Knowledge, Attitudes, and Practices Among the General Population During COVID-19 Outbreak in Iran: A National Cross-Sectional Online Survey.

Background: Emerged in December 2019, coronavirus disease 2019 (COVID-19) is one of the largest pandemics ever. During the early phase, little was known about public knowledge, attitudes, and practices (KAP) relating to coronavirus disease. This study was designed to determine KAP of Iranians toward COVID-19. Methods: A cross-sectional online survey was carried out in Iran from February 25 to April 25 using a self-administered questionnaire on 1,480 people. COVID-19-related KAP questions were adapted from other internationally validated questionnaires specific for infectious diseases. Results: All participants were aware of COVID-19. When asked unprompted, 80% of respondents could correctly cite fever, difficulty in breathing, and cough as signs/symptoms of COVID-19. Most of our sample population knew that staying at home and isolated (95.3%) as well as constant handwashing and using disinfectants (92.5%) could prevent COVID-19. However, there were also widespread misconceptions such as the belief that COVID-19 can be transmitted by wild animals (58%) and by air (48.3%). Unprompted, self-reported actions taken to avoid COVID-19 infection included handwashing with soap and water (95.4%), avoiding crowded places (93%), cleansing hands with other disinfectants (80.), and covering mouth and nose when coughing or sneezing (76.1%). The Internet and social media (94.5%) were the main coronavirus information sources. However, the most trusted information sources on coronavirus were health and medical professionals (79.3%). The majority of participants (77.0%) wanted more information about coronavirus to be available. Conclusion: Our findings suggest that people's knowledge and attitude toward COVID-19 at the time of its outbreak was at a high level.

Favipiravir for treating patients with novel coronavirus (COVID-19): protocol for a systematic review and meta-analysis of randomised clinical trials.

INTRODUCTION: An outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was reported in Wuhan, China, in mid-December 2019, and declared a pandemic by the WHO on 11 March 2020. Due to the unknown nature of the disease and the lack of specific drugs, several potential treatments were used for patients. This systematic review and meta-analysis will evaluate studies of the effects of favipiravir in COVID-19 pneumonia. METHODS AND ANALYSIS: We will search electronic databases including LitCovid hub, PubMed, Scopus, ISI Web of Sciences, Cochrane and Embase using keywords related to COVID-19 and favipiravir. We will search the reference lists of all included studies and reviews. We will also search for clinical trial registries, such as ClinicalTrials.gov, for the ongoing clinical trials. All randomised clinical trials investigating the safety and efficacy of favipiravir compared with other control groups for the treatment of patients with confirmed infection with SARS-CoV-2 will be included. Patients' survival at the end of the treatment as well as the follow-up will be the primary outcome of the treatment, followed by the time and rate of the patient with a negative COVID-19 test. The desired secondary outcome will consist of a decreased rate of symptoms, proportion of intensive care unit (ICU) transfers, length of the hospital stay, ICU treatments, the quality of life and additional adverse events. Data synthesis will be conducted using CMA V.2. Two independent investigators will be screening titles, abstracts and full texts of included studies, based on eligibility criteria. These investigators will then independently extract the data and appraise the quality of said studies. All potential discrepancies will be resolved through consultation with the third reviewer. Statistical heterogeneity will be assessed using a standard I2 test. A funnel plot, Egger's test and Begg's test will be used for detecting asymmetry to explore possible publication bias. ETHICS AND DISSEMINATION: All findings of this systematic review and meta-analysis will help identify the safety and efficacy of favipiravir for patients with COVID-19. Given that the design of the study is a systematic review, there is no need to follow the code of ethics protocol. The results of this study will be published in a reputable journal. PROSPERO REGISTRATION NUMBER: CRD42020180032.

Covid-19 in Iran: the good, the bad and the ugly strategies for preparedness - A report from the field

The emergence of Covid-19, a novel unknown virus which is challenging the whole countries all over the world has seen different strategies from various governments. Iran, as one of the first countries experienced the onset of the virus outbreak had some course of policy makings and implementation which should be assessed so that lessons could be learnt for the future. Although some negative actions and policies like delays in cancellation of the international flights especially from China, not taking the disease seriously and comparing it to seasonal influenza and the like are hard to ignore, some impressive actions are also vividly clear. Policies like social distancing, dramatically increasing social awareness about preventive actions in terms of public health, and using masks and the like were cost-effective policies which resulted in successful control of the virus in the first onset. While some ill managerial decision makings are quite clear in Iranian authorities, the huge catastrophic effect of sanctions cannot be forgotten. Maybe in level situations with similar countries, Iran will have far better results regarding preparedness for pandemics like Covid-19.