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Background: SARS-CoV-2 virus infects host cells through ACE2 and TMPRSS2 receptors. Protein levels of ACE2 and TMPRSS2 have not been assessed in allergic airways. Method(s): We collected biopsies of endobronchial tissue from steroid-naive mild allergic asthmatics (AA n=23) and non-asthmatic controls (NA n=11), and inferior nasal turbinate tissue from AA with allergic rhinitis (AR n=8) and nonAA/AR controls (NR n=5). Tissue was immune-stained for SARS-CoV-2 receptor ACE2 and surface protein TMPRSS2. The number of immuno-positive cells in epithelium and laminae propria was expressed per mm2 of tissue. Result(s): The number of cells expressing ACE2 was higher in AA endobronchial tissue compared to NA control and AR nasal tissue. TMPRSS2 was higher in AR nasal tissue compared to NR control, and higher in control NA endobronchial tissue versus control NR nasal tissue. Co-expression of ACE2+TMPRSS2 was higher in AA endobronchial tissue versus NA control and trending higher in AR nasal tissue versus NR control (p=0.08). Conclusion(s): Overall, ACE2 is more highly expressed in endobronchial tissue versus nasal tissue, suggesting SARS-CoV-2 may more readily infect lower versus upper airways. It is unknown whether the higher expression of ACE2 and ACE2+TMPRSS2 observed in the airways of mild allergic asthmatic donors versus control donors translates to higher susceptibility to infection.
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Rationale: The incidence of SARS-CoV-2 infection and the impact of corticosteroid treatment in patients with symptomatic airway disease has been a concern. We examined airway expression of SARS-CoV-2 receptors following allergen challenge and steroid intervention in asthmatic patients. Method(s): From steroid-naive mild allergic asthmatic (AA n=23) we collected endobronchial biopsies pre and 24hr post allergen inhalation challenge (AIC). In a subset of AA with allergic rhinitis (AR n=8) we collected inferior nasal turbinate biopsies pre and 24hr post-nasal allergen challenges (NAC) after placebo treatment or after 21 days of 22 mg BID triamcinolone nasal spray. FEV1 and PNIF expressed as % fall from baseline quantified the early (ER, 0-2h) and late (LR, 3-7h) airway responses post challenge. Epithelium and laminae propria were immunostained for ACE2 and TMPRSS2 and expressed as # cells/mm2. Result(s): AIC reduced FEV1 (31% ER, 19% LR) and the number of bronchial cells immunopositive for ACE2, TMPRSS2 and double positive for ACE2/TMPRSS2 (P=0.0002, P=0.04, P=0.02, respectively). The PNIF reduction by NAC (69% ER, 49% LR) was attenuated by triamcinolone (31% ER, 18% LR), but without changes in ACE2 or TMPRSS2 in nasal tissue after NAC or steroid treatment (all P>0.05). In the nasal tissue, significantly fewer cells expressed ACE2 compared to bronchi (P=0.007). Conclusion(s): ACE2 and TMPRSS2 expression in bronchial tissue is reduced in the T2 microenvironment post allergen challenge, however it is unknown if this protects lower airways from SARS-CoV-2 infection. Low expression of ACE2 and TMPRSS2 in nasal tissue made it difficult to determine the effects of NAC or steroid.
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Objective: Due to the important role of police during COVID-19 pandemics and lack of previous studies on the impact of personal protective equipment (PPE) in reduction of COVID-19 infection among police officers, we aimed to investigate the role of using PPE in prevention of COVID-19 infection among Iranian police personnel. Methods: This cross-sectional survey was conducted in Tehran, Iran during January 2021 to November 2022. The study sample consisted of police personnel who were active in field operations. Demographics (age, height, weight, gender, marital status, number of children and underlying diseases) and job characteristics such as fre-quency and type of operations, involvement of colleagues with COVID-19, and COVID-19 infection history, using PPE, types of used PPE (mask, face shield, gloves, etc), protective strategies (such as social distancing) and COVID-19 vaccination were recorded. Statistical analysis was performed with IBM SPSS Statistics for Windows, version 25. Results: Totally, 340 participants were analyzed (33.54±9.74 years old, 91.2% males), of whom, 150 participants (44.1%) reported at least one episode of confirmed COVID-19 infection. The most common component of PPE used both during operations and daily life was face mask (44.7% and 75%, respectively). The most popular mea-sure with higher adherence compared to others was social distancing with 70% popularity and an adherence score of 5.85±3.74. Three hundred subjects (88.2%) had received at least one dose of COVID-19 vaccine. Among PPE items, using face mask, washing hands with soap, social distancing and vaccination were significantly different between patients with and without prior COVID-19 infection (p>0.05). Conclusion: The findings showed that use of PPE is significantly efficacious in reduction of COVID-19 infection among police officers. Therefore, despite difficulties of using PPE among police forces, it is strongly recom-mended for virus spread control in this population. © 2023 Tehran University of Medical Sciences.
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Background: COVID-19 is a newly emerging disease that causes a pandemic situation in the world. Coronavirus can enter into the body in several ways and it damages other organs of the body in addition to the respiratory system. This study aimed at verifying extra-pulmonary manifestation of COVID-19. Methods: The present study was conducted as cross-sectional in a single center from March 1 to May 1 2020 at Firoozgar educational Hospital in Tehran, Iran. 107 patients with confirmed COVID-19 pneumonia according to WHO interim guidance were recruited in this study. Extra-pulmonary manifestations of COVID-19 were recorded. SPSS version 26 was used for all the analyses. Results: The mean (SD) and the median age were 59.3 (17.4) and 62.0 years, respectively and 58 (54.2%) were men. Body temperature of the patients who were equal or less than 60 years was significantly higher than other patients (39.02 vs. 38.08°C, p=0001). The most common extra-pulmonary manifestation was GI symptoms including nausea, vomiting, abdominal pain, diarrhea, hepatocellular Liver Function Test (LFT) abnormality, cholestatic LFT abnormality, and amylase lipase incensement [37 patients (34.6%]. Ophthalmological, cardiac, neurological and dermatological manifestations were shown in 6.5, 6.5, 14.9 and 14.0% of the patients, respectively. Conclusion: Investigating the clinical and radiological symptoms of COVID-19 showed that SARS-CoV-2 infection may also be associated with extrapulmonary symptoms. Therefore, clinicians and radiologists should be familiar with such symptoms of the disease. Copyright © 2022, Journal of Iranian Medical Council. All rights reserved.
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Introduction: Preparedness a social behavior with public trust the prerequisite for proper social functioning can reduce disaster sufferings. The aim of this study was to determine the public trust, preparedness, and the influencing factors regarding the COVID-19 pandemic situation in Iran. Methods: This online cross-sectional study conducted on Tehran residents (>= 18 years) during the fifth epidemic wave. The tool designed to assess the intention to prepare, public trust, and the subscales. T-test used to compare the means and linear regression to determine the factors influencing on the outcomes. Results: About 26.5% of 407 participants (mean age standard deviation: 40.8 (12.8) years) showed low trust. The mean levels of total trust (P = 0.011), general trust (P = 0.048), and trust to managing authorities (P = 0.018) were significantly lower in men. Adjusted to confounding variables, total trust was lower in men (ss = -3.8, P = 0.01) and less educated (ss = -6.48, P = 0.02) but higher in high-income (ss = 5.7, P = 0.02) people. Only 20% of people were highly prepared. Intention to prepare was higher in families having the elderly (ss = 5.72.8, P = 0.048). Conclusion: Low trust in the managing authorities and their provided information tend to less considering health and preparedness measures in society.
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Background and Aim: Evidence shows that COVID-19 pandemic affects non-communicable diseases (NCDs), significantly. This study aimed to analyze the status of prevention and management services of NCDs at the level of primary health care (PHC) system during the COVID-19 pandemic. Materials and Methods: In this situation analysis study, first the circulars communicated at the level of PHC system from beginning of the pandemic to the end of September 2020 were manually and electronically retrieved, and those which included a decision or action in terms of governance and coordination mechanisms to provide NCDs in crisis and reopening stages, were analyzed. Then, the plans of major NCDs services in low-risk, intermediate, and high-risk conditions were developed and finalized based on the circulars. Finally, situation analysis was performed using SWOT analysis, and proposed strategies were extracted.
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Background and Aim: Covid-19 pandemic has caused significant disruptions in the provision of non-communicable disease prevention and management services in many countries and there is a concern that this disorder will lead to long-term complications of these diseases;This study aimed to quantitatively analyze the status of some prevention and management services of non-communicable diseases in the primary health care system of Iran during the Covid-19 pandemic. Materials and Methods: In this study, the routine data of 8 services related to the prevention and management of non-communicable diseases in the integrated electronic health record system (SIB) within 10 months after the outbreak of Covid-19 were compared to the same period last year.
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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes COVID-19, a disease currently spreading around the world. Some drugs are underway or being used to combat this disease. Several proteins of the virus can be targeted in therapeutic approaches. Two structural proteins, membrane (M), envelope (E) have critical roles in virus life cycle, such as assembly, budding, envelope formation and pathogenesis. Here, we employed the in silico strategies to identify and evaluate the selected potential compounds against M and E proteins. For this, the structures of proteins were modeled and then several groups of compounds as FDA approved, natural products or under clinical trials were screened from DrugBank and ZINC databases. The selected dockings were analyzed and the ligands with best binding affinity scores were subjected to evaluate drug-likeness and medicinal chemistry friendliness through prediction of ADMET properties. Normal mode analyses were also performed for six selected complexes to explore the collective motions of proteins. Molecular dynamic (MD) simulation was also performed to calculate the stability of two docked protein-ligand complexes. The results revealed that several compounds had high affinity to the proteins along with some acceptable profiles of mobility and deformability, especially, for M protein. The aim of this study was finding the potential compounds with inhibitory effect on membrane and envelope proteins of SARS-CoV-2 and according to the results several compounds especially some FDA-approved drugs and natural compounds shown that can be applied as hit compounds against these structural proteins of the virus.
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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [COVID-19] quickly turned into a pandemic. Gastrointestinal involvement, especially liver diseases, is one of the main complications of COVID-19 patients. Objectives: The current study aimed to evaluate the high incidence of liver involvement in COVID-19 hospitalized patients and its association with mortality. Methods: A total of 560 hospitalized patients with a confirmed diagnosis of COVID-19 were included. Death was considered as the outcome. In addition to liver enzymes, demographic, clinical, and other laboratory data were also collected. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels_ 40 were considered as abnormal. To investigate the association between abnormal levels of liver enzymes and death, multiple regression logistic was used. Results: According to the findings, 29.1% (95% CI = 25.3% - 32.9%) of patients had high levels (_ 40 IU) of ALT, and 45.1% (95% CI = 40.9% - 49.3%) had high levels of AST (_ 40 IU). The frequency (based on %) of high levels of AST (_ 40 U/liter) was significantly higher in patients who died [67.3% (95% CI = 54.5% - 80.1%] of COVID-19 than those who survived [44.9% (95% CI = 39.7% - 50.0%)] (Pvalue < 0.001). No significant difference was detected in ALT between expired [29.1% (95% CI = 16.7% - 41.5%)] and survived patients [30.7% (95% CI = 25.9% - 35.5%] (P-value = 0.791). AST was found to have an independent association with death in multiple logistic regression (Wald = 4.429, OR (95% CI) = 1.014 (1.008 - 1.020), P-value = 0.035). Conclusions: Liver involvement is a common finding in COVID-19 hospitalized patients. Higher levels of AST were significantly associated with an increased mortality rate in COVID-19 patients.