Prognostic comparison of COVID-19 outpatients and inpatients treated with Remdesivr: A retrospective cohort study.

INTRODUCTION: Since the late COVID-19, many countries have faced various surges and peaks within the number of infected. Iran was one of the countries that faced many surges and peaks within these years and faced many inadequacies and shortages of resources and hospital beds. Hence the healthcare system started using in-hospital medication such as Remdesivir in outpatients to reduce the load of patients admitted to the hospital. This study aimed to evaluate and compare the reported signs, symptoms, and outcomes of COVID-infected hospitalized and out-patients receiving Remdesivir. METHODS: In this retrospective cohort study, 214 patients (121 outpatient and 93 hospitalized) with moderate levels of Covid infection between October 2021 and February 2022 were studied. Both groups were treated with 200mg of Remdesivir, followed by 100 mg daily intravenous injections for five days; signs and symptoms, such as pain, shortness of breath, cough, fever and etc., of patients at the initiation and the end of treatment were recorded. Moreover, the patients' blood oxygen saturation was assessed two to three times a day, and the mean of the recorded measures was considered as the daily oxygen saturation. The outpatient group had to visit the hospital daily for treatment and assessment. At the treatment's end, mortality rates, disease signs, and symptoms alleviations were compared between the groups. RESULTS: The outpatient and hospitalized group's mean age was 40.30 ± 12.25 and 37.70 ± 12.00 years, and 51.2% and 55.9% were males, respectively. There was no statistical difference between baseline and clinical characteristics in the outpatients and hospitalized groups. After adjusting for oxygen saturation at baseline and gender in the multivariable Cox regression analysis, the risk of death did not statistically differ between the hospitalized and outpatient group (hazard ratio: 0.99, 95% confidence interval: 0.39-2.50)) at the end of the study. CONCLUSION: Based on the results of this study, the outcome, signs, and symptoms of inpatient and outpatient Remdesivir treatment groups did not differ significantly. Hence in COVID-19 surges where we have limitations in admitting patients, outpatient Remdesivir treatment for those without any underlying diseases can be a proper management method.

The mental health status of offshore oil platform workers during the COVID-19 pandemic.

Background: Previous studies indicated that offshore workers have a high level of work-related stress on an everyday basis. This study aims to assess the prevalence and determinants of mental health conditions in offshore oil platform workers during the COVID-19 pandemic. Methods: Workers of three oil and gas platforms were assessed in this cross-sectional study. Their mental status was evaluated by the Posttraumatic Stress Disorder (PTSD-8) questionnaire, and Depression Anxiety, Stress Scales (DASS) questionnaires. Furthermore, we assessed satisfaction with life (SWL) with a single question. Finally, multivariate logistic regression was used to determine the association of demographic and work-related variables with mental health outcomes. Results: Overall, 278 (Males:197, Females: 81) out of 315 invited workers with a mean age of 35.6 (SD: 7.2) years were included in this study using a random sampling method (participation rate: 88.2%). PTSD symptoms and Insomnia were observed in 9 (3.2%) and 138 (49.6%) of the participants, respectively. The prevalence of stress, anxiety, and depressive symptoms were 72 (25.9%), 70 (24.6%), and 85 (30.5%), respectively. Based on multivariable (adjusted) logistic regression analysis, women had significantly higher odds of stress and anxiety than men; those with an academic education were significantly more dissatisfied with their lives than those without an academic education. Conclusion: Our findings revealed a high prevalence of anxiety, depressive symptoms, and stress among offshore oil platformers during the COVID-19 pandemic, especially in women. Indicating that women and those with a higher education level in the oil platform work settings are more susceptible to stressors.

Relationships among COVID-19 phobia, health anxiety, and social relations in women living with HIV in Iran: A path analysis.

INTRODUCTION: The COVID-19 pandemic and its consequences have caused fear and anxiety worldwide and imposed a significant physical and psychological burden on people, especially women living with HIV (WLHIV). However, WLHIV were not studied as well as others during the pandemic. Hence, this study aimed to determine the relationships between COVID-19 phobia, health anxiety, and social relations in WLHIV. MATERIALS AND METHODS: This cross-sectional study enrolled 300 WLHIV who had records at the Iranian Research Center for HIV/AIDS of Tehran University of Medical Sciences. Data were collected using sociodemographic questionnaire, the fear of COVID-19 scale, the social relations questionnaire, the socioeconomic status scale and the health anxiety inventory. Path-analysis was used to assess the direct and indirct associations between variables. RESULTS: Based on the path analysis, among variables that had significant causal relationships with social relations, socioeconomic status (ß = -0.14) showed the greatest negative relationship, and health anxiety (ß = 0.11) had the strongest positive relationship on the direct path. On the indirect path, fear of COVID-19 (ß = 0.049) displayed the greatest positive relationship. The level of education (ß = 0.29) was the only variable showing a significant positive relationship with social relations on both direct and indirect paths. CONCLUSION: Our result showed that increased fear and health anxiety related to a higher social relations score in WLHIV. Hence, due to their vulnerability, these people require more support and education to adhere to health protocols in future pandemics and similar situations.

Bilateral Central Retinal Vein Occlusion and Stevens-Johnson Syndrome Associated with Coronavirus-19: A Case Report.

Purpose: To report a case of bilateral central retinal vein occlusion (CRVO) associated with coronavirus-19 (COVID-19) infection. Methods: A 43-year-old man presented to the emergency department with flu-like symptoms, severe erythema, a rash on his face, and respiratory distress. He was admitted to the intensive care unit, and the reverse transcriptase-polymerase chain reaction test was positive for the severe acute respiratory syndrome coronavirus-2 virus. The routine blood work was unremarkable. The dermatologist noted positive Nikolsky's sign, and the patient was diagnosed with Stevens-Johnson syndrome (SJS), which affected 18% of his body and was later confirmed by skin biopsy. Later, he reported worsening vision. Results: Ophthalmic examination and fundus fluorescein angiography showed bilateral CRVO. Despite best medical efforts, including treatment with systemic dexamethasone and remdesivir, the patient died on the 6 days of his hospitalization. Conclusion: This was a rare bilateral CRVO and SJS case in a young patient, probably caused by the COVID-19 infection.

Effects of the covid-19 pandemic on neurological diseases.

BACKGROUND: Covid-19 has caused many complications for both the infected and those in need of medical care. This may be due to infection-related prognosis worsening or the patients' avoidance of referring to the hospital for fear of contracting the infection. The decline of acute referral to the ER of many significant conditions with severe results on both the well-being and life-expectancy is a serious concern. To address these concerns, we designed this study to evaluate the recent pandemic's impact on "in-hospital mortality" caused by neurological disorders pre and postpandemic. METHODS AND MATERIAL: The inclusion criteria were any acute neurological condition and the consent of the patients eligible for our study. The definitions of all assessed conditions and the comorbidities are ICD-10 based. Hypertension and diabetes mellitus, due to their high prevalence, were evaluated separately from other internal comorbidities. The total number of the enrolled patients was 1742, 671 of whom had been during the COVID-19 pandemic, and 1071 had attended the ER during the prepandemic era. RESULTS: The overall mortality was significantly higher during the pandemic, and the covid infected had suffered higher mortality rates. (p-value < 0.05) CONCLUSION: During the pandemic, those with minor strokes and other nonlife-threatening ailments had avoided hospital care leading to a significantly higher rate of critical conditions. Increased incidence of strokes and ICHs during the pandemic, too, caused significant increased in-hospital mortality.

Prevalence and associated factors of psychosocial distress among seafarers during COVID-19 pandemic.

BACKGROUND: In the context of growing concerns about seafarers' mental health during the COVID-19 pandemic, this study aimed to assess the prevalence and associated factors of psychosocial distress among seafarers of ocean-going vessels during the current health emergency. METHODS: This cross-sectional study was conducted among 470 multinational seafarers working on two oil tanker international shipping companies. Psychosocial distress was assessed by using Depression-Anxiety-Stress Scale (DASS-21). General Health Questionnaire-12 (GHQ-12) and Zung Self-Rating Anxiety Scale (SAS) were used to assessed genral psychiatry disorders and self-rate anxiety. Perceived health status was assessed by a single-item question. Multivariate logistic regression was used to determine the association between demographic and work-related variables with mental health outcomes. RESULTS: Overall, 439 out of 470 invited seafarers with a mean age of 34.5 (SD: 8.05) participated in this study (participation rate: 93.4%). The prevalence (95% confidence interval) of depression, anxiety, stress, self-rated anxiety, general psychiatric disorders, and poor perceived health status was 12.3% (9.4-15.7), 11.6% (8.7-15.0), 5.9% (3.9-8.5), 2.1% (0.9-3.8), 42.6% (38.0-47.4), and 4.3% (2.6-6.6), respectively. In the multivariate model, by increasing the duration of stay (per month) on board, the odds of depression increased by 20% (OR: 1.20 (95% CI: 1.02-1.40)). Also, non-officer seafarers experienced significantly lower psychosocial distress such as anxiety and stress levels than officers. CONCLUSION: High prevalence of depression, anxiety, and general psychiatric disorders among seafarers during COVID-19 was observed. Our findings also highlight the factors that need to be considered to protect seafarers' mental well-being. Further studies to evaluate the impact of COVID-19 on psychological health issues at sea are recommended.

Comparison of psychological symptoms between infected and non-infected COVID-19 health care workers.

BACKGROUND: Studies have shown that health care workers (HCWs), as front liners of the coronavirus (COVID-19) pandemic, are at high risk for psychological symptoms, but few studies have compared these symptoms in infected and non-infected HCWs. This study compares psychological symptoms among these two groups. METHODS: In this cross-sectional study, 938 HCWs from various medical fields working in the leading general hospitals of Alborz province, Iran, were selected using a multistage sampling method. The participants had contact with COVID-19 patients. Post-traumatic stress disorder-8 (PTSD-8) is a validated questionnaire that we used to evaluate PTSD symptoms along with its subscales, including intrusion, avoidance, and hypervigilance. Also, the Depression, Anxiety, and Stress Scale-21 questionnaire was used to assess the severity of the aforementioned conditions in HCWs. Multivariate logistic regression was used to compare psychological symptoms in infected and non-infected HCWs. RESULTS: Among 938 included HCWs, 55 had a history of confirmed COVID-19 infection. Prevalence of stress, anxiety, depression, intrusion, hypervigilance, and avoidance among infected HCWs were significantly higher in comparison to non-infected HCWs. In the multivariate logistic model, history of COVID-19 infection among HCWs was associated with a significantly increased risk of anxiety, depression, stress, intrusion, hyper-vigilance, and avoidance. CONCLUSION: The present study showed that the HCWs with COVID-19 infection were at a high risk of displaying psychological symptoms. Therefore, it is also necessary to develop psychological support and interventions for HCWs, especially those who got infected with the virus.

Prevalence and severity of depression, anxiety, stress and perceived stress in hospitalized patients with COVID-19.

PURPOSE: COVID-19, a disease that can be transmitted from person to person and with serious health problems, can be associated with mental health disorders. In this study, we evaluated the prevalence and severity of depression, anxiety, stress, and stress perception among a group of patients with COVID-19 who were hospitalized. METHODS: In this cross-sectional study, 106 inpatients with COVID-19 who had stable clinical conditions were evaluated psychologically by two questionnaires: Depression, Anxiety and Stress Scales-21 (DASS-21) and Perceived Stress Scale (PSS-4). RESULTS: More than one third of patients had underlying disease. Overall, 97.2% of patients with COVID-19 had some degree of depression. Severity of depression, according to the DASS questionnaire, was 85.8%. All patients (100%) had severe (0.9%) and very severe (99.1%) anxiety. Regarding to stress levels, 97.1% of patients had some degree of stress. In the severity of stress category, 84.9% of patients had severe and very severe stress. In terms of perceived stress, 73.6% of patients had high levels and 22.6% had moderate levels. A positive strong correlation was found between depression and perceived stress (Coefficient: 0.33, P-value: 0.001). Correlation between anxiety and perceived stress was statistically significant (Coefficient: 0.2, P-value: 0.04). CONCLUSIONS: The existence of such a high prevalence and severity of psychiatric disorders among hospitalized patients with COVID-19 underscores the need for serious attention to the mental health status of these patients. It seems that health policymakers need to have coherent plans for screening cases and managing related situations.