ABSTRACT
Severe coronavirus disease of 2019 (COVID-19) usually begins approximately one week after the onset of symptoms. Dyspnea is the most common symptom of severe disease and is often accompanied by hypoxemia. Progressive respiratory failure develops in many patients with severe COVID-19 after the onset of dyspnea and hypoxemia. These patients commonly meet the criteria for acute respiratory distress syndrome (ARDS), which is defined as the acute onset of bilateral infiltrates, severe hypoxemia, and lung edema. The majority of patients with severe COVID-19 showed some thromboembolic complications as well central or peripheral nervous system complications. Severe COVID-19 may also lead to acute cardiac, kidney, and liver injury, cardiac arrhythmias, coagulopathy, and shock. These organ failures may be associated with uncontrolled inflammation characterized by elevations in C-reactive protein and pro-inflammatory cytokines, including Interleukin-6, Interleukin-1, and tumor necro-sis factor-alpha. This may associate with high fevers, thrombocytopenia, and exacerbating lung and cardiovascular complications. According to the American College of Obstetricians and Gynecologists (ACOG), the relative risk of COVID-19 infection is con-siderably lower relative to the risk of pandemic H1N1 (hemagglutinin type 1 and neuraminidase type 1) influenza infection in pregnant women. Less severe COVID-19 in pregnancy also was reported. Regulatory T cells (Tregs) are important in controlling adverse inflammatory reactions in severe COVID-19 making them effective cells for immunotherapy in severe COVID-19. Im-pairment in the number and/or function of Tregs was reported in severe COVID-19. Tregs are also part of the complex network of immune cells at the feto-maternal interface, and in peripheral blood that may have a critical role in facilitating implantation, pla-cental development, and maintaining maternal tolerance. Pregnancy-induced Tregs are developed to control immune responses against paternal antigens. This review provides a new insight into whether the severity of COVID-19 could be influenced by the adoptive transfer of pregnancy-induced regulatory T cells in pregnant women.
ABSTRACT
Background: The risk for transmission of COVID-19 to people in close contact with infected people, especially healthcare workers, has not been well estimated. Therefore the present study was conducted to assess the household secondary attack rate (SAR) of COVID-19 among healthcare workers and related factors. Material(s) and Method(s): The present prospective case-ascertained study was conducted on 202 healthcare workers with confirmed COVID-19 in Hamadan, diagnosed from March 1, 2020, to August 20, 2020. For households with close contact with the index case, RT-PCR was performed regardless of symptoms. We defined SAR as the proportion of secondary cases from the total contacts that live in the index case household. SAR was reported as a percentage and 95% confidence interval (CI). Multiple logistic regression was performed to explore the predictors of COVID-19 transmission of index cases to their households. Result(s): We found 36 secondary cases out of 391 household contacts with laboratory confirmation (RT-PCR), representing a household SAR of 9.2% (95% CI: 6.3, 12.1). Among factors related to the family member, female gender (OR: 2.9, 95% CI: 1.2, 6.9), being the patient's spouse (OR: 2.2, 95% CI: 1.0, 4.6), and living in the apartment (OR: 2.78, 95% CI: 1.24, 6.23), and among factors related to index cases, hospitalization (OR: 5.9, 95% CI: 1.3, 26.9) and caught (OR: 2.4, 95% CI: 1.1, 5.2) were the significant predictors of disease transmission to other family members (P<0.05). Conclusion(s): The findings of this study suggest that the SAR is remarkable in household contacts of infected healthcare workers. Some characteristics of family members of the index case, including female gender, being the patient's spouse, and living in the apartment, and some characteristics of the index case, including hospitalization and caught, were associated with the increased SAR.Copyright © 2022 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran.
ABSTRACT
Objectives The medical and health facilities are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study tested the preprocedural prophylactic mouthwash rinses to reduce the oral viral load. The findings from this study will help the practitioners to select the best mouthwash for the patients to mitigate the risk of transmission during aerosolizing. This study aimed to evaluate the effectiveness of four commonly used types of mouthwash in reducing intraoral viral load among hospitalized coronavirus disease 2019 patients. Materials and Methods This prospective cohort study was conducted with 116 patients referred to the Masih Daneshvari Hospital in Tehran, Hamadan University of Medical Sciences of Hamadan City, and Mashhad University of Medical Sciences. Patients were randomized into four groups with each group rinsed their mouth with 20 mL of 2% povidone-iodine, 1% hydrogen peroxide, normal saline as a control study group, or 0.12% chlorhexidine, respectively, for 20 seconds. The standard reverse transcription polymerase chain reaction method evaluated the virus load before and at 1 hour, 2 hours, and 4 hours after using the mentioned mouthwash. Results Our results revealed that chlorhexidine and H 2O 2showed the highest efficiency in reducing SARS-Co-2 load in the oral cavity and nasopharyngeal region of patients;they increased the Ct values by 9 to 10 (before: 25.84 vs. after 32. 4, p < 0.455) (17.333 vs. after 26.497, p <0.097). Conclusion Our findings suggest that chlorhexidine and H 2O 2could be used in dental clinics to reduce the risk of transmitting the SARS-CoV-2 virus from infected individuals to dentists before dental procedures. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
ABSTRACT
Background and Objectives: The aim of this study was to investigate the epidemiological characteristics of patients with Covid-19 in Hamadan Province. Materials and Methods: In this descriptive cross-sectional study, demographic and epidemiological data of all people who presented to hospitals in Hamadan Province from February 2019 to December 2020 were extracted using two checklists. Data were then analyzed using the Stata software. Results: In this study, 9674 covid-19 positive patients were examined. According to results, 49.11% of the cases occurred in the elderly over 60 years. The rate of involvement was higher in females than males (51.57% vs. 48.43%). Moreover, 72.05% of the definitive patients lived in the city and 0.76% reported traveling to areas with a high prevalence of the disease two weeks before the onset of symptoms. The highest incidence of this disease per one hundred thousand population was in Malayer, Hamedan and Nahavand counties and the highest fetality was in Razan and Dargazin, Tuyserkan and Asadabad counties, respectively. The data of suspected, probable, and definite outpatients with Covid-19 presenting to medical centers were not evaluated in this study. Conclusion: Due to the high death rate in the elderly, males, those with underlying diseases, and people living in rural areas, it is necessary to design and apply precautionary measures in these groups. Attention should be paid to these high-risk groups in the shortest possible time to reduce the burden of this disease on individuals as well as the health care system. © 2021, Iranian Epidemiological Association. All rights reserved.