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Background: The outbreak of acute respiratory syndrome with novel coronavirus 2019 (COVID-19) in December 2019 in Wuhan, China, caused a worldwide outbreak of the disease. To treat the disease, some drugs were identified and introduced that did not show a significant effect on the recovery of the disease. Due to the need to manage inpatient beds, this study was conducted to evaluate the effectiveness of Remdesivir in the treatment of outpatients with moderate to severe COVID-19. Method(s): The present study was a retrospective cohort with a convenience sampling method. It was conducted by referring to the records of COVID-19 patients who were referred to the respiratory clinic of Shahid Beheshti Hospital as outpatients in the period from April to August 2021. Result(s): This study was conducted on 263 COVID-19 patients with a mean age of 51.16+/-14.39 years from 19 and 90 years old. Data were collected through a researcher-made checklist and analyzed using SPSS 20. Kolmogorov-Smirnov test, paired t-test, and Mc Nemar's test were used to evaluate the data. The significance level was considered at the level of 0.05. Conclusion(s): Findings revealed that no clear correlation was found between hospitalization and death rate compared to other patients. In our study, the risk factors for severe COVID-19 did not affect the rate of hospitalization or death of patients.Copyright © 2023 Bentham Science Publishers.
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Background and Objectives: Statins, which are primarily used for controlling blood cholesterol levels, have a well-known role in inhibiting the inflammatory process and reducing mortality rate of infectious diseases. This study aims to evaluate the effect of atorvastatin along with standard treatment protocol in hospitalized adults with COVID-19. Methods: This randomized controlled clinical trial was conducted on adults hospitalized due to COVID-19 infection at Shahid Beheshti Hospital in Qom, Iran from April to September 2020. They were randomly divided into groups of treatment (n=37, receiving atorvastatin 40 mg daily for 30 days plus standard treatment protocol) and control (n=37, receiving standard treatment protocol alone). The data were analyzed in SPSS v.22 software using chi-square, paired t-test, and ANOVA. P < 0.05 was statistically significant. Results: The CRP level in the atorvastatin-treated group decreased significantly such that there was a significant difference between the two groups after 30 days (P=0.01). There was no significant difference in Spo2 level on the discharge day. The length of hospitalization in the atorvastatin-treated group was significantly reduced compared to the control group (P < 0.05). Conclusion: The use of atorvastatin as an adjunctive treatment method, can significantly reduce the length of hospitalization and CRP level after 30 days in hospitalized patients.
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Background and Objectives: Factors disrupting the quality of sleep in patients with COVID-19 are considered one of the most important issues in the treatment of this disease. In this study, we aim to investigate the factors that disrupt the sleep quality of patients with Covid-19.
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Background: Coronavirus is one of the major pathogens of the human respiratory system and a major threat to the human health. Objectives: This modeling study aimed to project the epidemics trend of coronavirus disease 2019 (COVID-19) in Qom, Iran Methods: This study projected the COVID-19 outbreak in Qom using a modified susceptible-exposed-infectious-recovered (SEIR) compartmental model by the end of December 2020. The model was calibrated based on COVID-19 epidemic trend in Qom from 1 January to 11 July. The number of infected, hospitalized, and death cases were projected by 31 December. A Monte Carlo uncertainty analysis was applied to obtain 95% uncertainty interval (UI) around the estimates. Results: According to the results, the reduced contact rate and increased isolation rate were effective in reducing the size of the epidemic in all scenarios. By reducing the contact rate from eight to six, the number of new cases on the peak day, as well as the total number of cases admitted to the hospital by the end of the period (31 December), decreased. For example, in Scenario A, compared to Scenario E, with a decrease in contact rate from eight to six, the number of new cases on peak days decreased from 15,700 to 1,100. The largest decrease in the number of new cases on peak days was related to Scenario F with 270 cases. Also, the total number of cases decreased from 948,000 to 222,000 between the scenarios, and the largest decrease in this regard was related to Scenario F, with 188,000 cases. Conclusions: The parameters of contact rate and isolation rate can reduce the number of infected cases and prevent the outbreak, or at least delay the onset of the peak. This can help health policymakers and community leaders to upgrade their health care
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Introduction: One of the unique challenges for obstetricians in pregnancy is cardiovascular changes. This study aimed to evaluate electrocardiographic (ECG) changes in mothers with COVID-19. Materials and Methods: In a retrospective study, 89 pregnant women with positive reverse transcription-polymerase chain reaction for COVID-19, between 19 and 44 years old, were selected for the study, and 12 lead ECGs were extracted and recorded from the medical documents for all cases and all parameters analyzed. Results: Of the 89 patients that met inclusion criteria, only eight patients were admitted to intensive care unit. Of all, 64 cases (71.9%) had normal ECG, three patients showed atrioventricular (AV) block (3.4%), and three patients had first-degree AV block type (PR interval > 200 ms). The mean QTC interval was 428.6 & PLUSMN;37.4 ms and 15 (17%) patients had long QTC intervals (QTC & GE;460 ms). There was a significant relationship between antivirus treatment (P = 0.027), as well as hydroxychloroquine (HCQ) with PR interval (P = 0.002). A significant relationship was found between corticosteroids with QTC (P = 0.019) and antibiotics with QTC (P = 0.018). Conclusion: A significant association between corticosteroids usage and QTC interval as well as antiviral and HCQ treatment with PR interval. These changes during pregnancy and COVID-19 should be interpreted with caution by physicians. Understanding changes in electrocardiography can help in better and early diagnosis and management of pregnant mothers to prevent adverse outcomes.
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Objective: Since the outbreak of coronavirus disease 2019 (COVID-19), the triage of patients diagnosed with corona virus has been a very important issue. The aim of this study was to introduce a triage scoring system according to the clinical and para-clinical findings of patients in order to be admitted or discharged with COVID-19. Methods: After confirming the positive polymerase chain reaction (PCR) test for patients, we used a scoring system which included: the age of patient (less than 40 years and > 40 years), early vital signs at the time of admission, lab tests including C-reactive protein (CRP), white blood count (WBC), lactate dehydrogenase (LDH), D-dimer, chest imaging findings, comorbidity and shortness of breath. Results: The clinical score obtained for each variable in this scoring system was a number between 0 and 3. The total score was a minimum of 0 and a maximum of 17. A higher score indicated an increase in the intensity and the need for intensive care. These scores were classified into 3 groups: 0-4, 5-10 and above 10. In the next stage, patients were divided into three groups: mild, moderate and severe. In this regard, patients with mild symptoms were suggested to receive home quarantine and home treatment, patients with moderate symptoms were recommended hospitalization and medical care, and finally patients with severe symptoms were inclined to intensive care. Conclusion: In order to treat and manage patients with COVID-19, it is necessary to pay particular attention to clinical and para-clinical findings and prioritize these findings based on the severity and the condition of patients. © 2022, Kerman University of Medical Sciences. All rights reserved.
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Objective: To identify the incidence rate, relative risk, hotspot regions and incidence trend of COVID-19 in Qom province, northwest part of Iran in the first stage of the pandemic. Methods: The study included 1 125 officially reported PCR-confirmed cases of COVID-19 from 20 February 2020 to 20 April 2020 in 90 regions in Qom city, Iran. The Bayesian hierarchical spatial model was used to model the relative risk of COVID-19 in Qom city, and the segmented regression model was used to estimate the trend of COVID-19 incidence rate. The Poisson distribution was applied for the observed number of COVID-19, and independent Gamma prior was used for inference on log-relative risk parameters of the model. Results: The total incidence rate of COVID-19 was estimated at 89.5 per 100 000 persons in Qom city (95% CI: 84.3, 95.1). According to the results of the Bayesian hierarchical spatial model and posterior probabilities, 43.33% of the regions in Qom city have relative risk greater than 1;however, only 11.11% of them were significantly greater than 1. Based on Geographic Information Systems (GIS) spatial analysis, 10 spatial clusters were detected as active and emerging hotspot areas in the south and central parts of the city. The downward trend was estimated 10 days after the reporting of the first case (February 7, 2020);however, the incidence rate was decreased by an average of 4.24% per day (95%CI:-10.7, -3.5). Conclusions: Spatial clusters with high incidence rates of COVID-19 in Qom city were in the south and central regions due to the high population density. The GIS could depict the spatial hotspot clusters of COVID-19 for timely surveillance and decision-making as a way to contain the disease.