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Infectious diseases are disorders caused by microorganisms such as bacteria, viruses, parasites or fungi. According to the World Health Organization, infectious diseases cause about 26% of the world's deaths and are the leading cause of death in people younger than 50 years old. Infectious diseases are classified into new infectious diseases, which include SARS-1, SARS-2, bird flu, etc., and recurrent diseases, which include pre-existing infections with known incidence and geographical spread. Coronaviruses are a family of viruses widely found in animals and humans, responsible for a variety of diseases, ranging from common cold to much more severe diseases which often lead to pneumonia. The group of new diseases also includes Coronavirus 2019 (COVID-19), which initially causes a respiratory infection with the continuation of other complications. This virus is a new type of beta-coronavirus, which first appeared in China and later spread very fast all over the world leading to a global pandemic. Disease monitoring should primarily include erythrocyte sedimentation rate, leukocyte count, leukocyte formula, C-reactive protein (CRP), determination of Troponin I (hsTnI) and T (cTnT), pro-B Type N-terminal natriuretic peptide (NT-proBNP), fibrinogen and D-dimer levels. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Severe infectious disease caused by acute respiratory syndrome, COVID-19 (SARS-CoV-2), spread rapidly worldwide, infecting several million people. According to scientific data, the disease develops through several different stages. After 2–4 days of infection and disease development, the lower respiratory tract is attacked and in a relatively short time interstitial pneumonia develops in a certain number of patients (with genetic predisposition between 5 and 10% of cases). Patients infected with COVID-19 have symptoms such as very high temperatures, fever, persistent cough, joint and bone pain, in some cases diarrhea, and loss of appetite and taste. Disease monitoring should primarily include erythrocyte sedimentation rate, leukocyte count, leukocyte count formula, C-reactive protein (CRP), determination of troponin I (hsTnI) and T (cTnT) levels, N-terminal pro-B natriuretic peptide (NT-proBNP), fibrinogen, and D-dimer level. Previous studies have shown that in pneumonia developed from chronic and acute obstructive pulmonary infections, high levels of D-dimer are observed in patients, and it is suggested that this parameter can be used as a specific prognostic biomarker, and the values higher than > 1000 ng/ml represent increased risk factors for mortality in patients with COVID-19. Because vascular thrombosis affects the promotion of an unfavorable clinical progression for the patient, the identification of early and accurate predictors of the worst outcome seems to be essential for timely and appropriate anticoagulant treatment in patients with SARS-CoV-2 infection. Overall, these data suggest that acute myocardial damage, or heart failure, may be an important indicator of disease severity and adverse prognosis in patients with COVID-19. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Background: Due to uncontrolled lymphocyte reaction, the overproduction of cytokines in COVID-19 patients can cause sepsis-like symptoms, suggesting sepsis, cytokine release syndrome (CRS), and secondary hemophagocytic lymphohistiocytosis (sHLH). Since different therapeutic approaches are used for each diagnosis, differentiation is essential. This study aims to use H-score as a possible prognostic tool in COVID-19 patients. Method(s): A sample of 64 moderate and severe COVID-19 patients was enrolled in this study. Clinical and laboratory findings were assessed. H-score was initially calculated and reevaluated among severe cases 72 hours later and among moderate cases showing severe features of COVID-19. Result(s): Mortality of 31.3% was reported. Laboratory findings, including triglycerides (TG), ferritin, and aspartate aminotransferase (AST) showed significantly higher initial and follow-up laboratory assessment levels in severe cases than in moderate cases. Moreover, fibrinogen was significantly higher among severe cases than moderate cases at the initial assessment, but no significant difference was reported in the second fibrinogen assessment. Conclusion(s): In this study, H-score was useful as a predictive tool for the initial evaluation of severe cases of COVID-19. H-score is much lower in these patients than in non-COVID-19 HLH patients may be due to the different underlying immunologic pathophysiology of COVID-19;thus, each H-score criterion must be evaluated for sensitivity and specificity in COVID-19 patients. The H-score cut-offs, H-score may be useful for diagnosing immune overreaction and determining the need for more exclusive immunomodulatory treatments. Copyright © 2022 Shahid Beheshti University of Medical Sciences. All rights reserved.
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In recent years, Japanese banks have revived their leading international role in the provision of global liquidity. Since the start of the pandemic of COVID-19, Japanese banks have increased their overseas lending at a much higher pace. This article looks at the activities of Japanese banks, and the drivers behind such a surge by considering factors that characterize the domestic economy. It is argued that uncertainties associated with COVID-19, and government response by means of introducing numerous unconventional measures to counter adverse effects of the pandemic, have increased cash hoarding in the economy. Japanese banks have seen a surge in the deposits held, as well as a decline in loans. Data from the Senior Loan Officer Opinion Survey on Bank Lending Practices at Large Japanese Banks reveals that the demand for loans from all size firms and households has declined since mid-2020. Faced with ongoing razor-thin margins and prolonged low interest rates at home, Japanese banks have continued their overseas activities in a search for yield;and they have increased their exposure to offshore financial centers which could have potential domestic financial stability implications. © 2022, Journal of Economic Issues / Association for Evolutionary Economics.
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Introduction: Prominent prognostic parameters that reflect the severity of coronavirus disease 2019 (COVID-19) to adopt an appropriate therapeutic approach are not fully identified. This systematic review and meta-analysis aimed to explore the association between lymphocyte variation and disease severity in COVID-19 individuals. Methods: We searched Web of Science, Scopus, PubMed, EMBASE and WHO website to retrieve studies investigating lymphocyte subset counts in non-severe and severe cases of COVID-19. The pooled standardized mean difference (SMD) between two groups and the pooled average count of each lymphocyte subset were assessed by employing a random-effect model. Results: Thirty-nine investigations on 5087 participants, including 3578 non-severe patients and 1509 severe patients, were included. The pooled analysis showed that non-severe patients had higher total T lymphocytes (SMD = 1.01;95% CI: 0.82, 1.20;I2 = 75.7%), T helper cells (SMD = 1.07;95% CI: 0.85, 1.28;I2 = 85.4%), T cytotoxic cells (SMD = 1.07;95% CI: 0.82, 1.32;I2 = 87.1%), B cells (SMD = 0.72;95% CI: 0.45, 0.98;I2 = 79.7%), and natural killer cells (SMD = 0.65;95% CI: 0.47, 0.84;I2 = 63.1%) than severe patients and the average count of the corresponding lymphocyte signatures in non-severe patients/severe patients were 878.88/448.40, 493.12/268.96, 311.91/158.91, 177.09/110.37, and 155.02/103.09 cells/mu L, respectively. Conclusion: Lymphopenia may be a dilemma in COVID-19 management because over-activation of lymphocytes may lead to cytokine storm or acute respiratory distress syndrome (ARDS). In contrast, lymphopenia may increase SARS-CoV-2 amplification and COVID-19 severity. Therefore, novel therapies targeting lymphocyte proliferation or contraction may counterbalance lymphocyte counts in these patients.
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Considering that there are different reports about the effects of angiotensin II type-I receptor blockers (ARB) and angiotensin-converting enzyme inhibitors (ACEI) on the outcomes of the patients with COVID-19, we aimed to conduct this retrospective study on 138 hypertensive patients (81 ACEI/ARB users) to assess the patients’ outcomes by comparing ACEI/ARB and non-ACEI/ARB users. Multivariate adjusted cox regression model, by considering the effect of other variables, demonstrated that increased age (HR = 1.04, 95% CI = 1.01-1.07, P =0.003) and non-ACEI/ARB users (HR = 2.12 95% CI = 1.12-4.13, P = 0.021) were associated with increased risk of in-hospital mortality in about one week follow-up. In conclusion, we found that in-hospital mortality was lower in ACEI/ARB users, showing the positive effect of these treatments on patients’ outcomes.
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Coronavirus infectious disease 2019 (COVID-19) is confirmed to develop neurocognitive complications. In the present paper, we describe two patients with laboratory-confirmed COVID-19 and excessive daytime sleepiness. In the present study, we reported two laboratory-confirmed cases of COVID-19 with excessive daytime sleepiness. Patients had drowsiness and mild confusion on presentation. In both cases, CNS infections, including meningitis and encephalitis, were ruled out. Both patients’ symptoms remarkably improved following the therapeutic course indicating the direct effect of SARS-CoV2 in sleep modulating centers on the brain. COVID-19 should be considered in patients with excessive daytime sleepiness and drowsiness in the current outbreak.
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Background: Coronavirus disease 2019 (COVID-19) has been pandemic and has caused a great burden on almost all countries across the world. Different perspectives of this novel disease are poorly understood. This study sought to investigate the clinical and epidemiological characteristics of COVID-19 to efficiently assist the health system of Iran to conquer the outbreak. Materials and Methods: This retrospective observational study was performed on 394 patients with a diagnosis of COVID-19. The patients should have a history of hospitalization at Loghman-Hakim hospital, Tehran, Iran, for 10 weeks, beginning from the first official report of the disease in Iran. In the subsequent step, the baseline demographic and clinical and paraclinical information of the patients was documented. Finally, the patients were assessed if they had exhibited any morbidity or mortality. Results: The epidemiological examination of the COVID-19 population suggested a bell diagram pattern for the hospitalization rate, in which the 4th week of the study was the peak. The highest rate of secondary adverse events due to the virus was observed at the 6th and 7th weeks of the study course. On another note, clinical evaluations resulted in identifying specific abnormalities, such as bilateral opacity in chest computed tomography scans or low oxygen saturation in laboratory data. Conclusion: This study provides evidence concerning the clinical and epidemiological characteristics of COVID-19 in the first phase of the virus outbreak in Iran. Further studies comparing the disease features in the subsequent phases with findings of this study can pave the way for additional information in this regard.
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Introduction: As diabetes is highly prevalent worldwide, understanding particular dimensions of COVID-19 infection in diabetic patients is of significant importance. Objectives: The present research aimed to evaluate the outcome of diabetic patients with COVID-19 infection, and the clinical and biochemical characteristics in survived and non-survived patients. Patients and Methods: The present single-center, cross-sectional study examined laboratory and clinical features of 160 patients with diabetes who had moderate to severe criteria. The obtained data were categorized as survived or non-survived patients and then we compared the clinical characteristics in two groups. Results: In this study, 160 diabetic patients (75 men and 85 women) admitted with moderate to severe Covid-19 were evaluated. The mean age of studied patients was 51-90 years old, with diabetes duration of 5 to 15 years. One hundred thirty-one patients (81.9%) survived, but twenty-nine patients (18.1%) did not survive. Regarding the comparison of symptoms, only the loss of consciousness on admission was higher in non- survived patients;however, a majority of the non-survivors have been admitted to ICU, 23(79.3%) and 26 (89.6%) needed invasive mechanical ventilation;in comparison to survived patients also had a shorter duration of hospital stay (5.5 +/- 5.1 versus 8.4 +/- 6.1days). Non-survivors more probably suffer from high blood pressure [23 (79.3%) patients versus 80 (61%) patients] and chronic kidney disease [20 (69%) patients versus 9 (6.9%) patients;P<0.001]. Glycated hemoglobin (HbA1c) of more than 9%, and high fasting blood sugar, severe inflammatory response, hepatic, renal, and coagulation impairment was higher in non-survived than those who survived. Conclusion: Multifactorial parameters result in the poor prognosis in diabetic patients;therefore, it is critical for identifying the key clinical, as well as laboratory characteristics of COVID-19 cases that lead to severe disease and increase the risk of death.
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Sofosbuvir and daclatasvir have been used successfully since 2013 for hepatitis C treatment. It has been shown by different studies that sofosbuvir can inhibit RNA polymerase of other positive-strand RNA viruses including Flaviviridae and Togaviridae. Homology between hepatitis C virus RNA polymerase and severe acute respiratory syndrome coronavirus 2 has also been established. The efficacy of sofosbuvir and daclatasvir as potential choices in treating patients with coronavirus disease 2019 and their recovery can be hypothesized.