Parasitology and Covid-19: epidemiological, immunological, pathological, and therapeutic aspects

Studies suggest that there is a complex interaction between parasitic infections, human microbiota, and host immunity. Reports have shown that there is the prevalence of viral diseases have inverse correlations with their severities (as is the case for Covid-19), their resulting mortalities, and helminth infections in endemic areas. This review study was conducted to discover the possible association between parasitic infections and Covid-19 epidemics from immunological, pathological, and therapeutic aspects. Our studies were conducted by reviewing texts, reports, and articles on reputable websites such as PubMed, Science Direct, medRxvi, Google Scholar, and bioRxiv published by 2022 07 April for keywords such as a parasite, helminth, radioactive, COVID-19 or SARS-CoV-2. In particular, reports of co-infection with helminths with complications and severity of Covid-19 in endemic areas were considered. The findings indicate that parasitic helminths can regulate host immune responses associated with a viral infection. For example, intestinal parasitic infections may be effective in reducing the symptoms of SARS-CoV-2 and the complications of Covid-19. Infected hosts can induce an innate and Th2-compatible immune response to CD4+ T cells, eosinophils, and interleukins (IL-4, IL-5, and IL-10). Chronic helminth infections prevent strong immune responses by altering the host response to T helper 2 (Th2). Interestingly, some antimalarial drugs, such as Artemisinin-based combination therapies (ACTs), may inhibit SARS-CoV-2-induced severe acute respiratory syndrome (SARS). Parasitic infections may alter the host's immune response to SARS-CoV-2 with potentially beneficial or detrimental effects. However, more large-scale epidemiological studies are needed to uncover the links between parasitic infections and COVID-19 and to clarify existing ambiguities.

Investigation of Effective Drugs in the Treatment of Patients with COVID-19

Background: Due to the lack of definitive treatments for corona disease and the use of various medications in protocols around the world, it is necessary to conduct more epidemiological studies exploring the effect of different available therapeutic regimes;therefore, the present study aimed to explore the current effective drugs for the treatment of hospitalized COVID-19 patients. Methods: The present study is a descriptive-analytical study that was conducted between August and September of 2021 at Khalkhal University of Medical Sciences. A convenient sampling method was employed to retrieve the data from the available hospital records, including 252 documents from COVID-19 hospitalized patients. A researcher-made checklist was used to record the data. Data were analyzed using SPSS 26 software. Results: The findings showed that Hypertension and Hypotension (n=47,18.7%) are the most common underlying diseases in the study sample. The most therapeutic regimen was the combination of Remdesivir and Dexametason (n=137,54.4%) in hospitalized COVID-19 patients. There are a variety of organ involvements and presentations to the COVID-19;however, most patients experience a mild-to-moderate, self-limited disease;even though, the disease could progress to more fatal cases and lead to death. Conclusion: The main pathology exists in the lungs which are caused by an inappropriate immune response that leads to a severe inflammatory response. Therefore, antiviral and anti-inflammatory drugs are currently the first-line therapy for hospitalized patients. Copyright 2023, Journal of Iranian Medical Council.

Response and Adaptation of the Cardiac Autonomic System to Functional High-intensity Interval Training with Respiratory Facemasks: Impacts of the Training Period and Facemask Modality During a COVID-19 Pandemic

Background: Following the SARS-CoV-2 pandemic in 2019, medical face masks were widely recommended for large numbers of people and for long periods of time. The effect of wearing surgical and N95 face masks during long-term high-intensity interval training on the cardiac autonomic system has not been reported. Methods: Eighteen healthy men were randomly divided into three groups (surgical mask, N95 mask, and no mask) and performed high-intensity interval training with (80-90%-heart rate max) intensity three times a week, three repetitions in a session for four weeks. Heart rate variability parameters were evaluated with an electrocardiogram device and Kubius software. The R-R interval was recorded for 5 minutes in a sitting position in the pre-and post-modified Bruce test before and after four weeks of interval training to extract parasympathetic (RMSSD, HF, SD1), sympathetic indices (LF, LF/HF) and RR mean. We used the two-way ANOVA test and the Bonferroni post hoc test. Results: In all groups, four-week functional HIIT exercises increased the resting parasympathetic indices (RMSSD, SD1) compared to baseline levels. This increase was more evident in the N95 mask group than in the surgical mask group. In addition, the five-minute recovery of the cardiac autonomic system after a modified Bruce test following functional HIIT exercise increased parasympathetic tone (RMSSD, HFn.u) in all groups compared to baseline levels. Therefore, a four-week adaptation to HIIT exercises leads to faster recovery of sympathetic indices (LFn.u, LF/HF) in the Nomask group, as compared to the surgical and N95 groups. Despite the above, there was no significant difference in the recovery and resting values of cardiac autonomic system indices between the two types of surgical masks and N95 compared to the control group (No mask). Conclusions: Four weeks of high-intensity interval training using surgical and N95 face masks improved the cardiac autonomic nervous system. This data is important for recommending the use of face masks during physical activity. © 2023, Author(s).

Labour companionship and women's experiences of mistreatment during childbirth: results from a multi-country community-based survey

BACKGROUND: Evidence has shown the benefits of labour companions during childbirth. Few studies have documented the relationship between the absence of labour companions and mistreatment of women during childbirth in low-income and middle-income countries using a standardised tool. METHODS: We conducted a secondary analysis of the WHO multi-country study on how women are treated during childbirth, where a cross-sectional community survey was conducted with women up to 8 weeks after childbirth in Ghana, Guinea, Nigeria and Myanmar. Descriptive analysis and multivariable logistic regression were used to examine whether labour companionship was associated with various types of mistreatment. RESULTS: Of 2672 women, about half (50.4%) reported the presence of a labour companion. Approximately half (49.6%) of these women reported that the timing of support was during labour and after childbirth and most of the labour companions (47.0%) were their family members. Across Ghana, Guinea and Nigeria, women without a labour companion were more likely to report physical abuse, non-consented medical procedures and poor communication compared with women with a labour companion. However, there were country-level variations. In Guinea, the absence of labour companionship was associated with any physical abuse, verbal abuse, or stigma or discrimination (adjusted OR (AOR) 3.6, 1.9-6.9) and non-consented vaginal examinations (AOR 3.2, 1.6-6.4). In Ghana, it was associated with non-consented vaginal examinations (AOR 2.3, 1.7-3.1) and poor communication (AOR 2.0, 1.3-3.2). In Nigeria, it was associated with longer wait times (AOR 0.6, 0.3-0.9). CONCLUSION: Labour companionship is associated with lower levels of some forms of mistreatment that women experience during childbirth, depending on the setting. Further work is needed to ascertain how best to implement context-specific labour companionship to ensure benefits while maintaining women's choices and autonomy.