Examining the frequency of endoscopic findings in patients with covid-19 with upper gastrointestinal bleeding referred to al-Zahra Hospital of Isfahan.

Background: Gastrointestinal bleeding is one of the consequences of COVID-19, which is associated with increased hospitalization and patient mortality. This study was conducted to determine the prevalence of endoscopic findings and the outcome of gastrointestinal bleeding in patients with COVID-19 who were hospitalized from September to December 2019 in Al-Zahra Hospital, Isfahan. Method(s): In this cross-sectional study, out of 5800 patients who were admitted to Al-Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings. Result(s): Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070). Conclusion(s): The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding.Copyright © 2022 Tabesh et al. Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.

The role of physical activity in modulating COVID-19 neuropsychological complications: a narrative review

Since 2020, the COVID-19 pandemic, triggered by SARS-CoV-2, represents the major global issue affecting the lifestyle of people around the world. Wuhan, China was the first city to detect the SARS-CoV-2 virus, but the virus soon spread around the world, forcing the World Health Organization to declare a global epidemic on March 11, 2020 (1). Previous pathological conditions or comorbidities such as old age are one of the main causes of premature death and increased morbidity and mortality due to COVID-19 (4). Inactivity due to hospitalization and bed rest and reduced physical activity due to constant quarantine and social distancing can reduce the ability of organ systems to resist viral infection and the risk of damage to the immune, respiratory, and Increase cardiovascular systems, musculoskeletal and nervous system (4). On the other hand, the health benefits of physical activity, from cardiovascular health to mental health, have been well established (5). Decreased physical activity and increased sedentary behaviors were reported during quarantine in several populations, including children and patients with a variety of medical conditions (6). In general, COVID-19 lifestyle changes have led to a decrease in physical activity and consequently more inactivity in different parts of the community, which can pose a risk to general or mental health, especially for certain populations. In this study, we have tried to review the neurological and psychological effects of COVID-19 and the resulting lifestyle changes, and specifically the role of exercise in relation to these effects. Central nervous system (CNS) and peripheral nervous system (PNS) manifestations can occur during and after COVID-19, but the underlying mechanisms, symptomatology, and frequency of these complications are not well understood (7). Limited postmortem studies have shown signs of hypoxic brain damage and inflammatory neurological changes in the brainstem, while neuropathological data from the PNS are almost non-existent. Due to the cause, direct invasion of acute respiratory syndrome of COVID-19 virus to nerve tissue has been suggested in several cases, but autoimmune damage and neurological complications related to intensive care management can also be effective. The contribution of these mechanisms to the overall burden of CNS and PNS complications of COVID-19 is unknown (7). Follow-ups in Germany and the United Kingdom have shown that neuropsychological symptoms after COVID-19 in 20 to 70% of patients, even in young adults, last for months after the onset of respiratory symptoms, suggesting brain involvement persists (9). COVID-19, which enters through angiotensin-converting enzyme receptors, can damage endothelial cells, leading to inflammation, thrombosis, and brain damage. In addition, systemic inflammation leads to a decrease in monoamines and neurotrophic factors and activation of microglia, which leads to an increase in glutamate and N-methyl-d-aspartate-3 and excitatory toxicity, and these factors cause the onset or exacerbation of existing neuropsychiatric symptoms. They are already (9). However, the extent of damage caused by the COVID-19 pandemic strain is still speculated;it has recently been suggested that irregular neuro-endocrine-immune interactions may be behind psychiatric manifestations observed in quarantined individuals (12, 13). Persistent and increased stressful events can direct immune, endocrine, and nervous system responses primarily through hypothalamic-pituitary-adrenal (HPA) mediated dysfunction (12), and changes in the levels of systemic inflammatory mediators or the brain predispose individuals to pathological psychological conditions. It acts like anxiety and depression. In addition, stress can be a potential trigger for neuroinflammation, a term used to indicate an imbalance or intensification of immune signals in the brain that can lead to several disorders such as aggression, psychosis, depression, and anxiety disorders (12). Covid 19 has also been shown to alter nerve growth factors that may affect the neurop

Moral Distress, Burnout, and Job Satisfaction in Emergency Medical Technicians during the COVID-19 Pandemic

Background: Emergency medical technicians (EMTs) or paramedics may not be able to do according to their moral standards during the COVID-19 pandemic, which can cause burnout and job dissatisfaction. Objectives: This study aimed to evaluate moral distress (MD), job satisfaction, and burnout among EMTs during the COVID-19 pandemic. Methods: This cross-sectional study was conducted in Bam, Iran in 2020. In total, 134 EMTs completed the online survey that included demographic information, a MD scale, the Maslach Burnout Inventory, and an item for assessing job satisfaction. Descriptive statistics along with independent samples t-test, one-way analysis of variance, Mann-Whitney U, and Kruskal-Wallis tests, as well as multiple linear regression analysis were used to analyze data. Results: The mean scores of MD and job satisfaction were 25.44 +/- 12.78 and 3.63 +/- 1.07, respectively. Concerning severity, the mean scores of emotional exhaustion, depersonalization, and personal accomplishment (PA) were 35.45 +/- 5.04, 20.61 +/- 3.40, and 33.04 +/- 4.07, respectively. All three burnout subscales were significantly correlated with job satisfaction (P < 0.05) and MD (P < 0.05). Access to personal protective equipment and education level significantly predicted MD (P < 0.05). Conclusion: Despite high burnout and moderate MD, EMTs reported high job satisfaction, possibly because of increased social respect and salary. EMTs can avoid MD and burnout by learning how to handle ethical challenges during the COVID-19 pandemic.

Examining the frequency of endoscopic findings in patients with COVID-19 with upper gastrointestinal bleeding referred to al-Zahra Hospital of Isfahan

Background: Gastrointestinal bleeding is one of the consequences of COVID-19, which is associated with increased hospitalization and patient mortality. This study was conducted to determine the prevalence of endoscopic findings and the outcome of gastrointestinal bleeding in patients with COVID-19 who were hospitalized from September to December 2019 in Al-Zahra Hospital, Isfahan. Methods: In this cross-sectional study, out of 5800 patients who were admitted to Al- Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings. Results: Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070). Conclusion: The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding.

Association of Anti-N and -S Seroprevalence in Asymptom atic, Mildly Symptomatic, and Symptomatic SARS-COV-2 Natural Infection

Backgrounds: SARS-COV-2 infection is not always correlated with protection. Antibody seroprevalence in unvaccinated individuals, which is usually measured by N-specific antibodies, is not necessarily correlated with protection, while antibodies against S protein show a better correlation with protection due to its neutralizing epitopes. In this study, we tried to improve our conception of the hidden perspective of SARS-COV-2 in epidemiological reports and investigate anti-S antibody prevalence among anti-N antibody-positive asymptomatic and mildly symptomatic patients. Material(s) and Method(s): Blood samples were collected from asymptomatic or mildly symptomatic volunteer participants and symptomatic hospitalized patients with negative PCR results from May 30 to June 17, 2020. Detection of SARS-COV-2 antibodies was done using an ELISA kit targeting N or S protein. Finding(s): Totally, 716 samples from volunteer participants and 81 samples from symptomatic hospitalized patients with negative PCR results were evaluated. The test performance-adjusted seroprevalence (%95 CI) of SARS-COV-2 antibody was 17.3% (8.8-25.8%) for anti-N IgG in volunteers and 25.5% (12.8-39.7%) for anti-N and anti-S IgM in hospitalized patients. Among anti-N IgG positive infected individuals, %49.2 (21.4 and 78.8%) were anti-S antibody positive. Conclusion(s): The results showed that SARS-COV-2 infection sometimes occurs in individuals without symptoms or with mild symptoms, but in more than half of them, the produced antibody is not protective. The findings of hospitalized patients showed that the combination of IgM assay with real-time PCR improved the disease diagnosis by more than 25% in cases with negative molecular test results.Copyright © 2022, TMU Press.

Novel Coronavirus is the Only Virus Causing Childhood Invasive Diarrhea: A Case Series

Introduction: Typical manifestations of Coronavirus disease 2019 (COVID-19) include respiratory involvement. Gastrointestinal (GI) symptoms have also been reported as early clinical manifestations. The GI involvement can represent with diarrhea, vomiting, and abdominal pain. The present research aimed to identify dysentery as one of the signs of GI involvement in the novel coronavirus infection in children. Case Presentation: We report twelve patients with COVID-19 and dysentery. All these children had positive reverse transcriptionpolymerase chain reaction (RT-PCR) results. None had underlying illnesses or recent travel history. However, all children had contact with a first-degree relative affected by non-digestive COVID-19. In three patients, obvious dysentery was observed, and in the rest, red and white blood cells were evident in the stool exam. Stool exams were negative for bacterial infections, parasites, and the toxin of Clostridium difficile. Abdominal ultrasonography and echocardiographic evaluations to rule out multisystem inflammatory syndrome in children were normal. Supportive treatment, such as zinc supplementation and probiotics, was prescribed. They also received intravenous fluid therapy based on their dehydration percentage. In the end, they were discharged in good general condition without any complications. No GI complications were found in the follow-up series. Conclusion(s): Dysentery in children can be one of the GI manifestations of COVID-19, which is usually self-limiting. It does not require invasive diagnostic measures and antiviral treatments. This symptom is in contrast to other viral infections of the GI tract.Copyright © 2022, Author(s).

Staphylococcal Scalded Skin Syndrome Superinfection in a Child with COVID-19: A Brief Case Report

Background: While the exact prevalence of bacterial co-infection and superinfection in children with coronavirus disease 2019 (COVID-19) remains unclear, numerous scattered reports of it are on the rise. Case Presentation: Our case was a 14-month-old infant with fever, truncal erythema, and scalded skin in flexor folds and also in perianal and perioral regions. A positive Nikolsky's sign was observed. The oropharyngeal mucosa was intact. The patient was diagnosed with staphylococcal scalded skin syndrome (SSSS) according to clinical features and a skin culture report. Due to the general impact of COVID-19 these days, the patient was evaluated for coronavirus via a polymerase chain reaction (PCR) test, and the result was positive. The patient successfully responded to the treatment which included hydration, wet compress, topical emollient, topical mupirocin for periorificial regions, and intravenous clindamycin. He was discharged after nine days without any complications. Conclusion(s): This case highlights a clear bacterial infection superimposed on COVID-19. Nevertheless, inconspicuous cases of co-infections remain obscure and require a more diagnostic suspicion. Copyright © 2022 Hoseininasab et al.

Mortality risk factors among hospitalised COVID-19 patients

Introduction: COVID-19 is an acute viral infection that mainly affects the respiratory system leading to mortality. Therefore, positive COVID-19 patients may require intensive care unit (ICU) admission in severe cases. Many factors are thought to exacerbate the symptoms of COVID-19 resulting in increased mortality, smoking, hypertension and type 2 diabetes mellitus (T2DM) are on the top of these factors. Objective(s): This study was designed to detect the strength of association between death rate among COVID-19 ICU admitted patients and being smokers, type 2 diabetes mellitus (T2DM), or hypertension. Material(s) and Method(s): A cross-sectional study was conducted. A sample of 302 patients included all COVID-19 patients admitted to the ICU of the central hospital in Amman, Jordan, in July 2021. Result(s) and Conclusion(s): Of the total 302 patients, 171 were smokers. the death rate among smokers (67.25%) was significantly higher than (53.43%) among non-smokers X2= 5.966, p=0.0145. We found that 118 cases had T2DM. the death rate among patient with T2DM (62.71%) was insignificantly higher than (60.32%) among non-diabetic patients X2= 0.172, p=0.67. Of the 130 COVID-19 patients with hypertension, the death rate was (70.76%) significantly higher than (54.1%) among those without hypertension X2= 8.70, p=0.0031. Moreover, by using the OR and 95% CI. Interestingly, we found that smokers were almost two times significantly more prone to death than nonsmokers (OR=1.79, 95%CI:1.12 - 2.86, p=0.015). Also, patients with hypertension were two times significantly more prone to death than normotensive patients, (OR=2.06, 95% CI: 1.27 - 3.33, p=0.0034). On the other hand, T2DM showed an insignificant risk factor (OR=1.11) for death. 95% CI: 0.687- 1.78, p=0.6780. Smoking and hypertension act as significant risk factors to increase mortality in COVID-19 patients.

Comparison of clinical, radiological and laboratory findings in discharged and dead patients with COVID-19

Background: Coronavirus disease 19 (COVID-19) is a recently described infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Iran was the first country where the SARS-Cov-2 was detected in the Middle East. In the current study, we aimed to evaluate the clinical, radiological and laboratory findings in hospitalized COVID-19 confirmed cases in Iran. Methods: The clinical manifestations, radiological data, laboratory findings, and the underlying diseases of the patients with COVID-19 were obtained from electronic medical records. Next, this information was compared in discharged and dead patients. Results: Overall, 4028 patients with COVID-19 including 3088 discharged, 778 dead, and 162 still hospitalized patients were enrolled in this study. The highest percentage of people who recovered (55%) was between 30 and 60 years old and the highest percentage of deaths (74.4%) was more than 60 years old. Based on demographic data, 50.05% were female and 49.95% were male. Clinical evaluations revealed that dyspnea (56.9%), cough (31.4%) and fever (17.8%) were the most manifestations. Comorbidities were significantly higher in the dead group. Laboratory analysis revealed abnormalities in lymphocyte count (LYM), erythrocyte sedimentation rate (ESR), and inflammatory biomarkers such as C-reactive protein (CRP). The most prevalent computed tomography (CT) scan data were ground-glass opacity (GGO) (30.5%) and consolidation (9.4%). Conclusions: Laboratory parameters and clinical and radiological findings help to evaluate the follow-up of the disease in patients. Age and comorbidities are factors that predispose people to COVID-19. Further research is needed to evaluate the effects of various factors on the progression of COVID-19 infection.

Parents' risk perception in the predictive association between personal fable and sensation seeking with adolescents' pandemic related preventive behaviors during covid 19: A moderated mediation approach

Objective: Amid the barriers created by Covid-19 and the enforced strict governments' containments measures, adolescents were negatively impacted more than any other age group. Adolescents are known to display a pivotal role in spreading the virus because of their low conformity. To find the contributing and mediating factors associated with teens' extensive noncompliance, this study focuses on the mechanisms of adopting preventive behaviors. Method: This cross-sectional study was administered online using convenience sampling over four weeks during severe lockdown 4th peak outbreak period. Data were gathered online from 422 adolescents with an average age of 15.48 years (SD=2.74) and their parents. Analysis of data was done by PROCESS macro for SPSS version 25. Results: Personal fable and sensation seeking were predictive of rule-disrespecting in adolescents of both genders. Mediation modeling demonstrated that parents' risk perception partially mediated the predictive relationship between personal fable and sensation seeking with pandemic preventive behaviors in girls ( personal fable: [B = -0.034, 95% CI = (-0.076, -0.005)];sensation seeking [B = -0.047, 95% CI = (-0.102, -0.008)]). Conclusion: These findings highlight the importance of some peculiar characteristics of this developmental stage in explaining adherence to pandemic-related preventative behaviors. It seems that teen boys are more vulnerable in pandemic time frames regarding their inattention to parents' recommendations.

Intensive Care Unit, Cardiac Care Unit, and Emergency Department Nurses? Perceptions of Medical Device-Related Pressure Injuries: A Cross-Sectional Study br

BACKGROUND: Nurses' perception of medical device-related pressure injuries (MDRPIs) may affect their performance, but there is a lack of studies in this area.PURPOSE: The current study aimed to examine intensive care unit (ICU), cardiac care unit (CCU) and emergency department nurses' perception of proper prevention of MDRPIs and care for individuals with such injuries.METHODS: This descriptive study was conducted in 4 general hospitals in Iran in 2021. All nurses (N = 310) working in ICUs, CCUs and emergency departments of these facilities were invited to complete a researcher-made demographic check-list and an 11-item questionnaire to assess attitudes toward MDRPIs. The questionnaire item responses were scored from 1 (strongly agree) to 5 (strongly disagree) with the total score for the 11 items ranging from 11 to 55. A score of 11 to 25 was categorized as indicating a negative attitude toward proper prevention of MDRPIs and care for such patients;a score of 26 to 40 indicated a neutral attitude, and a score >40 indicated a positive attitude.RESULTS: A total of 260 nurses fulfilled the data col-lection tool. The response rate was 83.8%. The mean total score of attitude toward MDRPIs was 41.7. No significant relationship was observed between the total score of nurses' attitudes and their demographic variables. Of the 260 participants, 159 stated they had not received any trainings on MDRPIs at nursing schools during their education, 212 stated they had not participated in any scientific workshops on MDRPIs, and 167 described their knowledge about the prevention and care of MDRPIs as insuf-ficient.CONCLUSION: Among ICU, CCU, and emergency nurses in Iran, most had a positive attitude toward the prevention and care of MDRPIs, but steps should be taken to offer more opportunities for nurses to increase their knowledge in this area

Cutaneous Manifestations of Novel Coronavirus Disease (COVID-19): A Case with Staphylococcal Scalded Skin Syndrome (SSSS)

Background: The coronavirus disease 2019 (COVID‐19) was first reported in December 2019 in Wuhan, China. Skin manifestations of COVID-19 have been reported sporadically. Staphylococcus aureus occurs after viral infection due to unregulated IFN-α. We designed this reported case to pay more attention to the rare skin manifestations following COVID-19. Case Report: The patient was a 12-month-old girl who presented with fever and skin rashes. Two days before admission, erythematous rashes spread around the mouth, nose, eyes, and trunk. Erythematous lesions begin to peel the next day. RT-PCR of the nasopharynx was positive for COVID-19. Treatment with vancomycin and clindamycin was started. The patient was discharged with complete recovery of skin lesions. Conclusion: One of the early manifestations of COVID-19 in children can be fever and rash. Clinical suspicion led to more attention to complications of bacterial superinfection such as staphylococcal scalded skin syndrome.

Investigation of the Severity of Increased QT Interval Incidence in Young Patients with COVID-19

Introduction: ECG abnormality is a major problem in COVID-19 patients, especially in the elderly, which can result in fatal dysrhythmias. In this article, QT interval prolongation was investigated in admitted Covid-19 patients of 20-50 years of age without any history of cardiac problems. Methods: This study is a descriptive and analytical study. All consenting patients admitted to the hospital for Covid-19 infection aged 20-50 years old entered the study. Patients with underlying heart and kidney disease, history of taking any medication or cardiac dysrhythmias were excluded. An electrocardiogram was performed on admission and the third day of hospitalization. Results: The average length of hospital stay was 7.9 +/- 3.68 days. and all patients had QT interval prolongation after 3 days, but no cardiac dysrhythmia occurred. There was no statistically significant increase in QTc interval for each drug used alone, but the use of various drugs that affect the electrical conduction of the heart and also the presence of underlying inflammation, especially in patient's heart cells can be the underlying cause of QTc interval prolongation. Many Covid-19 patients have QT interval prolongation. It can be due the infection itself, the drugs used for treatment or viral myocarditis. The results of the present study showed that taking drugs such as kaletra even for 3 days can significantly increase the QTc interval in patients, so care should be taken in the use of these drugs to avoid iatrogenic cardiac disease in patients, although in most cases the increase was mild and didn't cause mortality in patients.

Coronavirus Disease-19 (COVID-19) Presenting with Severe Acute Pancreatitis: A Case Report from Iran

The 2019 Coronavirus disease pandemic (COVID-19) has spread to over two hundred countries worldwide, affecting > 170 million people and causing >3,500,000 deaths (May 29, 2021). Severe COVID-19 disease mostly disturbs the respiratory system, but gastrointestinal symptoms, including vomiting, nausea and diarrhea, are also present. Herein, we are reporting a COVID-19 patient with acute pancreatitis (AP) in Zanjan, Iran. This patient showed acute pancreatitis as a COVID-19-related complication, emphasizing the importance of evaluating pancreas-specific plasma amylase levels in patients with COVID-19 and intestinal cramping. © 2022, Zanjan University of Medical Sciences and Health Services. All rights reserved.

Chest CT findings in patients with COVID-19 infection: a systematic review and meta-analysis

In this work, we evaluated computed tomography (CT) results of the chest in patients with COVID-19 pneumonia. Preliminary articles were searched in the scientific databases PubMed, MEDLINE, Embase, EBSCO between 2019 to 2021. Fixed-effect model for meta-analysis using the inverse-variance method calculates effect size with 95% confidence interval (CI). Data analysis was performed using STATA software version 16. Overall effect size of Ground glass opacities (GGO) in patients with coronavirus disease 2019 (COVID-19) was 2.30 (ES, 95% CI 1.56, 3.3). Ground-glass opacity was a typical finding in COVID-19 pneumonia on CT;its incidence was about 80%. Abnormal CT in patients with COVID-19 was 2.69 (ES, 95% CI 2.52, 2.87). Ground-glass opacity is the foremost typical CT scan result in coronavirus disease 2019, and lung involvement is more common in bilateral and lower lung areas.

Imaging Biomarker Knowledge Transfer for Attention-Based Diagnosis of COVID-19 in Lung Ultrasound Videos

The use of lung ultrasound imaging has recently emerged as a quick, cost-effective, and safe method for diagnosis of patients with COVID-19. Challenges with training deep networks to identify COVID-19 signatures in lung ultrasound data are that large datasets do not yet exist;disease signatures are sparse, but are spatially and temporally correlated;and signatures may appear sporadically in ultrasound video sequences. We propose an attention-based video model that is specifically designed to detect these disease signatures, and leverage a knowledge transfer approach to overcome existing limitations in data availability. In our design, a convolutional neural network extracts spatially encoded features, which are fed to a transformer encoder to capture temporal information across the frames and focus on the most important frames. We guide the network to learn clinically relevant features by training it on a pulmonary biomarker detection task, and then transferring the model’s knowledge learned from this problem to achieve 80% precision and 87% recall for COVID-19. Our results outperform the state-of-the-art model on a public lung ultrasound dataset. We perform ablation studies to highlight the efficacy of our design over previous state-of-the-art frame-based approaches. To demonstrate that our approach learns clinically relevant imaging biomarkers, we introduce a novel method for generating attention-based video classification explanations called Biomarker Attention-scaled Class Activation Mapping (Bio-AttCAM). Our analysis of the activation map shows high correlation with the key frames selected by clinicians. © 2021, Springer Nature Switzerland AG.

Binocular optic neuritis in an eight-year-old boy due to covid-19 infection

Introduction: Optic neuritis or inflammation of the optic nerve is a frequent cause of acute optic nerve damage in children and adults. Optic neuritis can occur in association with some viruses, such as influenza and mumps viruses. At the end of 2019, a novel coronavirus, known as COVID-19, spread throughout the world. Coronavirus is known to cause optic neuritis in animal models, and several adult cases have been reported up to now, as well. However, to date, no case of optic neuritis has been reported in children with COVID-19. Case Presentation: The patient was an eight-year-old boy referred to our center, complaining of sudden bilateral and progressive blurring of vision with right-eye preference. He had a history of severe headache for three days in the previous two weeks and slight mood disturbance. On physical examination, bilateral disk swelling and significant loss of vision were detected in his both eyes. Magnetic resonance imaging (MRI) of the brain showed bilateral maxillary sinus thickening with mild optic nerves enlargement with slightly hyperintense T2 and mild post-contrast enhancement. No pathologic finding was seen in the brain, and cerebrospinal fluid and other immunologic tests were normal. Due to the patient’s history of headache and outbreak of COVID-19, a nasopharyn-geal reverse transcription-polymerase chain reaction (RT-PCR) test for COVID-19 was requested, and a positive result was obtained, confirming the diagnosis of COVID-19 infection. The optic neuritis was treated with pulsed methylprednisolone and the patients’ vision improved. Conclusions: In this article, we reported an eight-year-old child with optic neuritis and headache in the context of COVID-19. No case of optic neuritis has been reported in children with COVID-19. © 2021, Author(s).

Effects of high-speed wind, humidity, and temperature on the generation of a sars-cov-2 aerosol;a novel point of view

The new coronavirus (SARS-CoV-2) is rapidly spreading across communities around the world. Respiratory droplet transmission is a common transmission route for many airborne diseases, including novel coronavirus disease (COVID-19). Wearing the face mask prevents respiratory droplet transmission. Both face mask leakage and non-use of the face mask under high-speed wind conditions can increase the risk of SARS-CoV-2 transmission. The respiratory droplets’ behavior during sneezing or coughing (i.e., the size and the distance between droplets) depends on face mask wearing. The respiratory droplets during coughing and sneezing break apart into extremely small respiratory droplets (i.e., cloud of aerosol) upon interaction with the high-speed wind condition. The volume-of-fluid (VOF) method has been used to study the deformation and breakup of a single respiratory droplet placed in high-speed wind flow in the presence of smaller neighboring respiratory droplets. The effect of the diameter of respiratory droplets and the distance between them on the breakup mechanism has been investigated using open-source field operation and manipulation (OpenFOAM) libraries. The results are presented for the dimensionless distance and the normalized diameter of the secondary respiratory droplet in the ranges of 2 to 6 and 0.4 to 0.8, respectively. According to the results of simulations, the spreading of SARS-CoV-2 increases with a decrease in respiratory droplet breakup time. In addition, the effects of ambient relative humidity and temperature on the cloud of respiratory particles were analyzed. © 2021, AAGR Aerosol and Air Quality Research. All rights reserved.

Efficacy of 3-layer felt masks containing polypropylene membranes in particle filtration with SARS-CoV-2 size range

Background and Aim: The use of a mask is an effective measure to reduce the transmission of Covid-19. Today, due to the lack of N95 masks and medical masks with good performance, felt masks are widely used due to their ease of manufacture and low cost. The aim of this study was to determine the effectiveness of 3-layer felt masks containing polypropylene membranes in filtering particle size in the SARS-CoV-2 range.

Coronavirus disease 2019 in children with acute respiratory infection: A study from southeastern Iran

Background: Different aspects of coronavirus disease 2019 (COVID-19) in children have not been well understood so far. Objectives: In this paper, we reported the clinical, Paraclinical, and epidemiological features of the hospitalized children infected with COVID-19 in the southeast of Iran. Methods: This cross-sectional study was conducted in six hospitals affiliated to Kerman University of Medical Sciences. All children who were under the age of 15 years old hospitalized with acute respiratory infection from February 20 to May 14, 2020, were included in this study. Demographic characteristics, past medical history data, and disease-related data such as symptoms, signs, radiologic, and laboratory data were collected. Results: Of 97 hospitalized children with an acute respiratory infection, 13 cases (13.4%) had been diagnosed to be infected by COVID-19. The mean (standard deviation) and median of age of the patients with COVID-19 were 68.0 (55.9) and 60 months, respectively. Fever (n = 11, 84.6%), cough (n = 8, 61.5%), respiratory distress (n = 5, 38.5%), and gastrointestinal symptoms (n = 5, 38.5%) were known as the most common symptoms in patients with COVID-19. Frequency fever (84.6% vs 47. 6%, P = 0.016) and respiratory distress (38.8% vs 13.1%, P = 0.022) were significantly higher in patients with COVID-19 compared to non-COVID individuals. Frequency of admission in the intensive care unit (38.5% vs. 27.4%, P = 0.668) and death rate (15.4% vs. 7.1%, P = 0.291) were higher in patients with COVID-19 compared to non-COVID-19 subjects, but there were no significant differences between the two groups in term of these variables. Conclusions: A low proportion of children hospitalized with acute respiratory syndrome were infected by COVID-19. Most of the children with COVID-19 recovered with supportive care with no need for any specific treatment. © 2020, Author(s).