ABSTRACT
Background and purpose: Tocilizumab (TCZ), a monoclonal antibody against interleukin-6 (IL-6) receptor, is emerged as an alternative treatment for COVID-19 patients with a risk of cytokine storms. This study aimed at investigating the efficacy of TCZ in patients with COVID-19. Material(s) and Method(s): In a retrospective observational study, we examined the demographic and clinical characteristics of patients with COVID-19 and also the outcomes of TCZ therapy (Actemra and Temziva) in Qaemshahr Razi Hospital. Result(s): Out of 56 cases, 32 (57.1%) were women and the median age of the patients was 57.5 years. Among the patients, 19 (33.9%) were admitted to ICU where seven (12.7%) were intubated and eight (14.3%) patients deceased. Before TCZ therapy, mean oxygen saturation level was 90.1% which elevated to 93.8% after receiving TCZ (P=0.001). In this study, Temziva was associated with lower mortality rate compared with Actemra (P=0.004). Conclusion(s): TCZ therapy in patients with COVID-19 could improve oxygen saturation level and Temziva results in lower mortality rate. However, further studies with larger sample size are required to confirm these results. Copyright © 2022, Mazandaran University of Medical Sciences. All rights reserved.
ABSTRACT
Background and purpose: COVID-19 is a viral respiratory disease that results in high mortality. Evidence suggests that micronutrients affect viral and bacterial infections. This study was performed to evaluate the effectiveness of micronutrients (vitamin D, vitamin C, and selenium) on the disease severity in patients hospitalized with COVID-19. Materials and methods: This retrospective cross-sectional study was carried out in patients with diagnosis of COVID-19 in Qaemshahr Razi Hospital, 2020. Medical records were reviewed and 42 were selected. Data of patients that received micronutrients including vitamin D, vitamin C, and selenium and those that did not receive these supplements were compared. Duration of hospitalization, respiratory support, oxygen therapy, requiring invasive/non-invasive mechanical ventilation, and incident of death were investigated. Statistical analysis was done in SPSS V25.
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Background and purpose: COVID-19 could potentially disrupt routine care management in health systems. One of such problems is associated with HIV surveillance. The aim of this research was to study the effects of COVID-19 pandemic on HIV care indicators. Materials and methods: This retrospective cohort study was performed using data at individual and aggregate levels obtained from center for disease control and prevention in Mazandaran province affiliated with Mazandaran University of Medical Sciences. We modulated upon Poisson regression for analyzing the impact of COVID-19 pandemic on HIV incidence, mortality, treatment failure, hospitalization, refer to counselling center, HIV viral load (VL), and CD4 cell count monitoring.
ABSTRACT
Background and purpose: COVID-19 could potentially disrupt routine care management in health systems. One of such problems is associated with HIV surveillance. The aim of this research was to study the effects of COVID-19 pandemic on HIV care indicators. Material(s) and Method(s): This retrospective cohort study was performed using data at individual and aggregate levels obtained from center for disease control and prevention in Mazandaran province affiliated with Mazandaran University of Medical Sciences. We modulated upon Poisson regression for analyzing the impact of COVID-19 pandemic on HIV incidence, mortality, treatment failure, hospitalization, refer to counselling center, HIV viral load (VL), and CD4 cell count monitoring. Result(s): One year after COVID-19 pandemic, the incidence of HIV was 0.44 per 100,000 people less compared with one year earlier (P= 0.051). CD4 counting and patients follow up at this time were 0.32 less (P< 0.001) and 1.11 more (P= 0.045) per 100,000 people, respectively compared with those before the COVID-19 pandemic. Conclusion(s): Current study showed that COVID-19 pandemic disrupted HIV care. It seems that despite regular follow up services provided by health center staff, coronaphobia was a huge barrier to care programs in HIV patients. Copyright © 2022, Mazandaran University of Medical Sciences. All rights reserved.
ABSTRACT
Background and purpose: COVID-19 is a viral respiratory disease that results in high mortality. Evidence suggests that micronutrients affect viral and bacterial infections. This study was performed to evaluate the effectiveness of micronutrients (vitamin D, vitamin C, and selenium) on the disease severity in patients hospitalized with COVID-19. Material(s) and Method(s): This retrospective cross-sectional study was carried out in patients with diagnosis of COVID-19 in Qaemshahr Razi Hospital, 2020. Medical records were reviewed and 42 were selected. Data of patients that received micronutrients including vitamin D, vitamin C, and selenium and those that did not receive these supplements were compared. Duration of hospitalization, respiratory support, oxygen therapy, requiring invasive/non-invasive mechanical ventilation, and incident of death were investigated. Statistical analysis was done in SPSS V25. Result(s): Survival rates in the groups receiving vitamin C, D, and selenium were not significantly different from the groups that did not receive these supplements (P= 0.42, 0.63, 0.084, respectively). The study showed no significant relationship between vitamin D, C, and selenium intake and the need for ventilation due to respiratory distress (P= 0.139, 0.2, and 0.8, respectively). Conclusion(s): No remarkable difference was seen between the recipients of vitamin C, D, and selenium and those who did not receive supplements in terms of survival and the need for mechanical ventilation. So, these supplements did not affect the clinical outcomes of patients with COVID-19. Copyright © 2022, Mazandaran University of Medical Sciences. All rights reserved.
ABSTRACT
Background: Lymphopenia is an important but nonspecific laboratory indicator of COVID-19. Objectives: To describe epidemiologic and clinical characteristics of the first cases of the COVID-19 referred to a center dedicated to COVID-19 patients in Iran. Methods: This research is a retrospective cross-sectional study on 100 confirmed cases with COVID-19, hospitalized from February 25 to March 10, 2020, in Qaemshahr Razi Hospital in Mazandaran Province, Iran. The main demographic data, clinical features, including outcomes, laboratory findings, and therapeutic protocols, were collected in a structured form and analyzed. Results: The Mean±SD age of the patients was 56.7±15.6 years. Fifty-nine percent (n=59) of the patients were male. Nineteen percent (n=19) were admitted to the ICU. The median (IQR) time from disease onset to hospital admission was 5 (3-7) days. The most common symptoms were fever (73%), dyspnea (67%), dry cough (61%), and myalgia (61%). The severity of the disease was moderate in most patients (n=54). The average hospital stay for patients was 7 days. The non-survivor cases in comparison to survived ones were from a higher age group (65 vs 52 years;P=0.001), had a higher frequency of underlying diseases (68.4% vs 39.5%;P=0.039), had a lower peripheral capillary O2 saturation at the time of admission (79% vs 94%;P<0.001), and were more likely to have lymphopenia (63.2% vs 37%;P=0.034). Conclusion: Lymphopenia, increased neutrophil to lymphocyte ratio and decreased peripheral capillary O2 saturation are commonly seen in COVID-19 patients, especially among severe cases, and can be used in developing clinical prediction rules.
ABSTRACT
In late December 2019, a global outbreak (pandemic) of the coronavirus was reported, which WHO named 2019-nCoV. The virus is now spreading rapidly and has affected many countries, including Iran. There is no definitive and effective treatment for this virus yet. This report aimed to define the effect of Tocilizumab in patient with COVID-19. This case report is about a 52-year-old man with COVID-19 that has been treated with tocilizumab. The reported patient had an acceptable improvement in oxygen saturation but no significant change in lung CT scan. After 3 days treatment patient with Tocilizumab, extensive bilateral lungs involvement still exist but SPO2 level iimprovement up to 90%. According to the results, this drug had a positive impact on oxygen saturation. However, we cannot be certain whether this drug positively affected the patient's coronavirus disease.
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Background: Various digestive symptoms have been frequently reported in a significant portion of patients infected with the virus since the outbreak of Coronavirus Disease 2019 (COVED-19). Most patients with COVID-19 have a fever accompanied by respiratory signs and symptoms, such as cough and dyspnea. We present 36 cases with a chief complaint of Gastrointestinal (GI) symptoms along with respiratory symptoms In this Study, we aimed at investigating the prevalence and outcomes of COVID-19 patients with digestive symptoms.
ABSTRACT
Background: Various digestive symptoms have been frequently reported in a significant portion of patients infected with the virus since the outbreak of Coronavirus Disease 2019 (COVID-19). Most patients with COVID-19 have a fever accompanied by respiratory signs and symptoms, such as cough and dyspnea. We present 36 cases with a chief complaint of Gastrointestinal (GI) symptoms along with respiratory symptoms. In this study, we aimed at investigating the prevalence and outcomes of COVID-19 patients with digestive symptoms. Methods: A variety of observed GI symptoms included nausea and vomiting (72.2%), diarrhea (25%), abdominal pain (19.4%), loss of appetite (14%), and anosmia (14%). The most non-GI symptoms were dyspnea (66.7%), fever (66.7%), dry cough (58.3%), myalgia (52.4%), and others. Six patients (16.6%) were critically ill, 7 (19.4%) were in stable condition, and 23 patients (64%) showed moderate symptoms. Among the patients, 7 (19.5%) needed critical care and were admitted to ICU. Leucopenia, lymphopenia, and elevated acute-phase proteins were other features observed in these patients. The most common antiviral regimen was hydroxychloroquine and oseltamivir. Finally, 32 patients (89%) were discharged, and 4 (11%) died. Conclusion: This case series study highlights that patients with COVID-19 are prone to GI symptoms along with fever and respiratory symptoms. Patients may even present with digestive symptoms and without any respiratory symptoms. Hence, clinicians should pay more attention to these patients and help diagnose COVID-19 earlier to start prompt treatment before the occurrence of severe disease.