Investigating the association between allergic diseases and COVID-19 in 400 Iranian patients (preprint)

Background: Allergic diseases may play a role as a predisposing factor for coronavirus disease 2019 (COVID-19). The aim of this study was to investigate the allergy comorbidity and their association with the patients with COVID-19. Methods: Demographic data, clinical symptoms, laboratory and radiologic findings and having underlying diseases of the patients were resgistered. Allergic diseases were identified by using the standard GA2LEN questionnaire. The severity of COVID-19 was assessed by visual analog scale (VAS) and ICU admission. Results: Of 400 COVID-19 patients, 158 (39.5%) had allergic diseases. And, there was a reversely association beween an having allergy comorbidity and the severity of COVID-19 infection (P= 0.005, relative risk, 0.96; 95% CI, 0.77-1.19). The frequency of asthma, allergic rhinitis (AR), chronic rhinosinusitis, atopic dermatitis, chronic urticaria, and food or drug allergy was 7.3%, 16%, 1.8%, 5%, 10% and 13.3%, respectively. Importantly, only AR was reversly associated with the severity of COVID-19 (P= 0.02, relative risk, 0.96; 95% CI, 0.77-1.19). Additionally, 43% of the patients presented hypoxemia, and 93.5% had chest CT scan involvement. Interestingly, patients with allergic than non allergic diseases had significantly lower hypoxemia and chest CT involvement (P= 0.002 and P= 0.003, respectively). Conclusion: This study showed that allergic diseases were not found to be a predisposing factor for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Importantly, the patients with AR developed mild symptoms of COVID-19 and they were admitted to ICU significantly less than the non-AR patients.

Economic Burden of Hospitalized COVID-19 Patients in Iran (preprint)

Background: The outbreak of COVID -19 has had destructive influences on social and economic systems as well as many aspects of human life. In this study, we aimed to estimate the economic effects of COVID-19 at the individual and societal levels during a fiscal year.Methods: This is an economic evaluation study conducted as cross-sectional. Data of the COVID-19 patients referred to the hospitals affiliated to Bushehr University of Medical Sciences between March 2020 and 2021 were collected through the hospital information system (HIS). Cost of illness analysis was used to estimate the economic burden of COVID-19 for the province and Iran. The study methodology was based upon the human capital approach and bottom-up technic. Results: The COVID -19 pandemic has resulted in 9711 confirmed hospital cases and 767 deaths in Bushehr province during the study period. The direct medical costs were estimated to be 439,774,265,491 Rials ($ 27,893,839) in total with mean cost of 45,286,198 Rials ($ 2872) per patient. Hospitalization, drugs and ICU costs were the highest with 36.44, 30.80 and 26.88% of total direct costs respectively. Indirect costs, including income loss due to hospitalization, recovery period at home and premature death were 20,884,492,800 ($ 1,324,654), 62,058,707,200 ($ 3,936,237) and 854,181,793,653 ($ 54,178,726) Rials. Finally economic burden for the province and country was estimated to be 1,376,899,259,144 Rials ($ 87,333,455) and 83,957,271,899,024 Rials ($ 5,325,210,700).Conclusion: The results showed that the economic burden of this disease particularly premature deaths costs is remarkably high. In addition, direct costs could go beyond the health system capacity. Therefore, in order to increase the resiliency of the health system and the stability in services delivery, preventive-oriented strategies have to be more seriously considered by policymakers.

Respiratory Rehabilitation After Blood Transfusion in a COVID-19 Patient: A Case Report (preprint)

Background: The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been identified as the most crucial threat of the century. Due to severe pneumonia and acute respiratory distress syndrome (ARDS), the SARS-CoV-2 can cause shortness of breath, hypoxemia, and the need to mechanical ventilation, intensive care unit (ICU) management, and eventual death. We have tried to use a non-invasive approach to prevent patient from needing respiratory support with invasive ventilation (IV). Here, for the first time, improvement of oxygen delivery and oxygen saturation levels were observed in a COVID-19 patient using packed red blood cells (PRBCs) transfusion.Case presentation: A 63-year-old man with a history of smoking and addiction who came to our hospital facility with fever, shortness of breath and decreased blood oxygen saturation. High-resolution chest CT revealed bilateral and multifocal ground-glass opacities consistent with COVID-19. Subsequently, the COVID-19 infection was confirmed by real-time polymerase chain reaction (qRT-PCR) assay of the upper respiratory tract. Conclusions: Oxygen delivery and oxygen saturation improvement were observed in the COVID-19 patient, after PRBCs transfusions.