ABSTRACT
Objectives: This systematic review and meta-analysis aimed to compare coronavirus disease 2019 (COVID-19) (Wuhan strain) features in children and adults during the initial pandemic phase. Method(s): Until June 4, 2020, a systematic search was conducted on the EMBASE, PubMed, Web of Science, Google Scholar, and Scopus to find and collect studies based on available data among adults and children. The heterogeneity of the studies was assessed using I2 statistics and chi-square testing. The random-effect model was used to pool the effect sizes due to inter-study heterogeneity (chi-square P-value 0.1 and I2 >50%). Result(s): Fever (65.73%), cough (53.78%), expectoration (37.9%), gastrointestinal symptoms (37.01%), headache (23.41%), shortness of breath (21.65%), and myalgia (20.79%) were the most common symptoms reported in children, according to the pooled estimation analysis. Arthralgia (Effect estimate (ES): adults = 2.15, children = 17.94) and headache (ES: adults = 9.22, children = 23.41) were significantly observed higher in children (P-value = 0.019). Adult patients had a higher rate of abnormal computer tomography (CT)-scan findings, while most children had a normal study. Adults had significantly higher rates of comorbidities, whereas children had significantly higher rates of asthma (ES: 17.94% vs 8.85%;P-value = 0.026) and malignancy (ES: 10.36% vs 5.47%;P-value = 0.045). During initial pandemic phase, hydroxychloroquine (ES: 66.21% vs 29.01%;P-value = 0.001) and antibiotics (ES: 77.86% vs 38.01%;P-value = 0.001) were used much more frequently in adult patients. Adults used much more antibiotics than children. Nonetheless, antibiotics were given to around 40% of the children studied. Conclusion(s): Although children were afflicted less than adults in the early stages of the pandemic and had lower mortality, clinical and radiological findings, as well as prognostic factors, did not differ significantly between adults and children. However, with the advent of novel variants, clinical signs and symptoms, complications, and outcomes changed in children significantly. Copyright © 2022, Author(s).
ABSTRACT
Background: Hemorrhagic stroke (HS) is a devastating complication during extracorporeal membrane oxygenation (ECMO), but markers for risk stratification are unknown. Lactate dehydrogenase (LDH) is a readily available biomarker of global tissue injury and permeability. We sought to determine whether an elevated LDH at baseline is related to eventual HS during ECMO for COVID-19. Method(s): A multicenter, retrospective study was conducted. Adult patients with COVID-19 requiring ECMO between March 2020 and February 2022 were included. LDH values prior to ECMO were captured. Patients were categorized into high (>750 U/L) or low (<=750 U/L) LDH groups. Result(s): There were 520 patients (47+/-11 years old) that underwent ECMO placement in 17 centers and 384 had an available LDH. In this cohort, 122 (32%) had a high LDH. Forty (10%) patients required venoarterial ECMO, while the remaining 344 (90%) received venovenous support only. Twenty-one out of 122 (17%) patients with a high LDH had a HS in comparison to 21 out of 262 (8%) with a low LDH. At 100 days, the probability of a HS was 40% in the high LDH group and 23% in those with a low LDH, p=0.002. After adjustment for age, sex and antecedent cardiopulmonary resuscitation, high LDH was associated with subsequent HS (aHR: 2.73, 95% CI 1.46-5.12). Findings were similar when restricting to patients supported by venovenous ECMO only. Conclusion(s): Elevated LDH prior to ECMO is associated with a HS during device support. LDH can risk stratify cases for impending cerebral bleeding during ECMO.
ABSTRACT
Introduction: The emergence of the novel Coronavirus Disease 2019 (COVID-19) sparked an unprecedented effort to develop effective vaccines against the disease. Some factors may boost the vaccine efficacy, including sufficient sleep and morning vaccination. We aimed to conduct a rapid systematic review to summarize data regarding the association between sleep and time of vaccination with immunity after vaccination. Materials and Methods: The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, and three databases (PubMed, Web of Science, and Scopus) were searched up to March 12, 2022. Results: Eight studies were included regarding the sleep and immune response after vaccination, of them, five studies were on influenza, two studies on hepatitis A (HAV), and one study on hepatitis B. Accordingly, six out of eight studies found a positive correlation between sleep and immune response after vaccination. Regarding the time of vaccination, seven studies were eligible to be included (two studies on influenza, one study on HAV and influenza, one study on BCG, one study on hexavalent vaccine, and two studies on SARS-CoV-2 vaccine). Among them, four out of seven studies (including a study on SARS-CoV-2 inactivated vaccine) reported the priorities of morning versus afternoon vaccination regarding antibody production and immune response after vaccination. Conclusion: Taken together, cumulative evidence suggests that sufficient sleep and vaccination in the morning could enhance the immune response after vaccination. Hence, modulating the time of vaccination and sufficient sleep could a be simple and applicable strategy for increasing vaccine efficacy. Future studies could be performed with SARS-CoV-2 vaccines to investigate the effects of time of vaccination and sufficient sleep on COVID-19 vaccine efficacy.
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Background and Aim: The COVID-19 pandemic is capable of severely affecting the mental health of health care workers, who are at the forefront of this crisis;while the official staff of health organizations is facing the same danger. Therefore, monitoring awareness and other mental health issues to understand the mediating factors and awareness of appropriate interventions is a necessary priority. Therefore, the purpose of this study was to compare the level of knowledge, attitude, and practice of medical and administrative staff in facing the COVID-19 virus. Methods & Materials: This cross-sectional descriptive study was performed on 160 medical and administrative staff of Jahrom hospitals in 2020. Demographic information questionnaire and researcher-made questionnaire of knowledge, attitude and practice of medical personnel about coronavirus (Covid 19) were used to collect information. Data were analyzed using SPSS software version 21 and descriptive and inferential statistical tests.
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Background and Aim: The recent Coronavirus Disease 2019 (COVID-19) outbreak has caused a lot of stress and anxiety in the world. Given that health care workers are at the forefront of fighting against COVID-19, they are the first to be exposed to this disease. Methods & Materials: This is a descriptive cross-sectional study conducted on 402 medical and administrative staff working in hospitals and health centers affiliated to Jahrom University of Medical Sciences in 2020. Data collection tools were a demographic form and the Corona Disease Anxiety Scale (CDAS). Ethical Considerations: This study was approved by the Vice-Chancellor for Research of Jahrom University of Medical Sciences (Code: IR. JUMS. REC.1399.046).
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Background and Aim: COVID19 was developed in late 2019 and is rapidly spreading across the globe, including Iran. The main programs offered are to prevent the spread of the disease based on personal hygiene and to observe behaviors such as social distance. Meanwhile, the knowledge of medical students about the disease and the behavior they offer against it is also important for people because of this pattern. In this study, the awareness, attitude and performance of medical students in Jahrom city against this disease have been studied.