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Background: Hospitals are one of the primary resources for disease transmission, so many guidelines were published, and neuro-surgeons were advised to postpone elective spine surgeries during the COVID-19 pandemic. Objective(s): To avoid pulmonary complications and reduce the risk of spreading the virus and contracting the disease during the COVID-19 era, we operated a group of our patients under spinal anesthesia rather than general anesthesia. Method(s): We retrospectively analyzed all patients who underwent discectomy surgery for lumbar spinal disc herniation under SA between September 2020 and 2021. Result(s): Sixty-four patients diagnosed with lumbar disc herniation underwent lumbar discectomy with SA. All patients except three were male. The mean age was 44.52 +/- 7.95 years (28 to 64 years). The mean procedure time for SA was 10 minutes. The duration of the surgery was 40 to 90 minutes per each level of disc herniation. The mean blood loss was 350 cc (200 to 600 cc). The most common involved level was L4/L5 intervertebral disc (n = 40 patients;63.5%). The mean recovery time was 20 minutes. Only three patients requested more analgesics for relief of their pain postoperatively. All patients with discectomy were discharged a day after surgery, and in the case of fusion, two days after surgery. All the patients were followed up for six months, showing no recurrence symptoms, good pain relief, satisfaction with the surgery, and no bad memory of the surgery. Conclusion(s): Spinal anesthesia is a good alternative or even the main anesthesia route for patients with lumbar disc herniation. More studies are needed to elucidate the best candidate for SA in patients with lumbar pathology.Copyright © 2023, Author(s).
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Background and aim: The corona epidemic and its impact on the society led the government policy to support the production of medicine and related vaccines. Vaccination is known to be an effective preventive measure and eradication of this disease. However, information on different brands of vaccines at different times, age groups, occupations or underlying diseases is not available. The present study intends to compare incidence of COVID-19 after AstraZeneca, Sinopharm and Sputnik vaccination in patients referred to hospitals affiliated to Shoushtar University of Medical Sciences, 2021. Also determine the effect of vaccination in reducing the severity of symptoms and death and the necessary information and education to the public about the possibility of coronavirus after vaccination, to continue to follow health protocols. Method(s): The present study is a retrospective cross-sectional study In order to evaluate and compare the rate of covid-19 and the death rate in vaccinated people in Shoushtar,Iran. The study population of this study includes people who have received one or two doses of Corona vaccine Sputnik V, Sinopharm and AstraZeneca and have referred to medical centers affiliated to Shoushtar University of Medical Sciences (May 2021 to september 2021). 639 Samples were selected based on inclusion criteria from the research community. Patient information including demographic information, information on vaccines, underlying diseases, severity of COVID-19 symptoms, length of hospital stay and previous history of COVID-19. Statistical analysis was performed using Chi-square, Anova at a significance level of 0.05, with SPSS.V18 software. Result(s): The mean age of study participants was 56.58 years. The median duration of infection after vaccination was 30(IQR: 20-50) days, with the range (4-180).46.9% of patients were admitted to routine hospital wards and 4.1% of patients were admitted to intensive care units. The prevalence of covid-19 infection in vaccinated is 0.3% in total. There is a significant difference between the three types of vaccines in terms of the proportion (p<0.001). The prevalence of covid-19 in patients vaccinated with Sputnik vaccine was (2.6%) and in Sinopharm vaccine (0.25%). the mortality rate in Sputnik vaccine was zero and in Astrazeneca vaccine was more than Sinopharm vaccine (p = .029) Conclusion(s): The results of the present study showed that the rate of death and re-infection in the used vaccines is different, so that re-infection in Sputnik vaccine was more than other vaccines (2.7%), but the duration of hospitalization in this vaccine was less than the others. Also, the death rate in Astrazanka vaccine was higher than others. The mean incidence of COVID-19 was 42.31 days after vaccination;the lowest incidence was reported 4 days after vaccination. Only 5% of patients needed to be admitted to the intensive care unit;the maximum length of hospital stay was estimated to be 3 to 4 days. Copyright © 2022, Anka Publishers. All rights reserved.
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Background: Covid-19 is a life-threatening disease-causing and accompanying multiple organ injuries in hospitalized patients. Case presentation: A 73-year-old male patient was admitted to a hospital in Tehran province. He had symptoms of COVID-19 disease, and his involvement with COVID-19 was confirmed by the molecular method and patchy areas of ground-glass opacities in the computed tomography (CT) scan. He was under treatment for his diabetes and hypertension. After a few hours of admission, he had low oxygen saturation (80%);hence he became under intensive care, oxygen, and anticoagulant therapy. On day 6 of ICU admission, his clinical status became worse when he had left side pain, hematuria, glucosuria, proteinuria, and high serum creatinine level (3.28 mg/dL). CT scan imaging was indicating of renal hematoma. The surgical or any invasive intervention was impossible due to the unstable status of the patient. Packed red cell and plasma replacement therapy were not effective in the prevention of expiration of the patient on day 7 of hospitalization. Spontaneous renal hemorrhage concurrent with COVID-19 disease was the defmite diagnosis for this case. Conclusion: We think that COVID-19 involvement may accelerate renal injury in our case. Anyhow, there were multiple predisposing risk factors for renal hematoma, in this case, such as diabetes, anticoagulant therapy, and COVID-19. We suggest that COVID-19 involvement accelerates renal problems. Nevertheless, this conclusion should be confirmed by other reports and research by clinical scientists.
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Background Studies have shown that morbidity and mortality critically increase from COVID-19 in patients with Alzheimer's disease and dementia. But we had an Alzheimer's disease patient treated rapidly from COVID-19 involvement. We explore the probable cause of treatment using in-silico drug screening tools. Case presentation We present an 81-year-old female patient who recovered from COVID-19 disease despite her severe dementia and Alzheimer's disease, and unfavorable respiratory status. The patient was under medical care for ten days. She received standard COVID-19 medical care plus her drugs for Alzheimer's disease. We found those drugs administered for Alzheimer's disease can interact, and probably inhibit, SARS-COV-2 main protease that plays a central role in virus replication. Conclusion Our patient remediated from COVID-19 very well despite being at a higher risk of morbidity and mortality. However, her amnesia may help her to fight and resist respiratory distress. In addition, administered drugs for Alzheimer's disease may interact with viral biomolecules and dwindle SARS-COV-2 replication.
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Aims: Patients after diagnosis of COVID-19 may have psychological problems. Illness perceptions and social support can play an important role in individuals’ health and the effects of stress. This study aimed to determine the relationship between mental health, perception of illness and perceived social support in Hospitalized Patients with COVID-19. Methods: The present study is a cross-sectional study that was conducted in 2020. 143 patients with coronavirus who met the inclusion criteria participated in this study. Inclusion criteria are age over 18 years, full consciousness, lack of physical and mental disabilities, diagnosis of coronavirus with the approval of an infectious disease specialist, no history of mental disorders, the ability to communicate with the researcher. Data collection tools were the 21-item depression, anxiety, and stress scale, Zimet’s multidimensional scale of perceived social support, and the brief illness perception questionnaire. Data were analyzed in SPSS 26. Results: The average score of depression, anxiety, and stress for all participants with coronavirus was 8.12±7.12, 11.74±6.02, and 13.92±6.80, respectively. 30.1% of the participants had high illness perception and 59.4% had high social support level. The multiple linear regression model showed illness perception and social support were associated with depression, anxiety, and stress. Drug history was associated with depression and anxiety. Oxygen saturation was associated with anxiety and stress (P<0.05). Conclusion: In general depression, anxiety, and stress in patients with Covid 19 are associated with the perception of illness and social support, which is more strongly associated with social support. © 2022, Tarbiat Modares University. All rights reserved.
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Introduction: Organ transplant recipients might be more likely to develop COVID-19, as they receive long-term immunosuppressives and have comorbidities. Case Presentation: Herein, we reported the case of a 32-year-old man with unilateral lung transplantation due to unclassifiable lung fibrosis on pathologic evaluation who presented with cough, fever, and headache. After evaluation with RT-PCR test and chest CT scan, COVID-19 in the previously transplanted lung was diagnosed. However, the other non-transplanted fibrotic lung was not involved. Conclusions: Lack of COVID-19 involvement in the fibrotic lung tissue in our case without any other risk factors might be related to the fact that the lung with underlying diseases was less susceptible to COVID-19 as unhealthy lungs have lower ACE2 receptors, or it might be related to genetic differences between the donor and recipient.
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Background: Telemedicine is considered an innovative approach for management and follow up of communicable diseases, when person to person contact has the risk of disease dissemination, such as the situation being experienced with corona virus infection. The aim of this study was to evaluate the role of telemedicine in patient follow-up and patient compliance in different communication methods. Materials and Methods: All patients discharged from a referral pulmonary hospital dedicated to coronavirus infected patients were given instructions on follow-up of symptoms. One group received messages via short message system regarding the severity of their symptoms. For the other group a mobile application was specially designed for tracking their well-being on a daily basis. Severity of symptoms and course of disease were monitored in each group for a two-month period. Results: A total 1091 patients with mean age of 53.96± 17.95 years were enrolled in the study. In the first group 406 (60.14%) messages were successfully sent, from which 150 (36.94%) patients replied. Also, 243(35%) patients contacted us by making phone calls. Of the total patients in the second group, 153(64%) patients started using the mobile application. Chief complaint of patients was mainly cough, shortness of breath, fatigue, and myalgia. Deep vein thrombosis, hyperglycemia, post kidney transplant patient and bloody diarrhea were among the reported cases. Conclusion: Patient follow-up during epidemics, especially when the disease course is unknown, is an important step in both successful patient management and disease control. This study showed the role of telemedicine for patient follow-up, mostly in detecting special situations. But, in order to be successful patient education and active follow-up are important factors that must be considered. © 2020 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran.
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Background: Coronavirus disease 2019 (COVID-19) has several chest computed tomography (CT) characteristics, which are important for the early management of this disease, because viral detection via RT-PCR can be time-consuming, resulting in a delayed pneumonia diagnosis. The Radiological Society of North America (RSNA) proposed a reporting language for CT findings related to COVID-19 and defined four CT categories: typical, indeterminate, atypical, and negative. Objectives: To retrospectively evaluate the chest CT characteristics of patients with COVID-19 pneumonia. Patients and Methods: A total of 115 hospitalized laboratory-verified COVID-19 cases, underdoing chest CT scan, were included in this study from April 30 to May 15, 2020. Of 115 cases, 53 were discharged from the hospital, and 62 expired. The initial clinical features and chest CT scans were assessed for the type, pattern, distribution, and frequency of lesions. Moreover, the findings were compared between ward-hospitalized, intensive care unit (ICU)-admitted, and non-surviving (expired) patients.
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Background. The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created an unprecedented and daunting challenge for humanity to survive. This has also affected the sporting events across the globe as the majority of the tournaments have been cancelled or postponed as a result. For life to return to pre-pandemic normalcy, an effective and safe vaccination program needs to be implemented, be readily accessible, widely available, and affordable at the same time. Objectives. In this review, we analyze various challenges which demonstrate that COVID-19 is far from over.Methods. A systematic literature search was conducted on PubMed, ScienceDirect, Medline, google scholar and Scopus from the commencement of the COVID-19 pandemic to 22 June 2021. The current report is a summary of data regarding challenges faced by the COVID-19 vaccination campaign and the challenges for a transition toward normalcy especially for big sports events. Results. The current COVID-19 pandemic has likely resulted in sporting events and tournaments being canceled, postponed, or held without or with restricted spectators around the world. A combination of measures including prompt vaccination with the beneficial impact of the vaccines in reducing the severity of disease, advances in treatment, expanded use of diagnostics and better implementation of public-health policies are a necessity. Following this implementation, a transition toward normality could be expected when the mortality rate of COVID-19 simulates the average influenza statistics, with public-health measures continuing to play an important role worldwide. Conclusion. The authors believe that COVID-19 will be endemic in the human population, similar to seasonal influenza, and that COVID-19 vaccines will be included as an add-on to seasonal influenza vaccinations, being administered every winter for at least the next few decades. With adequate vaccination, the sporting world will be able to withstand the challenges and resume global events, returning to pre-Covid levels of normalcy.
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BACKGROUND: The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults. METHODS: A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses "pre" and "during" the lockdown period. Participants responded to the Short Warwick-Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire. RESULTS: Replies from older adults (aged >55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p < 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F<sub>(2, 514)</sub> = 66.41 p < 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p < 0.001, R<sup>2</sup>: 0.20). CONCLUSION: COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.
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The novel coronavirus disease (COVID-19) has rapidly spread across the world and caused a pandemic, and still continues to evolve. In Iran, the first cases of COVID-19 were officially announced between February 19 and 23, 2020 and it soon became clear that Iran is one of the countries that is worst-hit by COVID-19 outbreak (1, 2).
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Computed tomography (CT) imaging has quickly found its place as a beneficial tool in the detection of coronavirus disease 2019 (COVID-19). To date, only a few studies have reported the distribution of lung lesions by segment. This study aimed to evaluate the lobar and segmental distribution of COVID-19 pneumonia based on patients’ chest CT scan. Methods: This was a retrospective study performed on 63 Iranian adult patients with a final diagnosis of COVID-19. All patients had undergone chest CT scan on admission. Demographic data and imaging profile, including segmental distribution, were evaluated. Moreover, a scoring scale was designed to assess the severity of ground-glass opacification (GGO). The relationship of GGO score with age, sex, and symptoms at presentation was investigated. Results: Among included patients, mean age of patients was 54.2 ±14.9 (range: 26 - 81) years old and 60.3% were male. Overall, the right lower lobe (87.3%) and the left lower lobe (85.7%) were more frequently involved. Specifically, predominant involvement was seen in the posterior segment of the left lower lobe (82.5%). The most common findings were peripheral GGO and consolidation, which were observed in 92.1% and 42.9% of patients, respectively. According to the self-designed GGO scoring scale, about half of the patients presented with mild GGO on admission. GGO score was found to be equally distributed among different sex and age categories;however, the presence of dyspnea on admission was significantly associated with a higher GGO score (p= 0.022). Cavitation, reticulation, calcification, bronchiectasis, tree-in-bud appearance and nodules were not identified in any of the cases. Conclusion: COVID-19 mainly affects the lower lobes of the lungs. GGO and consolidation in the lung periphery is the imaging hallmark in patients with COVID-19 infection. Absence of bronchiectasis, solitary nodules, cavitation, calcifications, treein-bud appearance, and reversed halo-sign indicates that these features are not common findings, at least in the earlier stages.
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The novel coronavirus (COVID-19), first reported in late December 2019, has affected the lives of many people throughout the world. Significant studies have been conducted on this pandemic, some of which have addressed understanding the relationship between different air pollutants and confirmed cases. In this study, the effects of four air pollutants (carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide) were assessed from February 19 to March 22, 2020 to explore how they can affect COVID-19 contagion in Iran. The mean concentrations of air pollutants were extracted from Sentinel 5P data. The COVID-19 confirmed case densities of two provinces, Semnan and Qom, were more than all other provinces. The effect of pollutants on the confirmed case densities was analyzed using multiple linear regression in order to estimate the impact coefficients for individual provinces. The impact coefficients determine the level of each pollutant's contribution to the density of total confirmed cases. Carbon monoxide, nitrogen dioxide, sulfur dioxide, and ozone had both considerable negative and positive correlations with the density of confirmed COVID-19 cases, although sulfur dioxide was correlated more negatively than positively. In Semnan, a high hot spot province, nitrogen dioxide had the most significant effect on the density of confirmed cases among all pollutants, while the effect of carbon monoxide was greater in Qom. The results indicated that even short-term exposure to higher concentrations of the pollutants could lead to an increased risk of COVID-19 outbreaks, which should be considered in adopting adequate and appropriate control policies to manage the disease.
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Various manifestations may appear in chest computed tomography (CT) scan of patients with coronavirus disease 2019 (COVID-19). In this pictorial review, we present chest CT manifestations of 14 patients with laboratory-confirmed COVID-19 disease and various manifestations including ground-glass and consolidative opacities, reticular opacities, halo sign, and other findings.