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Background: COVID-19 is associated with higher mortality rates in patients with cancer. In this study, we aimed to evaluate the clinical outcomes, and laboratory and imaging data of patients with solid tumor infected with COVID-19 infection. Method(s): This is a cross-sectional retrospective study performed in 2020-2022 on 85 patients with a previous diagnosis of solid tumors infected with COVID-19. We included all patients with tumors of solid organs that were diagnosed with COVID-19 infection and required hospitalization those patients previously hospitalized for treatments and were infected with COVID-19 during hospitalization. Demographic data of patients were collected using a checklist. We collected data regarding clinical outcome (discharge, hospitalization or death), duration of hospitalization, requiring ICU admission, duration of hospitalization divided by received drugs and type of tumor and mean survival time. Furthermore, we collected laboratory data from all patients. The radiologic characteristics of patients were also extracted from their data. Result(s): Breast cancer was the most common solid tumor (34.9%), followed by lung cancer (19.3%). The mortality rate was 24.1% (20 patients). The highest mortality rate in this study was for metastatic intestinal cancer to the lung (100%, one patient), followed by metastatic prostatic cancer to lung (50%, three patients). The highest hospitalization duration was for patients with glioblastoma multiform (GBM) (30 days). The mean survival time among patients with mortality was 19.15+/-1.80 days. The mean CT severity score of all patients was 27.53+/-22.90. Patient's most common radiologic sign was air space consolidation (89.1%). The highest CT severity score was found in patients with stomach cancer (46.67+/-5.77). Conclusion(s): The mortality rate in this study was 24.1%. Based on the results of our study and previous research, special care should be provided to patients with solid tumors during the COVID-19 pandemic and in infected cases.Copyright © 2022, E-Century Publishing Corporation. All rights reserved.
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Background. COVID-19 disease is the cause of daily morbidity and mortality worldwide due to its high transmissibility and pathogenicity. To date, intravenous immunoglobulin (IVIg) injection has been used as one of the various treatments for this disease. This study aimed to determine the effect of IVIg injection on the treatment of patients with Coronavirus-induced cytokine storm. Methods. A total of 174 patients with COVID-19 were included in this study based on their clinical characteristics and laboratory findings and were divided into two groups of IVIg recipients and non-recipients according to the treatment they received. Statistical analysis was performed using SPSS version 22.0. A p-value less than 0.05 was considered statistically significant. Results. IVIg was used to treat merely 20 patients and Kaletra and hemoperfusion drugs were used more among IVIg recipient patients (P=0.003 and P=0.001, respectively). COVID-19-positive PCR tests were significantly more frequent among IVIg recipients (P=0.026). The polymorphonuclear neutrophil (PMN) count (P=0.007) and sodium level (P=0.007) were significantly higher in the IVIg recipient group on the first admission day. Moreover, INR levels in the IVIg recipient group were significantly lower on the seventh admission day (P=0.020). The median of total intensive care unit (ICU) duration of hospitalization among IVIg recipients was significantly higher (P=0.001). Conclusion. It seems that the use of IVIg in COVID-19 patients should be further investigated. Practical Implications. IVIg injection could decrease mortality and slightly increase the survival rate among COVID-19 patients. © 2022 The Authors.
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Background: Coronavirus disease 2019 (COVID-19) has turned into a global public health crisis since the end of 2019. It may thus take years to develop new drugs, so evaluating the existing ones can play a key role in suppressing or even mitigating the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Objective(s): This study reflected on the effects of ivermectin (IVM) and metronidazole (MTR) vs. standard treatment protocols on symptoms, humoral immune responses, and outcomes of COVID-19 in hospitalized patients. Method(s): This triple-blinded randomized controlled trial (RCT) of IVM and MTR vs. standard treatment protocols was conducted from February 2021 to May 2021. A total number of 107 participants were accordingly selected from all patients infected with SARS-CoV-2 and positive results for SARS-CoV-2 based on the reverse transcription-polymerase chain reaction (RT-PCR) or the computerized tomography (CT) scan results at three teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. In this RCT, several indicators, including some vital signs, biomedical parameter, length of hospital stay (LOS), and death, were considered the outcomes. Result(s): A total number of 107 patients were recruited in this study. The results revealed that 10 patients (10.4%) expired during hospitalization. The mortality rate in IVM group (4.5%) was lower compared with MTZ (15.8%) and standard treatment (11.8%) (P = 169). After five days, the mean differences of lymphocyte and neutrophil counts differed significantly between groups (P = 0.020 and P = 0.029, respectively). But, other outcomes did not differ (P > 0.05). Conclusion(s): Based on this RCT, neither IVM nor MTZ could significantly affect COVID-19 patients' recovery patterns compared with the standard treatment protocols. Hence, more studies are needed to test diverse combinations of immunological response trigger-ing and anti-inflammatory drugs. Moreover, including and relying on IVM in clinical guidelines for COVID-19 should be cautioned and based on more evidence. Copyright © 2022 Author(s).
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The COVID-19 pandemic has caused many countries to deploy novel digital contact tracing (DCT) systems to boost the efficiency of manual tracing of infection chains. In this paper, we systematically analyze DCT solutions and categorize them based on their design approaches and architectures. We analyze them with regard to effectiveness, security, privacy and ethical aspects and compare prominent solutions based on these requirements. In particular, we discuss shortcomings of the Google and Apple Exposure Notification API (GAEN) that is currently widely adopted all over the world. We find that the security and privacy of GAEN has considerable deficiencies as it can be compromised by severe large-scale attacks. We also discuss other proposed approaches for contact tracing, including our proposal <sc>TraceCORONA</sc>, that are based on Diffie-Hellman (DH) key exchange and aim at tackling shortcomings of existing solutions. Our extensive analysis shows that <sc>TraceCORONA</sc> fulfills the above security requirements better than deployed state-of-the-art approaches. We have implemented <sc>TraceCORONA</sc> and its beta test version has been used by more than 2000 users without any major functional problems<uri>https://tracecorona.net/download-tracecorona/</uri>, demonstrating that there are no technical reasons requiring to make compromises with regard to the requirements of DCT approaches. IEEE
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Background: Different electrocardiographic (ECG) results, seen in coronavirus disease 2019 (COVID-19) patients are most likely due to the combined impact of acute COVID-19 and chronic heart disease. Few studies have addressed the effects of hypoxemia, the hallmark of the pandemic disease, on ECG. Objective(s): The present study discusses the prevalence of arrhythmias and disorders of conduction system in demised and survived COVID-19 patients, using ECG and Sokolow-Lyon voltage as a sign of hypoxemia to predict mortality in the admitted patients and after discharge. Method(s): We investigated the ECG, and other medical data of 960 COVID-19 patients admitted to Faghihi hospital in Shiraz, Iran, from August 2021 to December 2021. Result(s): Most of the patients were male (541 or 56.4%) and older than 65 years old (462 or 48.1%). A total of 475 (49.5%) patients died. Multiple logistic regression revealed an independent association between the COVID-19 death rate and cardiovascular disease (OR = 3.05;95% CI: 1.96-4.74), QT dispersion more than 40 (OR = 5.08;95% CI: 3.61-7.15), heart rate (more than 100 versus less than 60 OR = 2.86;95% CI: 1.03-7.9), ST segment elevation myocardial infarction (OR = 3.93;95% CI: 2.63-5.86), poor progression (OR = 2.33;95% CI: 1.56-3.49), hypertrophy (OR = 1.97;95% CI: 1.02-3.81), and Sokolow-Lyon (OR = 2.91;95% CI: 1.64-5.16). Conclusion(s): Electrocardiographic examination of COVID-19 patients is important during admission and after discharge. Sokolow-Lyon voltage less than 10 can be regarded as an independent predictor of mortality in COVID-19 patients discharged from hospital. Copyright © 2022, Author(s).
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The COVID-19 pandemic disrupted many aspects of our lives at a global scale. This includes the disruption of the research and teaching we perform within the security and privacy community. As the pandemic is weaning off, the lessons learnt during the pandemic can be very valuable in the future, both for navigating pandemic-like situations, and for accommodating greater inclination towards remote work and education. In this panel, international experts with various professional backgrounds and different points of view will discuss the impact they faced over the last two years, such as halting (or starting) specific research problems due to pandemic-related restrictions, unique challenges in deploying new experiments and how they overcame them, and finding novel ways to facilitate social events like conferences and hackathons. © 2022 Owner/Author.
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Introduction: The sudden onset and difficult consequences of COVID-19 pandemic are considered a trauma for healthcare. Despite its devastating consequences and psychological distress, it has also undergone positive changes. The main objective of this study was to explain post-traumatic growth among nurses and physicians during COVID-19 pandemic. Methods: In this study, a descriptive phenomenological approach was utilized and semi-structured interviews were conducted with 17 nurses and physicians who were selected by purposive sampling. The interviews were analyzed using Colizzi’s method. Results: The findings of the study were summarized into two main themes: distress with four subthemes including corona and loss of life, psychological trauma, ambiguity and confusion about the career path, environmental and interpersonal stress, and growth with four subthemes including alternative ways to overcome trauma, promoting interpersonal relationships, empathy in treatment, and finding meaning. Conclusion: The results of the present study revealed post-traumatic growth played an important role in maintaining the mental health of nurses and physicians beyond traumatic coronavirus pandemic. It is hoped that this study will encourage further exploration and examination of this subject and interventions for all groups of healthcare. © 2022, Kerman University of Medical Sciences. All rights reserved.
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Background: The Coronavirus Disease 2019 (COVID-19) pandemic promptly became a significant public health challenge with extra-pulmonary manifestations, including liver damage. Postmortem examination is crucial for gaining a better understanding of these manifestations and improving patient management This study summarized the current knowledge of the postmortem liver pathology of patients with COVID-19. Methods: This review was conducted on studies evaluating the postmortem macroscopic and microscopic findings of the liver in patients with COVID-19. Accordingly, we searched 4 electronic databases (PubMed, Scopus, Google Scholar, & Web of Science) until June 2021. From the 317 screened articles, 16 articles examining a total of 332 patients who had died due to COVID-19 were selected. Results: The significant findings of the liver were moderate macro and microvesicular steatosis with mild sinusoidal dilation, active lobular and portal vein thrombosis, mildly-increased lymphocyte filtration in sinusoidal space, and multifocal hepatic necrosis. Additionally, the most common comorbidities were hypertension and other metabolic diseases. In conclusion, liver damage due to COVID-19 infection has various manifestations in patients who have expired due to COVID-19. Conclusion: Therefore, monitoring liver function during the course and treatment of this disease is necessary for better patient management and to decrease the COVID-19-induced mortality rate COVID.
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Background: The Coronavirus Disease 2019 (COVID-19) pandemic promptly became a significant public health challenge with extra-pulmonary manifestations, including liver damage. Postmortem examination is crucial for gaining a better understanding of these manifestations and improving patient management. This study summarized the current knowledge of the postmortem liver pathology of patients with COVID-19. Methods: This review was conducted on studies evaluating the postmortem macroscopic and microscopic findings of the liver in patients with COVID-19. Accordingly, we searched 4 electronic databases (PubMed, Scopus, Google Scholar, & Web of Science) until June 2021. From the 317 screened articles, 16 articles examining a total of 332 patients who had died due to COVID-19 were selected. Results: The significant findings of the liver were moderate macro and microvesicular steatosis with mild sinusoidal dilation, active lobular and portal vein thrombosis, mildly-increased lymphocyte filtration in sinusoidal space, and multifocal hepatic necrosis. Additionally, the most common comorbidities were hypertension and other metabolic diseases. In conclusion, liver damage due to COVID-19 infection has various manifestations in patients who have expired due to COVID-19. Conclusion: Therefore, monitoring liver function during the course and treatment of this disease is necessary for better patient management and to decrease the COVID-19-induced mortality rate COVID.
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Objective: Healthcare workers (HCWs) are among the highest groups impacted by the COVID-19 pandemic. This study aimed to analyze professional quality of life (ProQOL) and its association with emotional well-being in HCWs during the pandemic. Methods: This cross-sectional study was conducted on HCWs being in close contact with COVID-19 patients in Iran. The questionnaires assessing ProQOL, emotional well-being, and demographic and occupational charac-teristics were recruited via email or social media. The ProQOL was used to measure compassion fatigue (CF), burnout (BO) and compassion satisfaction (CS). Results: Among the respondents, 705 HCWs were enrolled, including a higher proportion of physicians 449 (63.7%), females 452 (64.1%), and married 486 (68.9%). The mean of participants’ work experience was 8.41 ± 8.91 years. Almost all of HCWs showed moderate to high levels of CS (98.3%). Also, most of HCWs showed a moderate level of CF (96.3%), and the majority of them (76.6%) had a moderate level of BO. There were significant differences in the duration of contact with COVID-19 patients for all three components of ProQOL and emotional well-being score. Women had a higher level of BO than men (P=0.003). CS was significantly higher in married HCWs than in singles (P=0.007). Pearson correlation coefficient showed that CS had a negative relationship with CF and BO. However, there was a direct correlation between emotional well-being and the CS. Conclusion: During the COVID-19 pandemic, Iranian HCWs showed to have moderate to high levels of CS, and a moderate level of both CF and BO, and showed that emotional well-being had a direct correlation with CS. © 2022 Tehran University of Medical Sciences.
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The pathogenesis of inflammatory bowel disease (IBD) is influenced by immune system malfunction, particularly innate immune receptors such as toll-like receptors. Furthermore, it is critical to investigate the extremely close association between viruses and IBD incidence. Toll-like receptors (TLRs) 3, 5, and 7 are involved in antiviral immune responses. Finding a relationship between TLR-related virus and IBD is important not only for understanding the disease pathogenesis, but also for developing effective therapies. It has been shown that influenza is expressed more severely in patients with IBD who use immune system inhibitors, and the influenza vaccine is less effective in these patients. In dendritic cells, TLR7 and TLR8 regulate the production of interferons (IFNs) and inflammatory mediators. COVID-19 causes the production of IL-6, possibly due to the induction of TLR pathways. TLR activation by SARS-CoV-2 causes inflammation and IL-1 production, which induces the production of IL-6. Understanding TLR-associated viruses' molecular mechanisms can greatly help improve the quality of life of people with IBD. Therefore, the present study reviewed the role of TLR7, 8, and 3 in inflammatory bowel disease as well as their association with viral infections and evaluated different antagonists for the treatment of IBD.
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The main aim of the present study is to disclose the similarities or differences of the climate effects on the COVID-19 outbreak in two countries, which have different climatic conditions. Using the correlation modeling, the results revealed that some climatic factors, such as the ULR, temperature, and CH4 in the UAE and aerosol index and NO2 in Switzerland have positive lagged correlations with the outburst of COVID-19 by intensifying role within - 9, - 7, and - 2 days. The mitigating role was also observed for ozone/solar radiation and temperature/long-wave radiation in the UAE and Switzerland, respectively. The initial hypotheses of the research have confirmed the correlations between new cases of COVID-19 and ULR and aerosol indices in the UAE and Switzerland. However, the main finding revealed that the climate effects on the COVID-19 outbreak show different roles in the different countries, locating in dissimilar climatic zones. Accordingly, the COVID-19 can be intensified by increases of the ULR and temperature in an arid region, while it can be exactly mitigated by increases of these factors in a temperate area. This finding may be useful for future researches for identifying the essential influencing factors for the mitigating COVID-19 outbreak.
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Caused by coronavirus SARS-CoV-2, the COVID-19 disease spreads particularly through direct contact between people. Health authorities face the challenge of identifying and isolating infection chains to prevent the pandemic from spreading further. To improve the efficiency and effectiveness of manual contact tracing, many countries have recently introduced digital contact tracing apps running on smartphones of users for helping to identify contacts between individual users. These apps are usually based on beaconing pseudonymous identifiers over a proximity communication protocol like Bluetooth LE. The identification of potentially critical contacts is then performed by comparing the identifiers emitted by persons reported as infected and the identifiers observed by other users of the system and issuing appropriate warnings to them in case a matching identifier is found. However, by beaconing identifiers into their proximity, individual users potentially become traceable by entities that systematically collect observations in various places. To preserve privacy of users and be compliant to various privacy regulations many proposed systems use ephemeral, pseudo-random identifiers that are more difficult to link together. In this paper, we briefly analyze and discuss privacy properties of a selected number of proposed contact tracing solutions and the impact of the applied randomization approaches. We also discuss the pros and cons of these tracing schemes. © 2020 ACM.
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This guideline was developed to assure the highest level of protection against COVID-19 for both patients and health care providers in endoscopy departments while providing high quality and timely gastroenterology care during the current COVID-19 pandemic. We electronically searched the databases of PubMed, Google Scholar, and MedRxiv up to April 10, 2020. Then, a questionnaire was designed based on available documents and international recommendations. Three Delphi rounds were conducted via online forms. Eighteen statements were developed on risk stratification of patients and procedures and recommendations for performing necessary procedures while safeguarding patients, nurses, physicians and other service providers with appropriate use of personal protection equipment, sanitizing of environments and redesigning the endoscopy suits. Considering the dynamic of COVID-19 pandemic in the world and Iran, this guideline will be updated online as needed.