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BACKGROUND: Due to the high incidence and mortality of the worldwide COVID-19 pandemic, beneficial effects of effective antiviral and anti-inflammatory drugs used in other diseases, especially rheumatic diseases, were observed in the treatment of COVID-19. METHODS: Clinical and laboratory parameters of eight included cohort studies and five Randomized Control Trials between the baricitinib group and the control group were analyzed on the first day of admission and days 7, 14, and 28 during hospitalization. RESULTS: According to the meta-analysis result of eight included cohort studies with 2088 patients, the Pooled Risk Ratios were 0.46 (P < 0.001) for mortality, 6.14 (P < 0.001) for hospital discharge, and the mean differences of 76.78 (P < 0.001) for PaO2/FiO2 ratio was -47.32 (P = 0.02) for CRP, in the baricitinib group vs. control group on the seventh or fourteenth day of the treatment compared to the first day. Based on the meta-analysis of five RCT studies with 11,825 patients, the pooled RR was 0.84 (P = 0.001) for mortality and 1.07 (P = 0.014) for patients' recovery. The mean differences were -0.80 (P < 0.001) for hospitalization days, -0.51(P = 0.33) for time to recovery in the baricitinib group vs. control group. CONCLUSIONS: Baricitinib prescription is strongly recommended in moderate to severe COVID-19.
Subject(s)
COVID-19 Drug Treatment , Humans , Pandemics , SARS-CoV-2 , Anti-Inflammatory Agents , Intensive Care UnitsABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic in Iran is part of the worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The present study aimed to demonstrate the clinical characteristics of patients affected by COVID-19, in our tertiary teaching hospital. Medical records and compiled data of 668 patients with suspected COVID-19 were obtained retrospectively between January to April 2020. The present study outcomes included demographic features of infected patients, underlying diseases and conditions, the relationship between the results of reverse transcription-polymerase chain reaction (RT-PCR) or CT-scan with the manifestations of the disease, mortality rate, and age distribution of fatalities among men and women. The median age of hospitalized patients was 63 years old (from 18 to 94). The patients’ chief complaints in the admission time were cough, dyspnea, fever, and gastrointestinal problems, respectively. Hospitalized patients' common comorbidities were hypertension (HTN), and cardiovascular disease (CVD) (24%), diabetes mellitus (DM) (21.5%), asthma, or chronic obstructive pulmonary disease (COPD) (6%), or other underlying diseases (15.5%). One-third of patients had no comorbidity according to the data of medical records. In hospitalized patients, 169 (84.5%) had positive RT-PCR, and 156 (78%) had positive chest CT findings. The mortality rate of males was higher than females (66.3% vs. 33.3%) and in patients with positive RT-PCR compared to patients with positive chest CT-scan findings. The majority of deaths had a history of DM or HTN/CVD in their medical records. The chief complaint of patients was cough. DM and HTN or CVD were the common underlying disease related to death in hospitalized cases. Besides, the hospitalization and mortality rate in males was higher than in females. About 87% of dead hospitalized cases had positive RT-PCR results, and this rate was 82% for chest CT results.
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OBJECTIVES: Coronavirus disease 2019 (COVID-19) pandemic has caused a massive cutdown in outpatient urological investigations, procedures, and interventions. Female and functional urology (FFU) has been probably the most affected subspecialty in urology. Several scientific societies have published guidelines to manage this new situation, providing general recommendations. The aim of this study was to devise a robust questionnaire covering every different aspect of FFU to obtain recommendations on COVID-19 adaptations. METHODS: Delphi methodology was adapted to devise the survey questionnaires for male/female lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP), chronic pelvic pain (CPP), and neuro-urological disease. Content validity, face validity, and internal consistence were assessed to establish the final questionnaire. This study was ethically approved by the Local Research Ethics Committee. RESULTS: A total 97, 59, 79, 85, and 84 items for female and male LUTS, POPs, CPP, and neuro-urology respectively were approved by the participants. Content validity over 0.70 was obtained which seemed reasonable content validity scores. Internal consistency obtains values of Cronbach's alpha was between 0.70 and 0.90 which was acceptable. CONCLUSIONS: The collective wisdom obtained through a global survey using validated questionnaires covering every different aspect of FFU patient management is necessary. We have developed a robust and validated tool consisting of five questionnaires covering the most prevalent pathologies in FFU.
Subject(s)
COVID-19 , Urology , Female , Humans , Male , Reproducibility of Results , SARS-CoV-2 , Surveys and Questionnaires , Urologic Surgical Procedures/methodsABSTRACT
[...]8 studies were included. Glucocorticoids, Azithromycin, Remdesivir, Ropinavir/ritonavir combination therapy, Chloroquine (CQ), Hydroxychloroquine (HCQ), Interferon beta, IL-6 inhibitor (Tocilizumab), and Favipiravir are some of the drugs being recently used for patients with COVID-19. Results To evaluate the clinical efficacy of CQ and HCQ on the treatment of COVID-19-induced pneumonia and their effect on mortality and disease progression in this group of patients, eight studies (including five systematic reviews and three systematic reviews with meta-analysis) were included. [...]its clinical use must either adhere to the Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) framework or be ethically approved by the World Health Organization as a validated test. 2- Patil et at.2 announced the results of 100 studies, including 590368 cases, as follows: HCQ and CQ are effective in several studies (in vitro and clinical studies) in the treatment of mild to severe pneumonia
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CONTEXT: The safety and efficacy of several repurposed drugs, including hydroxychloroquine and chloroquine, with or without azithromycin, were presumed to be miraculous in treating patients with COVID-19. However, as it later transpired, these therapeutic agents seem to be associated with critical adverse cardiac events. OBJECTIVES: Given the skepticism around the advantages and disadvantages of the aforementioned treatment strategies, the present study aimed to investigate the clinical efficacy and cardiac toxicity of hydroxychloroquine or chloroquine with or without azithromycin in the setting of COVID-19 infection. METHOD: This was an umbrella review conducted on patients with COVID-19 who received hydroxychloroquine or chloroquine with or without azithromycin from January 2020 to November 2020. We systematically searched PubMed, Scopus, Cochrane, ProQuest, Web of Science, and Embase databases. RESULTS: Three studies (systematic review and meta-analysis) were analyzed to evaluate the arrhythmogenic potential of hydroxychloroquine or chloroquine with or without azithromycin in patients with COVID-19 and identify the clinical efficacy of such a combination. CONCLUSIONS: We found no benefit for patients with COVID-19 who received hydroxychloroquine or chloroquine alone or in combination with azithromycin. Moreover, it is noteworthy that these medications, particularly when considering co-administration, could result in both statistically and clinically elevated risks of notorious arrhythmias, such as TdP.
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BACKGROUND: The type of pneumonia that is caused by the new coronavirus (SARS-CoV-2) has spread across the world in a pandemic. It is not clear if COVID-19 patients have any lower urinary tract signs or symptoms. METHODS: The effect of COVID-19 on lower urinary tract function was studied in a prospective multi-centre, observational study including 238 patients who were admitted with symptoms caused by COVID-19 to the university hospital of Aachen in Germany and Tabriz in Iran. RESULTS: None of the patients reported to have any lower urinary tract symptoms. SARS-CoV-2 was found in the urine of 19% of the tested patients. The mortality rate in COVID-19 infected patients with microscopic haematuria together with white blood cells in their urine, was significantly increased from 48 to 61% in the Tabriz cohort (p-value = 0.03) and from 30 to 35% in the Aachen cohort (p-value =0.045). Furthermore, in the group of patients with SARS-CoV-2 urine PCR, the mortality rate rose from 30 to 58%. (p-value =0.039). CONCLUSION: Patients admitted with COVID-19 did not report to have any lower urinary tract symptoms, even those patient who had a positive Urine SARS-CoV-2 PCR. In addition, hematuria, WBC in urine as well as SARS- CoV-2 presence in urine, were found to be strong negative prognostic factors in admitted COVID-19 patients.
Subject(s)
COVID-19 , Urinary Tract , Humans , Pandemics , Prospective Studies , SARS-CoV-2ABSTRACT
BACKGROUND: In the current COVID-19 pandemic, there is a rising need for a rapid and reliable diagnostic tool. We hypothesized that chest computed tomography (CT) can be a potential alternative for reverse transcription-polymerase chain reaction (RT-PCR). The aim of this study was to compare the diagnostic value of chest CT and RT-PCR in Iranian patients with suspected COVID-19. METHODS: In a retrospective, single-center case series, 568 consecutive hospitalized or outpatient patients with suspected COVID-19 underwent chest CT and/or RT-PCR testing at Imam Reza Hospital, the tertiary teaching hospital of Tabriz University of Medical Sciences in Iran, from February 21 and March 28, 2020. RESULTS: The sensitivity of chest CT for signifying COVID-19 was 64% (95% CI: 56%-71%) on the basis of positive RT-PCR results as a standard method. CT imaging also had a specificity of 77% (95% CI: 73%-81%), positive predictive value of 35% (95% CI: 0.31-0.39), negative predictive value of 66% (95% CI: 0.61-0.69), positive likelihood ratio of 2.79 (95% CI: 2.26-3.46), and negative likelihood ratio of 0.47 (95% CI: 0.38-0.57). CONCLUSION: Chest CT had higher specificity in the diagnosis of COVID-19 than that of the previous studies. Therefore, it can play a crucial role in the early diagnosis. Similar to the previous studies, the typical CT features were patchy ground-glass opacities as well as peripheral aspects of the lungs consolidations.
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COVID-19 is a novel coronavirus that was reported by the world health organization in late December 2019. As an unexplained respiratory disease epidemic, which is similar to respiratory syndrome coronavirus SARS-CoV, it rapidly spread all over the world. The study aims to compare several parameters of COVID-19 and SARS-CoV infectious diseases in terms of incidence, mortality, and recovery rates. The publicly available dataset Worldometer (extracted on April 5, 2020) confirmed by WHO report was available for meta-analysis purposes using the Meta-MUMS tool. And, the reported outcomes of the analysis used a random-effects model to evaluate the event rate, and risk ratios thorough subgroup analysis forest plots. Seventeen countries for COVID-19 and eight countries of SARS infections, including COVID-19 group n = 1124243, and SARS-CoV group n = 8346, were analyzed. In this meta-analysis, a random effect model of relations of incidence, mortality, and recovery rates of COVID-19 and SARS world infections were determined. The meta-analysis and forest plots of two viral world infections showed that the incidence rate of COVID-19 infection is more than SARS infections, while recovery and mortality event rates of SARS-CoV are more than COVID-19 infection. And subgroup analysis showed that the mortality and recovery rates were higher in both SARS-CoV wand COVID-19 in comparison to incidence and mortality rates, respectively. In conclusion, the meta-analysis approach on the abovementioned dataset revealed the epidemiological and statistical analyses for comparing COVID-19 and SARS-CoV outbreaks.