of intravenous immunoglobulin gamma for the treatment of severe coronavirus disease 2019: a randomized placebo-controlled double-blind clinical trial.

An amendment to this paper has been published and can be accessed via the original article.

The use of intravenous immunoglobulin gamma for the treatment of severe coronavirus disease 2019: a randomized placebo-controlled double-blind clinical trial.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has infected people in many countries worldwide. Discovering an effective treatment for this disease, particularly in severe cases, has become the subject of intense scientific investigation. Therefore, the objective of this study was to evaluate the efficacy of intravenous immunoglobulin (IVIg) in patients with severe COVID-19 infection. METHODS: This study was conducted as a randomized placebo-controlled double-blind clinical trial. Fifty-nine patients with severe COVID-19 infection who did not respond to initial treatments were randomly assigned into two groups. One group received IVIg (human)-four vials daily for 3 days (in addition to initial treatment), while the other group received a placebo. Patients' demographic, clinical, and select laboratory test results, as well as the occurrence of in-hospital mortality, were recorded. RESULTS: Among total study subjects, 30 patients received IVIg and 29 patients received a placebo. Demographics, clinical characteristics, and laboratory tests were not statistically different (P > 0.05) between the two groups. The in-hospital mortality rate was significantly lower in the IVIg group compared to the control group (6 [20.0%] vs. 14 [48.3%], respectively; P = 0.022). Multivariate regression analysis demonstrated that administration of IVIg did indeed have a significant impact on mortality rate (aOR = 0.003 [95% CI: 0.001-0.815]; P = 0.042). CONCLUSIONS: Our study demonstrated that the administration of IVIg in patients with severe COVID-19 infection who did not respond to initial treatment could improve their clinical outcome and significantly reduce mortality rate. Further multicenter studies with larger sample sizes are nonetheless required to confirm the appropriateness of this medication as a standard treatment. TRIAL REGISTRATION: A study protocol was registered at the Iranian Registry of Clinical Trials ( www.IRCT.ir ), number IRCT20200501047259N1 . It was registered retrospectively on May 17th, 2020.

Clinical and radiological characteristics of pediatric patients with COVID-19: focus on imaging findings.

PURPOSE: CT imaging has been a detrimental tool in the diagnosis of COVID-19, but it has not been studied thoroughly in pediatric patients and its role in diagnosing COVID-19. METHODS: 27 pediatric patients with COVID-19 pneumonia were included. CT examination and molecular assay tests were performed from all participants. A standard checklist was utilized to extract information, and two radiologists separately reviewed the CT images. RESULTS: The mean age of patients was 4.7 ± 4.16 (mean ± SD) years. Seventeen patients were female, and ten were male. The most common imaging finding was ground-glass opacities followed by consolidations. Seven patients had a single area of involvement, five patients had multiple areas of involvement, and four patients had diffuse involvement. The sensitivity of CT imaging in diagnosing infections was 66.67%. Also, some uncommon imaging findings were seen, such as a tree-in-bud and lung collapse. CONCLUSION: CT imaging shows less involvement in pediatric compared to adult patients, due to pediatric patients having a milder form of the disease. CT imaging also has a lower sensitivity in detecting abnormal lungs compared to adult patients. The most common imaging findings are ground-glass opacities and consolidations, but other non-common imaging findings also exist.