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Background: People with chronic diseases of the immune system, such as multiple sclerosis (MS), are at risk for Covid-19 disease. However, more research is needed with long-term follow-up. The aim of the study was to follow up people with MS (PwMS) for up to three months after AstraZeneca vaccination for the recurrence of MS and Covid-19 infection. Method(s): This study was a case study (descriptive-analytical) of follow-up type. The study population was PwMS over 18 years of age in Kermanshah province who received both doses of the AstraZeneca vaccine. This study was conducted from August to November 2021. Sampling was done with existing methods based on the National MS Registry of Iran (NMSRI). Demographic information of patients was extracted from NMSRI. A researcher-made form was used to collect information by telephone three months after vaccination about clinical characteristics, Covid-19 infection, and recurrence of MS. Data were analyzed using SPSS-25 software. Result(s): Study participants were 40 MS patients with a mean (SD) age of 39.27 (8.8) years, including 32 (80.0%) women. A mean of 9.39 (4.6) years had passed since The patients were diagnosed with MS, and 29 (76.4%) had RR type MS. Four patients (10%) relapsed between the second dose and three months later, of whom two (50%) had sensory symptoms, one (25%) had optic nerve involvement, and one (25%) had motor symptoms and pyramidal pathway involvement. The symptoms of Covid-19 were mild in three patients (10%), while severe symptoms developed in one patient (10%) who received rituximab. Among the patients, no cases of thrombosis were observed. Infusion therapy, a leg fracture, and kidney stones were the only hospitalized cases. Conclusion(s): Covid-19 and MS relapse prevalence did not differ significantly in the three months before and after vaccination. There is a need for further studies with a longer follow-up period.Copyright © 2022 Razazian et al. Published by Tehran University of Medical Sciences.
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Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) is the virus causing Coronavirus Disease 2019 (COVID-19). Apart from respiratory disease, this virus can affect different organs. Objectives: Therefore, multiple mechanisms have been hypothesized for Acute Kidney Injury (AKI) in COVID-19. In this study, we evaluate the incidence and prognosis of AKI in COVID-19 patients. Methods: This retrospective cohort study assessed 397 COVID-19 patients hospitalized between April 1, 2020, and September 30, 2021. Patients with a sudden rise of serum creatinine level, more than 0.3 mg/dl in two days or more than 50% of the initial level in one week, were diagnosed with AKI. Demographic, laboratory, and clinical features were compared in AKI patients with patients without AKI. Results: A total of 397 patients with a mean age +or- standard deviation of 55.42 +or- 15.26 years were included in the study. According to diagnostic criteria, 48 (12.1%) patients developed AKI. Old age, a history of hypertension, and chronic renal failure were suggested as risk factors for AKI. High levels of C-Reactive Protein, Erythrocyte Sedimentation Rate, Lactate Dehydrogenase, D-dimer, and serum phosphorus upon arrival were also associated with an increased risk of AKI. In addition, the incidence of hypernatremia and hyperkalemia increased mortality in patients with AKI. Conclusion: The incidence of AKI in admitted COVID-19 patients affects the duration of hospitalization, the chance of ICU admission, and mortality. It is important to limit the use of nephrotoxic drugs and to maintain water-electrolyte balance to prevent the incidence of AKI and improve the outcome.
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Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) is the virus causing Coronavirus Disease 2019 (COVID19). Apart from respiratory disease, this virus can affect different organs. Objectives: Therefore, multiple mechanisms have been hypothesized for Acute Kidney Injury (AKI) in COVID-19. In this study, we evaluate the incidence and prognosis of AKI in COVID-19 patients. Methods: This retrospective cohort study assessed 397 COVID-19 patients hospitalized between April 1, 2020, and September 30, 2021. Patients with a sudden rise of serum creatinine level, more than 0.3 mg/dl in two days or more than 50% of the initial level in one week, were diagnosed with AKI. Demographic, laboratory, and clinical features were compared in AKI patients with patients without AKI. Results: A total of 397 patients with a mean age +/- standard deviation of 55.42 +/- 15.26 years were included in the study. According to diagnostic criteria, 48 (12.1%) patients developed AKI. Old age, a history of hypertension, and chronic renal failure were suggested as risk factors for AKI. High levels of C-Reactive Protein, Erythrocyte Sedimentation Rate, Lactate Dehydrogenase, D-dimer, and serum phosphorus upon arrival were also associated with an increased risk of AKI. In addition, the incidence of hypernatremia and hyperkalemia increased mortality in patients with AKI. Conclusion: The incidence of AKI in admitted COVID-19 patients affects the duration of hospitalization, the chance of ICU admission, and mortality. It is important to limit the use of nephrotoxic drugs and to maintain water-electrolyte balance to prevent the incidence of AKI and improve the outcome.
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Background: The aim of this study was to estimate the seroprevalence of SARS-CoV-2 infection in a general population from Kermanshah province, Iran. Method(s): The present study was a population-based cross-sectional design conducted in Kermanshah province in 2020. Sampling was performed in a multi-stage process, and 1967 participants were considered, and also 174 interviewers were assigned to collect data online. Then, 5 mL of blood sample was taken from every participant. The blood samples were centrifuged with the ELISA method to detect SARS-CoV-2-specific IgG and IgM antibodies in serum samples. Seropositive prevalence was adjusted by means of survey analysis. Case fatality rate (CFR) and infection fatality rate (IFR) were estimated. Result(s): A total of 1967 people from 14 cities of the province participated in the study. The mean age of participants was 35.7+/-16.9, and 50.4% were female. The lowest and highest seroprevalence was found in the cities of Paveh (2.3% [0.3-4.2]) and Harsin (61.6% [54.7-68.5]), respectively. The CFR and IFR in men and women were 3.4 vs. 3.3 and 0.1 vs. 0.3. The aged 60 years or older had the highest CFR and IFR with 11.2 and 3.7%, respectively. Conclusion(s): The prevalence of SARS-CoV-2 infection and IFR among the general population of Kermanshah province was 18.3 and 0.3%, respectively. The results of this study can assist the policymaker in assessing risk factors, and transmission dynamics of SARS-CoV-2 in a population and implementing preventive and control interventions.Copyright © 2023 Shadmani et al.
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Background: Evidence reveals that COVID-19, in addition to impacting the respiratory system, affects other organs, including the male and female reproductive systems. The purpose of this study was to examine the impact of COVID-19 on the human reproductive system. Method(s): Data were collected in SID, Science Direct, PubMed, and Google Scholar databases. The Keywords including COVID- 19, reproductive system, fertility, and factors related to mesh term utilization and Boolean strategy were used. Papers from 2019 to 2022 were extracted. Finally, out of 58 searched articles, 20 articles related to the purpose of the study were reviewed. Result(s): The results were organized into two categories. The first category deals with the effect of COVID-19 on the female reproductive system including Sleep disorders following quarantine on gonadotropin release and its effect on the ovaries and menstrual cycle, preterm delivery, increased cesarean delivery, the possibility of intrauterine infection of the fetus and dysfunction of the reproductive glands. The second category concerns the effect of COVID-19 on the male reproductive system including abnormal semen quality, possible effect on gonocyte differentiation in the early stages of spermatogenesis, negative effect on spermatogenesis, testicular dysfunction, and changes in testosterone concentration by increasing serum LH, testicular inflammation, decreased sperm concentration in semen, impaired sperm motility, dysfunction of the reproductive glands, significant damage to the seminiferous tube, swelling of Sertoli cells, decreased Leydig cells, significant disorder on semen volume and impaired sperm morphology. Conclusion(s): The findings revealed that COVID-19 has an impact on various aspects of the human reproductive system. Midwives and gynecologists should alleviate couples' fears about infertility by recognizing these cases and offering suitable counseling to couples infected with COVID-19.
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Background: Although many aspects of the COVID-19 disease have not yet been clarified, dysregulation of the immune system may play a crucial role in the progression of the disease. In this study, the lymphocyte subsets were evaluated in patients with different severities of COVID-19. Material(s) and Method(s): In this prospective study, the frequencies of peripheral lymphocyte subsets (CD3+, CD4+, and CD8+ T cells;CD19+ and CD20+ B cells;CD16+/CD56+ NK cells, and CD4+/CD25+/FOXP3+ regulatory T cells) were evaluated in 67 patients with confirmed COVID-19 on the first day of their admission. Result(s): The mean age of patients was 51.3 +/- 14.8 years. Thirty-two patients (47.8%) were classified as severe cases, and 11 (16.4%) were categorized as critical. The frequencies of blood lymphocytes, CD3+ cells, CD25+FOXP3+ T cells, and absolute count of CD3+ T cells, CD25+FOXP3+ T cells, CD4+ T cells, CD8+ T cells, and CD16+56+ lymphocytes were lower in more severe cases compared to the milder patients. The percentages of lymphocytes, T cells, and NK cells were significantly lower in the deceased patients. (p= 0.002 and p= 0.042, p=0.006, respectively). Conclusion(s): Findings of this cohort study demonstrated that the frequencies of CD4+, CD8+, CD25+FOXP3+ T cells, and NK cells differed in the severe cases of COVID-19. Moreover, lower frequency of T cells and NK cells could be predictors of mortality in these patients.Copyright © 2022, Shaheed Beheshti University of Medical Sciences and Health Services. All rights reserved.
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Considering the increasing prevalence and burden of coronavirus disease 2019 (COVID-19) disease and false-negative results in routine reverse transcription-polymerase chain reaction (RT-PCR) tests, additional diagnostic methods are needed to diagnose active cases of this disease. This prospective study was conducted on patients, in whom clinical and radiological symptoms/signs were in favor of COVID-19 while their first PCR test was negative. Later on, a second RT-PCR was performed and serological evaluation was carried out and results were compared with each other. Out of 707 patients who had been referred to the hospital and were clinically and radiologically suspicious of disease, 137 patients with negative RT-PCR tests entered the study. RT-PCR assay became positive for the second time in 45 (32.8%). Anti-COVID-19 IgM and IgG antibodies were positive in 83 (60.6%) and 86 (62.8%) patients, respectively. Finally, it was determined that serological test was diagnostic in 73% of patients and the diagnostic yield of serology was significantly higher after the first week of illness (54.8% in the first week and 88% after that). Taking advantage of both serological tests and RT-PCR helps in diagnosing 83.9% of cases. Based on the present study, the serology may be useful as a complementary test and in parallel to RT-PCR assay for diagnosis of COVID-19 among admitted symptomatic cases.
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Background: People with chronic diseases of the immune system, such as multiple sclerosis (MS), are at risk for Covid-19 disease. However, more research is needed with long-term follow-up. The aim of the study was to follow up people with MS (PwMS) for up to three months after AstraZeneca vaccination for the recurrence of MS and Covid-19 infection. Methods: This study was a case study (descriptive-analytical) of follow-up type. The study population was PwMS over 18 years of age in Kermanshah province who received both doses of the AstraZeneca vaccine. This study was conducted from August to November 2021. Sampling was done with existing methods based on the National MS Registry of Iran (NMSRI). Demographic information of patients was extracted from NMSRI. A researcher-made form was used to collect information by telephone three months after vaccination about clinical characteristics, Covid-19 infection, and recurrence of MS. Data were analyzed using SPSS-25 software. Results: Study participants were 40 MS patients with a mean (SD) age of 39.27 (8.8) years, including 32 (80.0%) women. A mean of 9.39 (4.6) years had passed since The patients were diagnosed with MS, and 29 (76.4%) had RR type MS. Four patients (10%) relapsed between the second dose and three months later, of whom two (50%) had sensory symptoms, one (25%) had optic nerve involvement, and one (25%) had motor symptoms and pyramidal pathway involvement. The symptoms of Covid-19 were mild in three patients (10%), while severe symptoms developed in one patient (10%) who received rituximab. Among the patients, no cases of thrombosis were observed. Infusion therapy, a leg fracture, and kidney stones were the only hospitalized cases. Conclusion: Covid-19 and MS relapse prevalence did not differ significantly in the three months before and after vaccination. There is a need for further studies with a longer follow-up period.
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The epidemic of COVID-19 has been the most mathematically informative pandemic. The unprecedented information gives rise to some unprecedented models, problems, and discussions. One of these new matters is modeling the epicenters of a pandemic. The present paper is the first attempt to model the waiting time to introduce a new epicenter during a pandemic. This modeling is conducted in terms of time-to-event, the number of epicenters, and the normalized time. We model the waiting time data by an exponential distribution, therefore, the number of epicenters can be represented through a Poisson process. Then, the parameters are estimated by the method of moments and maximum likelihood method. All the simulations are the result of 10,000 runs conducted on MATLAB R2015b. It is expected to encounter 12 and 14 (with probability 95%, 3-24 and 7-23) epicenters from 15th May to 13th June and from June 14 to July 12, 2020, respectively. We forecast that the cumulative number of confirmed cases for coming epicenters is over 10,000 when they join the existing epicenters. The paper suggests that the time to epicenter is a suitable criterion to compare the spreading speed of an epidemic in different periods or even different epidemics. Highlights: The study aims to model the time to the next epicenters during the pandemic COVID-19. The study introduces the time to epicenter as a criterion to study of spreading speed of an epidemic in different periods or compare different epidemics. The study deals with the number of cumulative confirmed cases at the time that a region become epicenter. The study proposes the Poisson process as the model to describe the number of epicenters. The study suggests that exponential distribution can model the time to event for the epicenters of COVID-19.Copyright © 2023 International Biometric Society-Chinese Region.
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Background: It is currently recommended to vaccinate against SARS CoV-2 for people with multiple sclerosis (MS), but it is uncertain what effect it will have on people with MS (PwMS). Objectives: We aimed to compare the side effects of the first and second doses of the Sinopharm vaccine in PwMS. Materials & Methods: This descriptive-analytical follow-up study was conducted on PwMS patients in Kermanshah province, Iran, who received the Sinopharm vaccine using the nationwide MS registry of Iran (NMSRI) by available methods between May and August 2021. Using a researcher-made questionnaire, demographic and clinical information about PwMS, as well as side effects from the Sinopharm vaccine were collected by telephone 5-14 days after the first and second doses. Data were analyzed using SPSS software version 25. Results: Study participants included 188 PwMS, including 148 females (78.7%) and 40 males (21.3%). PwMS had Median age of 42.66±11.1 years and Median 9.57±7.0 for disease duration. In the 1st dose, the prevalence of side effects was significantly higher than in the second dose (58.5% vs 47.0%, P=0.012). Fatigue (30.1%), myalgia (29.8%), fever (25.0%), and headache (22.3%) were the most common in the first dose, and fatigue (27.1%), headache (18.6%), myalgia (17.5%) and fever (14.9%) were the most common in the second dose. COVID-19 was present in 51 people (27.3%) before vaccination. Conclusion: Sinopharm vaccine side effects were significantly more prevalent in the first dose than in the second dose. Most side effects are moderate in severity and transient. © 2018 The Authors. This is an open access article under the CC-By-NC license.
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Background: People with chronic diseases of the immune system, such as multiple sclerosis (MS), are at risk for Covid-19 disease. However, more research is needed with long-term follow-up. The aim of the study was to follow up people with MS (PwMS) for up to three months after AstraZeneca vaccination for the recurrence of MS and Covid-19 infection. Method(s): This study was a case study (descriptive-analytical) of follow-up type. The study population was PwMS over 18 years of age in Kermanshah province who received both doses of the AstraZeneca vaccine. This study was conducted from August to November 2021. Sampling was done with existing methods based on the National MS Registry of Iran (NMSRI). Demographic information of patients was extracted from NMSRI. A researcher-made form was used to collect information by telephone three months after vaccination about clinical characteristics, Covid-19 infection, and recurrence of MS. Data were analyzed using SPSS-25 software. Result(s): Study participants were 40 MS patients with a mean (SD) age of 39.27 (8.8) years, including 32 (80.0%) women. A mean of 9.39 (4.6) years had passed since The patients were diagnosed with MS, and 29 (76.4%) had RR type MS. Four patients (10%) relapsed between the second dose and three months later, of whom two (50%) had sensory symptoms, one (25%) had optic nerve involvement, and one (25%) had motor symptoms and pyramidal pathway involvement. The symptoms of Covid-19 were mild in three patients (10%), while severe symptoms developed in one patient (10%) who received rituximab. Among the patients, no cases of thrombosis were observed. Infusion therapy, a leg fracture, and kidney stones were the only hospitalized cases. Conclusion(s): Covid-19 and MS relapse prevalence did not differ significantly in the three months before and after vaccination. There is a need for further studies with a longer follow-up period. Copyright © 2022 Razazian et al. Published by Tehran University of Medical Sciences.
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Severe acute respiratory syndrome coronavirus-2 has led to a widespread pandemic whose spread is astonishing, its treatment is uncertain, mortality is significant, and associated socioeconomic complications are uncontrollable. Although little is known about the pathogenesis of the disease, severe cases of COVID-19 are usually associated with cytokine release syndrome and high serum levels of inflammatory cytokines, which are thought to be the leading cause of death in these patients. Different pathways cause inflammation and the release of cytokines, one of which is the Bruton Tyrosine Kinase (BTK) pathway, which is important for the production of several anti-inflammatory cytokines. Theoretically, inhibition of BTK signaling could reduce cytokine levels and subsequent anti-inflammatory effects. The purpose of this review article is to investigate the role of B'I'K in the pathogenesis of COVID-19 disease and the possible effects of its inhibitory drugs in the treatment of this disease.
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Facial recognition and identification which play an important role in human-computer interaction, secure authentication and criminal face recognition, are impeded by the advent of face masks due to COVID-19 pandemic. This is a challenging problem due to the following reasons: (i) masks cover quite a large part of the face even below the chin, (ii) it is not possible to collect and prepare a real paired-face images with and without mask object, (iii) face alterations and the presence of different masks is even more challenging. In this work, we propose a general framework that can be used to reconstruct the hidden part of face concealed by mask. We have employed GAN-based unpaired domain translation technique to translate masked face images from the source to the unmasked images in the destination domain. To this end, we also create a paired datasets of real face images and synthesized correspondence's with face-masks and use it towards training of our proposed GAN-based facial reconstruction system which can be used for facial identification and secure authentication in human-computer interaction. The obtained results demonstrate that our model outperforms other representative state-of-the-art face completion approaches both qualitatively and quantitatively. © 2022 Owner/Author.
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The aim of this study is to investigate coronary and pulmonary complications in patients admitted to the intensive care unit. Medicinal chemistry discusses the discovery, synthesis and evolution, identification and interpretation of the action method of bioactive compounds at the molecular level, and its emphasis is mainly on drugs. The history of the introduction of medicinal chemistry as the science of the first pharmacopoeia published in the 16th century and later centuries. A treasure trove of pharmaceutical agents rich in new drugs of plant and mineral origin were introduced. In the late 19th century, medicinal chemistry underwent a dramatic change with the discovery of Paul Ehrlich, who is called as the father of modern chemotherapy, in connection to the fact that chemical compounds exhibit selective toxicity against specific infectious agents. At the same time, Emile Fisher proposed the key-lock theory, which was a logical change in the action mechanism of drugs. However, it is not clear why coronary heart disease occurs in some people with Covid-19 disease. However, most experts agree that the long-term effects of Covid-19 are related capability to cause a widespread inflammatory response in the body. This inflammation, which causes blood to clot in the blood vessels of the lungs, heart, brain, kidneys, and even the legs, can damage blood vessels, leading to ulceration and a wide range of long-term complications.
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Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread widely all around the world and has infected too many healthcare workers (HCWs) as the pioneers combating coronavirus disease 2019 (COVID-19). This study aims to evaluate the symptoms and outcome of medical staff from a tertiary hospital in Tehran, Iran. Materials and Methods: The diagnoses of 29 HCWs presenting COVID-19 symptoms were confirmed by molecular and imaging studies. Epidemiologic and disease-related data were collected via phone calls and filling a questionnaire and then analyzed descriptively. Results: Eighteen (62.1%) of the affected HCWs were males. The mean age of them was 41.86 years with a lower average (38.27) for females than males. Nurses comprised 41.4% of our population. Only 2 (6.9%) patients were admitted to the respiratory care unit (RCU) (), marked as critical patients. The most presented symptoms were fever (79.3%) and dyspnea (79.3%). Overall, 55.2% of them had a longer exposure time (more than a week), which was more frequent in men than women. Conclusion: Fever was the most prevalent symptom among the study group. Even though the clinical features of COVID-19 among HCWs cannot be copiously determined by this study, it highlights the requirement for comparative studies to illustrate differences among HCWs and the general population. There might be an association between the duration of the exposure and the risk of the infection in men.
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Despite the fact that about two years have passed since the onset of the COVID-19 pandemic, there is still no curative treatment for the disease. Most cases of COVID-19 have mild or moderate illness and do not require hospitalization. This guideline released by the National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital COVID-19 Expert Group to provide a treatment guide for outpatient management of COVID-19.
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“The Effect of COVID-19 Vaccination on Reducing the Risk of Infection, Hospitalization, and Death in Isfahan Province, Iran.” by Ziba Taherian, Mostafa Rezaei, Asefeh Haddadpour, Zahra Amini, Iran J Public Health, 51(1), Jan 2022, 188-195. The above article, published online at https://ijph.tums.ac.ir/index.php/ijph/article/view/26539 has been retracted by agreement between the authors & the journal's Editor-in-Chief. After post-publication peer review, some concerns were raised on the terminology used in the results, discussion & related analysis. Some dates were reported incorrectly & there were some inconsistencies in reporting vaccine brand names. In addition, some unintentional errors have been found in the paper typesetting. The retraction has been agreed by all panel of authors mentioned in the paper, so that the necessary corrections and completing the analysis are being made properly. © 2022 Taherian et al. Published by Tehran University of Medical Sciences.
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Background: It has been believed that infants are at a lower risk for the severe symptoms and complications that arise from COVID-19. This report represents details on a newborn with sepsis that has been diagnosed with COVID-19 and, unfortunately, did not survive. Case presentation: The case was a 1-day-old female newborn, admitted to the surgical intensive care unit in Namazee Hospital, Shiraz, Iran, for a bladder exstrophy operation. She gradually started to deteriorate on the fourth day after the surgery, diagnosed with sepsis based on the results of her blood culture. Progressively, her vital signs and blood tests fell within normal ranges after being treated with broad-spectrum antibiotics. Without any fever, the neonate became severely irritable on the 16th day after her birth and hospitalization. Considering lymphopenia, high CRP, and abnormal chest x-ray, pharyngeal swab sampled for COVID 19. The newborn died from multi-organ failure on the 18th day of life. Reverse transcription-polymerase chain reaction (RT-PCR) confirmed the COVID 19 infection in the dead newborn. The parents' pharyngeal sample, however, was negative for COVID 19. Conclusion: Growing awareness of sepsis as a risk factor for the severity of the COVID-19 infection in the neonatal period can be a form of knowledge for physicians to begin early treatment and reduce odds of mortality in this group of patients.
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COVID-19 leads to mild symptoms within the majority of infected patients, but can cause severe multiple organ failure and death. There is only limited information regarding the consequences of this new emerging infection with congenital disorders. According to the previous studies, many people with Down syndrome are considered high risk for complications related to respiratory diseases. We report two trisomy 21 patients who suffered from COVID-19 and summarize the early experience with COVID-19 and Down syndrome. The course of the disease was severe in these two cases, and our concern is close monitoring of the patients with Down syndrome for early signs of COVID-19. © 2020 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran.
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Background: Provided that COVID-19 pandemic has led to mental wellbeing disorders for city dwellers, and given that there is a significant association between outdoor activities and mental health, this paper investigated how the frequency of walking during the pandemic contributes to the immediate and subsequent ‘mood’. Methods: A longitudinal data collection method was adopted to verify the ‘mood’ of the participants before and after walking. The survey was conducted with 100 participants in a walking path in Shiraz, Iran, on Jan 2021. The quantitative analysis methods were performed in SPSS to examine the mental wellbeing outcomes of walking in the outdoor walking path when considering the psychological impacts of the pandemic and the quan-tity. Results: The result affirms the positive contribution of walking in the improvement of mental-wellbeing-mood during the pandemic;though, such a mood boost is in a direct relationship with the quantity of the activity with-in a week. Moreover, other factors can play a significant role, including the ‘mood before walking’, and the age of the participants. Conclusion: It is likely that encouraging people to consider walking as their routine activity can lead to several positive consequences on mental wellbeing since walking as a basic outdoor activity during the pandemic can contribute on the mood. . © 2021, Tehran University of Medical Sciences. All rights reserved.