The Association of Opioid Use Disorder and COVID-19, a Longitudinal Study

Background: Coronavirus disease 2019 (COVID-19) quickly spread to the world, causing a pandemic. While some studies have found no link between opioid use disorder (OUD) and COVID-19, the role of opioid on COVID-19 is challenging. The present study aimed to determine the relationship between OUD and COVID-19. Methods: This was a prospective cohort study. We used data from the third phase of the Shahroud Eye Cohort Study on 4394 participants which started in September 2019 and ended before the COVID-19 epidemic in Shahroud in February 2020. The participants were followed for about 13 months till March 26, 2021. COVID-19 was detected by RT-PCR on swap samples from the oropharynx and nasopharynx. The incidence of COVID-19 compared in OUD and non-OUD participants, and relative risk was calculated in log-binomial regression models. Results: Among the 4394 participants with a mean age of 61.1 years, 120 people had OUD. The incidence of COVID-19 in participants with OUD and non-OUD was 4.17% and 6.22%, respectively (P-value: 0356). The relative risk of OUD for COVID-19 was 0.60 (95% confidence intervals: 0.25–1.44;P value: 0.251). Conclusions: OUD was not associated with COVID-19. The claim that people with OUD are less likely to develop COVID-19 is not supported by these data.

The Association of Opioid Use Disorder and COVID-19, a Longitudinal Study.

Background: Coronavirus disease 2019 (COVID-19) quickly spread to the world, causing a pandemic. While some studies have found no link between opioid use disorder (OUD) and COVID-19, the role of opioid on COVID-19 is challenging. The present study aimed to determine the relationship between OUD and COVID-19. Methods: This was a prospective cohort study. We used data from the third phase of the Shahroud Eye Cohort Study on 4394 participants which started in September 2019 and ended before the COVID-19 epidemic in Shahroud in February 2020. The participants were followed for about 13 months till March 26, 2021. COVID-19 was detected by RT-PCR on swap samples from the oropharynx and nasopharynx. The incidence of COVID-19 compared in OUD and non-OUD participants, and relative risk was calculated in log-binomial regression models. Results: Among the 4394 participants with a mean age of 61.1 years, 120 people had OUD. The incidence of COVID-19 in participants with OUD and non-OUD was 4.17% and 6.22%, respectively (P-value: 0356). The relative risk of OUD for COVID-19 was 0.60 (95% confidence intervals: 0.25-1.44; P value: 0.251). Conclusions: OUD was not associated with COVID-19. The claim that people with OUD are less likely to develop COVID-19 is not supported by these data.

Health Consequences of Overexposure to Disinfectants and Self-Medication against SARS-CoV-2: A Cautionary Tale Review

To control and prevent the spread of the infectious agents in the environment and body, various measures have been taken, including the use of disinfectants for hands and surfaces, use of detergents, self-medication by herbal concoctions, and dietary supplements. Although these actions may have a therapeutic effect or reduce the viral load, incorrect use (abuse or overuse) could have negative health repercussions. Therefore, public awareness in this context is essential. The purpose of this narrative review was to evaluate the health consequences of overexposure to disinfectants and self-medication against infectious agents, specially SARS-CoV-2. The literature search for this review was conducted using related keywords in PubMed, Web of Science (WOS), and Scopus databases. This review found a significant number of reported poisoning cases during the pandemic as a result of the overuse of alcoholic hand sanitizers, household bleach products, and detergents. This paper also provides an integrated systemic overview of the possible toxic effects of self-medication, alcohol consumption, and self-administration of dietary supplements and herbs during the COVID-19 pandemic. The present review indicated that the main adverse effects associated with the overuse of popular preventative actions against contagious respiratory illnesses specially COVID-19 and Influenza (flu) were methanol intoxication, skin damage, respiratory problems, gastrointestinal ulcers, nausea, vomiting, epigastric pain, and liver injury. Due to the significant increase in the use of these preventative measures, it is essential to raise public awareness of the side effects of their excessive and unnecessary use.

Clinical, Laboratory and Imaging Characteristics of Hospitalized COVID-19 Patients with Neurologic Involvement; a Cross-Sectional Study.

Introduction: Although neurologic involvement and neuroimaging abnormalities have been frequently identified in COVID-19 patients, the underlying factors remain unclear. In this study, we assessed the association of the neurological manifestations and neuroimaging features of hospitalized COVID-19 patients with their clinical, laboratory, and imaging characteristics. Methods: This multicenter cross-sectional study was conducted between September 2020 and March 2021 at two large academic hospitals in Tehran, Iran. We used census sampling from medical records to enroll hospitalized patients with a positive COVID-19 Polymerase chain reaction (PCR) test who underwent brain imaging due to presenting any acute neurologic symptom during hospital stay. Results: Of the 4372 hospitalized patients with COVID-19, only 211 met the inclusion criteria (35.5% with severe infection). Central nervous system and psychiatric manifestations were significantly more common in severe cases (p ≤ 0.044). Approximately, 30% had a new abnormality on their neuroimaging, with ischemic (38/63) and hemorrhagic (16/63) insults being the most common. The most frequent reasons that provoked cranial imaging were headache (27%), altered consciousness (25.6%), focal neurologic signs (19.9%), and delirium (18%). Analysis revealed a positive correlation for age, neutrophilia, lymphopenia, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) with the emergence of neuroimaging abnormalities (p ≤ 0.018). In addition, patients with new neuroimaging abnormalities had a significantly higher lung CT score than those without any pathologic findings (11.1 ± 4.8 vs. 5.9 ± 4.8, p < 0.001). Conclusion: Approximately 30% of the study population had various acute neuroimaging findings. The lung CT score, neutrophil count, and age were strong predictors of acute neuroimaging abnormalities in hospitalized COVID-19 patients.

The risk factors of COVID-19 in 50–74 years old people: a longitudinal population-based study

To investigate the risk factors of COVID-19 infection in a longitudinal study of a population aged 50–74 years.Data were collected from Shahroud Eye Cohort study and the COVID-19 electronic registry in Shahroud, northeast Iran. Participants were followed for about 13 months and predisposing factors for COVID-19 infection were investigated using log binominal model and calculating relative risks.From the beginning of the COVID-19 outbreak in Shahroud (February 20, 2020) to March 26, 2021, out of 4,394 participants in the Eye Cohort study, 271 (6.1%) were diagnosed with COVID-19 with a positive reverse transcription polymerase chain reaction test on two nasopharyngeal and oropharyngeal swabs. Risk factors for COVID-19 infection included male gender (relative risk (RR) = 1.51;95% confidence intervals (CI), 1.15–1.99), body mass index (BMI) over 25 (RR = 1.03;95% CI, 1.01–1.05), and diabetes (RR = 1.31;95% CI, 1.02–1.67). Also, smoking (RR = 0.51;95% CI, 0.28–0.93) and education (RR = 0.95;95% CI, 0.92–0.98) showed inverse associations.Men, diabetics, and those with BMI over 25 should be more cognizant and adhere to health protocols related to COVID-19 prevention and should be given priority for vaccination.

Implications of Sex Difference in CT Scan Findings and Outcome of Patients with COVID-19 Pneumonia.

PURPOSE: The novel coronavirus pandemic has caused significant morbidity and mortality since December 2019. Although the role of chest CT for diagnosing coronavirus disease 2019 (COVID-19) pneumonia is still debatable, the modality has been used in scenarios of constrained reverse-transcription polymerase chain reaction (RT-PCR) testing. The epidemiologic reports indicate an unexplored difference between men and women in disease severity. We aimed to study the role of sex on disease severity and its correlation with CT findings. MATERIALS AND METHODS: Authors retrospectively studied all confirmed cases of COVID-19 with thoracic CT scans obtained at three hospitals from February 25, 2020, to March 15, 2020, in Tehran, Iran. CT involvement patterns of COVID-19 were analyzed based on sex and age of patients. RESULTS: One hundred fifteen patients (64.3% [74/115] men) were enrolled, with a median age of 57 years (age range, 21-89). Thirty patients were admitted to the intensive care unit, and 30 patients died during the hospital stay. Seventy-seven percent (37/48) of patients with unfavorable prognosis were male. Peripheral distribution of opacities was more common in men than women. When grouped by an age cut-off of 60 years, the women in the elder group had a peribronchovascular distribution pattern, and younger men showed an anterior distribution of opacities. Women younger than 60 years had significantly lower severity scores (CT-scores) (7.5 ± 6.8). Receiver operating characteristic (ROC) curve analysis demonstrated a CT-score cut-off of 14.5 to have 100% sensitivity and 91.9% specificity for predicting poor prognosis in women younger than 60 years. CONCLUSION: Opacity patterns on chest CT scans in COVID-19 are different based on sex and age, and men are at higher risk of disease severity and death.© RSNA, 2020.

Deep COVID DeteCT: an international experience on COVID-19 lung detection and prognosis using chest CT.

The Coronavirus disease 2019 (COVID-19) presents open questions in how we clinically diagnose and assess disease course. Recently, chest computed tomography (CT) has shown utility for COVID-19 diagnosis. In this study, we developed Deep COVID DeteCT (DCD), a deep learning convolutional neural network (CNN) that uses the entire chest CT volume to automatically predict COVID-19 (COVID+) from non-COVID-19 (COVID-) pneumonia and normal controls. We discuss training strategies and differences in performance across 13 international institutions and 8 countries. The inclusion of non-China sites in training significantly improved classification performance with area under the curve (AUCs) and accuracies above 0.8 on most test sites. Furthermore, using available follow-up scans, we investigate methods to track patient disease course and predict prognosis.

A Multicenter Survey on the Trend of Chest CT Scan Utilization: Tracing the First Footsteps of COVID-19 in Iran.

BACKGROUND: Chest computed tomography (CT) scan has been used widely to diagnose COVID-19 in Iran. OBJECTIVES: To trace the footsteps of COVID-19 in Iran by exploring the trend in using chest CT scans and its economic impact on radiology departments. Methods: In this cross-sectional study, the number of imaging examinations from 33 tertiary radiology departments in 9 large cities of Iran was collected from September 23, 2019 to March 20, 2020 (Months 1 to 6) and the corresponding months in 2018-2019. RESULTS: A 50.2% increase was noted in the chest CT scan utilization in 2019-2020 compared to 2018-2019. This increase was +15%, +15%, +27%, +2%, +1% in Months 1-5 of 2019-2020, respectively. In Month 6 of 2019-2020, a 251% increase in the acquisition of chest CT scans was observed compared to the Month 6 of 2018-2019. Following negative balance of revenue from Month 1 to 5 with respect to the inflation rate, the total income in Month 6 was further 1.5% less than the same Month in 2018-19. CONCLUSION: The observed peak in chest CT utilization in Month 3 prior to the surge in Month 6 could be explained by the seasonal influenza. However, unawareness about an emerging viral disease, i.e. COVID-19, might have underutilized chest CT in Months 4 and 5 before the official announcement in Month 6. The unbalanced increase in the workload of radiology departments in the shortage of cardiothoracic radiologists with the simultaneous decrease in income initiated a vicious cycle that worsened the economic repercussions of the pandemic.