Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 25
Filter
1.
Indian J Crit Care Med ; 26(6): 688-695, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1911933

ABSTRACT

Background: Prioritizing the patients requiring intensive care may decrease the fatality of coronavirus disease-2019 (COVID-19). Aims and objectives: To develop, validate, and compare two models based on machine-learning methods for predicting patients with COVID-19 requiring intensive care. Materials and methods: In 2021, 506 suspected COVID-19 patients, with clinical presentations along with radiographic findings, were laboratory confirmed and included in the study. The primary end-point was patients with COVID-19 requiring intensive care, defined as actual admission to the intensive care unit (ICU). The data were randomly partitioned into training and testing sets (70% and 30%, respectively) without overlapping. A decision-tree algorithm and multivariate logistic regression were performed to develop the models for predicting the cases based on their first 24 hours data. The predictive performance of the models was compared based on the area under the receiver operating characteristic curve (AUC), sensitivity, and accuracy of the models. Results: A 10-fold cross-validation decision-tree model predicted cases requiring intensive care with the AUC, accuracy, and sensitivity of 97%, 98%, and 94.74%, respectively. The same values in the machine-learning logistic regression model were 75%, 85.62%, and 55.26%, respectively. Creatinine, smoking, neutrophil/lymphocyte ratio, temperature, respiratory rate, partial thromboplastin time, white blood cell, Glasgow Coma Scale (GCS), dizziness, international normalized ratio, O2 saturation, C-reactive protein, diastolic blood pressure (DBP), and dry cough were the most important predictors. Conclusion: In an Iranian population, our decision-based machine-learning method offered an advantage over logistic regression for predicting patients requiring intensive care. This method can support clinicians in decision-making, using patients' early data, particularly in low- and middle-income countries where their resources are as limited as Iran. How to cite this article: Sabetian G, Azimi A, Kazemi A, Hoseini B, Asmarian N, Khaloo V, et al. Prediction of Patients with COVID-19 Requiring Intensive Care: A Cross-sectional Study based on Machine-learning Approach from Iran. Indian J Crit Care Med 2022;26(6):688-695. Ethics approval: This study was approved by the Ethical Committee of Shiraz University of Medical Sciences (IR.SUMS.REC.1399.018).

2.
Int J Clin Pract ; 2022: 1248325, 2022.
Article in English | MEDLINE | ID: covidwho-1891938

ABSTRACT

Background: Rhinocerebral mucormycosis is a serious invasive fungal infection that is one of the most aggressive and lethal of invasive mycoses. The coronavirus disease (COVID-19) has been linked to immune dysregulation, and patients with COVID-19 have been reported to be at risk for developing invasive fungal infections. This study is conducted to evaluate the concurrence of mucormycosis among COVID-19 patients. Methods: In this retrospective, cross-sectional study, hospital records of patients with mucormycosis, as well as COVID-19 admitted to Khalili Hospital, as the major referral center for functional endoscopic sinus surgery (FESS) in southern Iran, were collected. Demographic and clinical information was extracted and subsequently analyzed. Results: Among 59 mucormycosis patients undergoing FESS, 41 (69.5%) were during the COVID-19 pandemic, while 18 (30.5%) were during one year before the COVID-19 pandemic. The average age was 49.33 ± 20.52, and 64.4% had diabetes mellitus, while 62.7% had COVID-19. The most common presentation was periorbital edema (56.9%), followed by necrotic tissue (48.3%). Although the total number of cases increased during the COVID-19 period compared to the case before the pandemic, the overall pattern and features of the patients had no significant difference, except regarding a significant increase in the presentation of necrotic tissue and also the use of corticosteroids. Most cases developed mucormycosis two weeks after COVID-19. The overall mortality was 36.8%, which is not statistically associated with COVID-19. Conclusion: Even in the absence of comorbidities, physicians should be aware of the risk of secondary fungal infections in patients with COVID-19 who were treated with corticosteroids.


Subject(s)
COVID-19 , Mucormycosis , Case-Control Studies , Cross-Sectional Studies , Humans , Mucormycosis/drug therapy , Mucormycosis/epidemiology , Mucormycosis/surgery , Pandemics , Retrospective Studies
3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-331490

ABSTRACT

Objective: To evaluate the efficacy and side effects of each medication regime, a comparison was drawn between the administration of misoprostol with the combined use of misoprostol plus oxytocin and misoprostol plus methylergometrine for full expulsion of retained intrauterine tissues in patients who underwent a miscarriage. Design: randomized, double-blind, clinical trial Setting: gynecology and obstetrics clinic in Jahrom, Southern Iran Population: 90 patients with gestational age below 12 weeks and having undergone a recent miscarriage. Methods: They were randomly allocated into three groups after being screened for underlying diseases and coagulative blood disorders. For the first group, labeled as the control group, misoprostol was administered alone, while as, the combination of misoprostol plus methylergometrine and misoprostol plus oxytocin was prescribed for the second and third groups, respectively. Main Outcome Measures: Primary: Expulsion of retained products of conception;Secondary: Pain, Hemorrhage Results: Despite no significant statistical difference being observed in the expulsion of retained products of conception (RPOC)by the administration of misoprostol alone or with combined medical therapy of misoprostol with oxytocin or methylergometrine (P-value< 0.329), all of them showed a successful treatment. Additionally, the patients treated with misoprostol and oxytocin showed good results in expelling the RPOC(P=0.013);while as, those treated by misoprostol plus methylergometrine reported controlled pain and hemorrhage after an abortion (P=0.004). Conclusion: The course of medications viz. methylergometrine, oxytocin, and misoprostol indicated a successful outpatient treatment in patients that had experienced a miscarriage or an incomplete abortion. They are cost-effective and have shown lesser side effects.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321165

ABSTRACT

Background: In March 2020, the WHO declared the novel coronavirus (COVID-19) outbreak a global pandemic. Although the number of infected cases is increasing, information about its clinical characteristics in the Middle East, especially in Iran, a country which is considered to be one of the most important focal points of the disease in the world, is lacking. To date, there is no available literature on the clinical data on COVID-19 patients in Iran. Methods: : In this multicenter retrospective study, 113 hospitalized confirmed cases of COVID-19 admitted to university affiliated hospitals in Shiraz, Iran from February 20 to March 20 were entered in the study. Results: : The mean age was 53.75 years and 71 (62.8%) were males. The most common symptoms at onset were fatigue (75: 66.4%), cough (73: 64.6%), and fever (67: 59.3%). Laboratory data revealed significant correlation between lymphocyte count (P value= 0.003), partial thromboplastin time (P value= 0.000), international normalized ratio (P value= 0.000) with the severity of the disease. The most common abnormality in chest CT scans was ground-glass opacity (77: 93.9%), followed by consolidation (48: 58.5%). Our results revealed an overall 8% (9 out of 113 cases) mortality rate among patients, in which the majority was among patients admitted to the ICU (5: 55.6%). Conclusion: Evaluating the clinical data of COVID-19 patients and finding the source of infection and studying the behavior of the disease is crucial for understanding the pandemic.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321164

ABSTRACT

Background: Disease outbreak not only carries the risk of death to the public due to the infection, but it also can lead to unbearable psychological impact on the mental health of the individuals. This study aims to explore and evaluate the burden of psychological problems on the Iranian general population during the outbreak of COVID-19. Method: A cross-sectional web-based survey was conducted among the general population of Iran age 15 and above. Demographic variables, depression, and anxiety symptoms were evaluated using the Patient Health Questionnaire-9 and General Anxiety Disorder-7 questionnaires. Results: : Among the 8591 participants, the mean age was 34.37 (±11.25) years and 66.4% were female while 33.6% were male. Based on our results, 1295 (15.1%) and 1733 (20.1%) of the general population clinically significant depressive and anxiety symptoms respectively. Based on the demographic variables, female gender was associated with a higher risk for developing depression and anxiety symptoms, whereas getting information about the disease from medical journals and articles, being older, and being married were considered as associated protective factors. In terms of depression, being a healthcare worker was an associated risk factor. On the other hand, for anxiety, having higher education was a protective factor while a higher number of individuals in a household was considered as a risk factor. Conclusions: : This study identified a major mental health problem in the Iranian population during the time of the COVID-19 outbreak. Therefore, establishing a targeted mental health support program during the time of public emergencies, such as the disease outbreak, is advised.

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-321124

ABSTRACT

Background: The management of COVID-19 in organ transplant recipients is among the most imperative, yet less discussed, issues based on their immunocompromised status along with their vast post-transplant medication regimens. No conclusive study has been published to evaluate proper anti-viral and immunomodulator medications effect in treating COVID-19 patients to this date. Method: This retrospective study was conducted in Shiraz Transplant Hospital, Iran from March 2020 to May 2021 and included COVID-19 diagnosed patients based on SARS-CoV-2 RT-PCR positive test who had been hospitalized for at least 48 hours before enrolling in the study. Clinical and demographic information of patients, along with their treatment course and the medication used were evaluated and analyzed using multiple regression analysis. Results A total of 245 patients with a mean age of 49.59 years were included with a mortality rate of 8.16%. The administration of Remdesivir as an anti-viral drug (P-value˂0.001) and Tocilizumab as an immunomodulator drug (P-value < 0.001) could reduce the hospitalization period in the hospital and the intensive care unit, as well as the mortality rates significantly. Meanwhile, the patients treated with Lopinavir/Ritonavir experienced a lower chance of survival (OR < 1, P-value = 0.04). No significant difference was observed between various therapeutic regimens in clinical complications such as bacterial coinfections, cardiovascular and gastrointestinal adverse reactions, and liver or kidney dysfunctions. Conclusion The administration of Remdesivir as an anti-viral and Tocilizumab as an immunomodulatory drug in SOT recipients could be promising treatments of choice to manage COVID-19.

7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-321123

ABSTRACT

Background: With the ongoing coronavirus (COVID-19) pandemic, evaluating the incidence of infection in major health centers and assessing the employed protocols is necessary for the management of the disease. Aim Since Shiraz Transplant Center is one of the major transplant centers in Iran and the Middle East, this study was conducted to evaluate outcomes of the applied policies on COVID-19 disease detection and management. Methods During 4 months from March to June, patient's data diagnosed with the impression of COVID-19 were extracted and evaluated based on demographic and clinical features, along with the length of hospital stay and expenses. Findings: Our data demonstrated that a total of 190 individuals, with a median age of 58, were diagnosed with COVID-19 during the mentioned period. Among these, 21 patients had a positive PCR test and 56 patients had clinical symptoms in favor of COVID-19. Also, 113 (59%) patients were classified as mild based on clinical evidence and were treated on an outpatient basis. Furthermore, 81 out of 450 cases (18%) of the healthcare workers at our center had either PCR of clinical features in favor of COVID-19. The mortality rate of our study was 11% and diabetes mellitus, hypertension were considered risk factors for obtaining COVID-19 infection Conclusion Based on the reported data, our transplant center was able to provide early detection for COVID-19 and apply necessary treatment and prevention protocols to safeguard the patients under its coverage.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-320453

ABSTRACT

Introduction: Even though over a year has passed since the coronavirus 2019 (COVID-19) outbreak, our information regarding certain aspects of the disease, such as post-infection immunity is still very limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three subsequent surges. Method: The study population consisted of all HCWs in either public or private hospitals in Fars province, Southern Iran from 20 April 2020 up to 20 th February 2021. We calculated the rate of infection as the number of individuals with positive PCR tests divided by the cumulative number of person-days at risk. Poisson regression was utilized to calculate the adjusted rate ratio and estimated protection. Results: : During the study period, a total of 30,546 PCR tests were performed among HCWs, of which 13,749 HCWs were positive. Among a total of 141 diagnosed cases who experienced a second episode of COVID-19, 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection was observed. The daily rate of infection was 4.72 for previously infected HCWs, while 2.20 for HCWs without previous infection. The estimated protection against repeat infection after a previous SARS-CoV-2 infection was 94.8% (95% CI: 93.6-95.7). Conclusion: Re-positivity, relapse, and reinfection of SARS-CoV-2 are quite rare in the population of HCWs. Also, after a first episode of infection, estimated protection of 94.8% was achieved against repeat infections.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-320452

ABSTRACT

Objective: With the novel coronavirus pandemic, the impact on the healthcare system and workers cannot be overlooked. However, studies on the infection status of medical personnel are still lacking. It is imperative to ensure the safety of health-care workers (HCWs) not only to safeguard continuous patient care but also to ensure they do not transmit the virus, therefore evaluation infection rates in these groups are indicated. Methods: : Demographic and clinical data regarding infected cases among HCWs of Fars, Iran with positive SARS‐CoV‐2 PCR tests were obtained from 10th March to 16th May. Results: : Our data demonstrated a rate of 5.62% (273 out of 4854 cases) infection among HCW, with a mean age of 35 years and a dominance of female cases (146 cases: 53.5%). The majority of infected cases were among nurses (51.3%) while the most case infection rate (CIR) was among physicians (27 out of 842 performed test (3.2%)). Also, the highest rate of infection was in the emergency rooms (30.6%). Also, 35.5% of the patients were asymptomatic and the most frequent clinical features among symptomatic patients were myalgia (46%) and cough (45.5%). Although 5.5% were admitted to hospitals, there were no reports of ICU admission. Furthermore, 10.3% of the cases reported transmitting the infection to family and friends. Regarding safety precautions, 1.6% didn't wear masks and 18.7% didn't use gloves in work environments. Conclusion: HCWs are among the highest groups at risk of infection during the COVID-19 pandemic;therefore, analysis of the infection status of these groups is vital to maintain enough attention from the public, provide effective suggestions for government agencies and expanding protective measures is essential to decrease infection rates.

10.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-319800

ABSTRACT

Background: Although almost a year has passed since the Coronavirus disease 2019 (COVID-19) outbreak and promising reports of vaccines have been presented, we still have a long way until these measures are available for all. Furthermore, unsolved issues remained to choose appropriate corticosteroids treatment for COVID-19. We conducted a study to assess the effectiveness of methylprednisolone treatment versus dexamethasone for hospitalized COVID-19 patients. Method: In this prospective triple-blinded randomized controlled trial, we enrolled 86 hospitalized COVID-19 patients from August to November 2020, in Shiraz, Iran. Patients were randomly allocated into two groups to receive either methylprednisolone (2mg/kg/day) or dexamethasone (6mg/kg/day). Data was assessed based on a 9-point WHO ordinal scale extending from uninfected (point 0) to death (point 8). Results: There was no significant variation among the groups on the admission. However, the intervention group demonstrated significantly better clinical status compared to the control group at day 5 (4.02 vs. 5.21, P  = 0.002) and day 10 (2.90 vs. 4.71, P  = 0.001) of admission. There was also a significant difference in the overall mean score between the intervention group, and the control group, (3.909 vs. 4.873 respectively, P  = 0.004). The mean length of hospital stay was 7.43 ± 3.64 and 10.52 ± 5.47 days in the intervention and control groups, respectively ( P  = 0.015). The need for a ventilator was significantly lower in the intervention group than in the control group (18.2% vs 38.1% P  = 0.040). Conclusion: In the context of treating hospitalized hypoxic COVID-19 patients, methylprednisolone demonstrated better results compared to dexamethasone. Trial Registration: The trial was registered with IRCT.IR (08/04/2020-No. IRCT20200204046369N1).

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315841

ABSTRACT

Background: Given the limited number of beds in intensive care units, establishing a system that can predict the outcome in COVID19 positive patients based on imaging plays an important role in using resources efficiently. Therefor this study was conducted to design an optimal scoring system related to the severity of COVID19 cases for distinguishing severe from non-severe patients. Materials: and Methods: In this cross-sectional retrospective study, 82 patients with a definite diagnosis of COVID-19 infection, who had at least one chest CT scan in hospital course were enrolled.To assess the severity of pulmonary parenchymal involvement, we semi-quantitatively evaluated the extent and nature of abnormalities. The area of lung involvement was scored in three levels based on a 0-4 grading scale. Also, we established a 4-point scoring system for defining the nature of lung abnormalities. The two scores were multiplied by each other. A final radiologic severity score was determined after adding together the scores of all levels. Result: Of all cases, fifty-three (64.6%) were male with an average age of age 53.75. Among the patients in our study, 7 (8.5%) had severe disease and the mortality rate was 7.2%. The mean (±standard deviation) of the radiologic severity score was 34.3(±18.4) in the severe group and 11.3(±11.4) in the non-sever group. (P-value <0.05). Also, we found a significant reverse relationship between our severity score and O 2 saturation (P-value <0.05). Conclusion: The radiologic severity score demonstrated a significant correlation with the patients' mortality and severity of illness in COVID-19 patients.

12.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-309145

ABSTRACT

Although nearly a year has passed since the emerge of the SARS-CoV-2 virus, with it, a serious and novel pediatric condition called children's multisystem inflammatory syndrome (MIS-C) has subsequently emerged. In order to achieve a better understanding and management of the disease, documentation and reporting of atypical cases is justified, particularly with the growing number of children with inflammatory syndrome with clinical features simulating MIS during the ongoing COVID-19 pandemic. Based on similar reports from numerous countries with temporal relation to COVID-19 infection in the community, it is essential for general pediatricians to be on alert for such atypical presentations and early referral to tertiary care should be considered as appropriate. Here we four cases of Multisystem Inflammatory Syndrome (MIS) during the COVID-19 pandemic. Early diagnosis and treatment of patients meeting full or partial criteria for MIS are critical to preventing end-organ damage and other long-term complications, especially during times of public crisis and global health emergencies, such as the novel coronavirus pandemic.

13.
Health Sci Rep ; 5(1): e460, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1620136

ABSTRACT

BACKGROUND AND AIMS: Home quarantine and physical distancing at the time of coronavirus disease 2019 (COVID-19) had a severe effect on the mental health of the populations. Resilience has been reported previously to be a protective factor against anxiety, stress, and depression. This study evaluates the prevalence and severity of depression, anxiety, stress, and perceived stress and their relation with resilience associated with the COVID-19 pandemic among a sample of the general population in Southern Iran. METHODS: In this cross-sectional web-based survey, from April 12 to May 13, 2020, stress, anxiety, depression, perceived stress, and resilience were measured using the Persian version of Depression Anxiety and Stress Scale (DASS-21), Perceived Stress Scale (PSS-14), and Connor-Davidson Resilience Scale (CD-RISC). Statistical analyses were carried out using the IBM Statistical Package for Social Sciences. Mean ± standard deviation (SD) and frequencies were used to describe demographic data. Independent sample t-test, Spearman correlation, and the Pearson correlation coefficient were performed to examine anxiety, depression, stress, and resilience. RESULTS: Among a total of 538 participants, the overall prevalence of moderate-to-extremely severe depression, anxiety, and stress was found to be 26.1%, 33.2%, and 5.8%, respectively. The overall median PSS and resilience score were 30 and 70, respectively. There was a significant association between higher age and perceived stress. Male and high income were related to higher resilience scores. Perceived stress positively correlates with resilience, whereas depression significantly correlates with anxiety and stress. Individuals with underlying disease demonstrated significantly higher scores for depression and anxiety. Also, perceived stress had a significant but weak, positive correlation with age and the number of quarantine days. CONCLUSION: The occurring COVID-19 pandemic could be the culprit of psychological distress, anxiety, and depression of large population quantities. Our results showed a subordinate overall resilience in the general Iranian population during the COVID-19 pandemic.

14.
BMC Pediatr ; 21(1): 531, 2021 11 30.
Article in English | MEDLINE | ID: covidwho-1546765

ABSTRACT

BACKGROUND: With the ongoing coronavirus disease (COVID-19) pandemic, along with the development of new mutations of the virus and an increase in the number of cases among pediatrics, physicians should be aware and alerted on the atypical presentations of the disease, especially in less expected individuals. CASE PRESENTATION: Here we present a 12-year-old obese boy (BMI = 37.5 kg/m2) who presented with empyema, which was following SARS-CoV-2 infection. The patient had no history of fever. Due to the onset of dyspnea, a chest tube was inserted for him which was later altered to a pleural drainage needle catheter. CONCLUSION: Our case is the first report of COVID-19 presenting as empyema among pediatrics. Pleural empyema should be considered as a rare complication of COVID-19. Since there is still no guideline in the management of empyema in the context of COVID-19, delay in diagnosis and intervention may cause morbidity and mortality in children.


Subject(s)
COVID-19 , Empyema, Pleural , Pediatrics , Child , Empyema, Pleural/diagnosis , Empyema, Pleural/etiology , Empyema, Pleural/therapy , Humans , Male , Obesity , SARS-CoV-2
15.
Virol J ; 18(1): 228, 2021 11 22.
Article in English | MEDLINE | ID: covidwho-1528686

ABSTRACT

BACKGROUND: The management of COVID-19 in organ transplant recipients is among the most imperative, yet less discussed, issues based on their immunocompromised status along with their vast post-transplant medication regimens. No conclusive study has been published to evaluate proper anti-viral and immunomodulator medications effect in treating COVID-19 patients to this date. METHOD: This retrospective study was conducted in Shiraz Transplant Hospital, Iran from March 2020 to May 2021 and included COVID-19 diagnosed patients based on SARS-CoV-2 RT-PCR positive test who had been hospitalized for at least 48 h before enrolling in the study. Clinical and demographic information of patients, along with their treatment course and the medication used were evaluated and analyzed using multiple regression analysis. RESULTS: A total of 245 patients with a mean age of 49.59 years were included with a mortality rate of 8.16%. The administration of Remdesivir as an anti-viral drug (P value < 0.001) and Tocilizumab as an immunomodulator drug (P value < 0.001) could reduce the hospitalization period in the hospital and the intensive care unit, as well as the mortality rates significantly. Meanwhile, the patients treated with Lopinavir/Ritonavir experienced a lower chance of survival (OR < 1, P value = 0.04). No significant difference was observed between various therapeutic regimens in clinical complications such as bacterial coinfections, cardiovascular and gastrointestinal adverse reactions, and liver or kidney dysfunctions. CONCLUSION: The administration of Remdesivir as an anti-viral and Tocilizumab as an immunomodulatory drug in solid-organ transplant recipients could be promising treatments of choice to manage COVID-19.


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Antibodies, Monoclonal, Humanized/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/drug therapy , Immunologic Factors/therapeutic use , SARS-CoV-2/isolation & purification , Transplant Recipients , Adenosine Monophosphate/therapeutic use , Aged , Alanine/therapeutic use , COVID-19/diagnosis , COVID-19/mortality , COVID-19 Nucleic Acid Testing , COVID-19 Testing , Female , Humans , Iran/epidemiology , Length of Stay , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/genetics
16.
Case Rep Pediatr ; 2021: 9950588, 2021.
Article in English | MEDLINE | ID: covidwho-1463066

ABSTRACT

BACKGROUND: Although Kawasaki disease (KD) is the most common self-limited systemic vasculitis in pediatrics, the exact etiology of the disease, its association with other diseases, and pathogens is still unknown. In order to achieve a better understanding and management of the disease, documentation and reporting of atypical cases is justified, particularly with the growing number of children with inflammatory syndrome with clinical features simulating KD during the COVID-19 pandemic. Here, we present a case of an atypical case of KD presenting as multisystem inflammatory syndrome (MIS) during the COVID-19 pandemic. Case Presentation. The patient is a 7-year-old girl who developed fever (39°C) and erythematous multiform rash on the abdomen and along with erythema and edema on the extremities. Laboratory evaluation revealed neutrophilia and lymphopenia along with elevated C-reactive protein, erythrocyte sedimentation rate, troponin, lactate dehydrogenase, ferritin, and D-dimer. Although the patient did not fulfill the KD criteria, based on approved guidelines and approaches regarding atypical KD and multisystem inflammatory syndrome in children (MIS-C) during the COVID-19 pandemic, intravenous immunoglobulin along with aspirin was administered for the patients. The patient's symptoms resolved with an uneventful postdischarge course. CONCLUSION: Early diagnosis and treatment of patients meeting full or partial criteria for KD are critical to preventing end-organ damage and other long-term complications, especially during times of public crisis and global health emergencies, such as the novel coronavirus pandemic.

18.
BMC Infect Dis ; 21(1): 337, 2021 04 10.
Article in English | MEDLINE | ID: covidwho-1175297

ABSTRACT

BACKGROUND: Although almost a year has passed since the Coronavirus disease 2019 (COVID-19) outbreak and promising reports of vaccines have been presented, we still have a long way until these measures are available for all. Furthermore, the most appropriate corticosteroid and dose in the treatment of COVID-19 have remained uncertain. We conducted a study to assess the effectiveness of methylprednisolone treatment versus dexamethasone for hospitalized COVID-19 patients. METHODS: In this prospective triple-blinded randomized controlled trial, we enrolled 86 hospitalized COVID-19 patients from August to November 2020, in Shiraz, Iran. The patients were randomly allocated into two groups to receive either methylprednisolone (2 mg/kg/day; intervention group) or dexamethasone (6 mg/day; control group). Data were assessed based on a 9-point WHO ordinal scale extending from uninfected (point 0) to death (point 8). RESULTS: There were no significant differences between the groups on admission. However, the intervention group demonstrated significantly better clinical status compared to the control group at day 5 (4.02 vs. 5.21, p = 0.002) and day 10 (2.90 vs. 4.71, p = 0.001) of admission. There was also a significant difference in the overall mean score between the intervention group and the control group, (3.909 vs. 4.873 respectively, p = 0.004). The mean length of hospital stay was 7.43 ± 3.64 and 10.52 ± 5.47 days in the intervention and control groups, respectively (p = 0.015). The need for a ventilator was significantly lower in the intervention group than in the control group (18.2% vs 38.1% p = 0.040). CONCLUSION: In hospitalized hypoxic COVID-19 patients, methylprednisolone demonstrated better results compared to dexamethasone. TRIAL REGISTRATION: The trial was registered with IRCT.IR (08/04/2020-No. IRCT20200204046369N1 ).


Subject(s)
COVID-19/drug therapy , Dexamethasone/therapeutic use , Methylprednisolone/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Female , Hospitalization , Humans , Iran , Length of Stay , Male , Middle Aged , Prospective Studies , Respiration, Artificial , Treatment Outcome
19.
Biomed Res Int ; 2021: 5555316, 2021.
Article in English | MEDLINE | ID: covidwho-1156025

ABSTRACT

INTRODUCTION: Burning mouth syndrome (BMS) is one of the challenging clinical problems not only in its diagnosis and treatment but also its concurring mental impact. This study is aimed at determining the association between psychological factors, including emotional stress, depression, anxiety, and sleep pattern among BMS patients. METHODS: In this cross-sectional study, 19 patients with idiopathic BMS were enrolled along with a control group equivalent in age and sex, but without BMS. Questionnaires used were the Visual Analog Scale (VAS), the Pittsburgh Sleep Quality Index (PSQI), and the Depression, Anxiety, and Stress Scale (DASS-21). Demographic information was also recorded and analyzed. RESULTS: There was a significant correlation among the two groups of BMS and non-BMS patients regarding stress, depression, and sleep disorder. The average severity of the burning score was 8.31 among the patients. Furthermore, a significant correlation was observed among mental disorders and educational level and sex, but not with age. There was also no significant correlation among the severity of the burning score with sex, education, and mental disorder. CONCLUSION: BMS is significantly associated with psychological symptoms. This condition requires proper treatment and support because it can represent psychological or mental issues and/or have a significant effect on daily life.


Subject(s)
Burning Mouth Syndrome , Depression , Pain Measurement , Psychological Distress , Sleep Wake Disorders , Surveys and Questionnaires , Burning Mouth Syndrome/etiology , Burning Mouth Syndrome/physiopathology , Depression/complications , Depression/physiopathology , Female , Humans , Male , Middle Aged , Sleep Wake Disorders/complications , Sleep Wake Disorders/physiopathology
20.
Virol J ; 18(1): 58, 2021 03 17.
Article in English | MEDLINE | ID: covidwho-1140494

ABSTRACT

OBJECTIVE: With the novel coronavirus pandemic, the impact on the healthcare system and workers cannot be overlooked. However, studies on the infection status of medical personnel are still lacking. It is imperative to ensure the safety of health-care workers (HCWs) not only to safeguard continuous patient care but also to ensure they do not transmit the virus, therefore evaluation of infection rates in these groups are indicated. METHODS: Demographic and clinical data regarding infected cases among HCWs of Fars, Iran with positive SARS-CoV-2 PCR tests were obtained from 10th March to 17th May 2020. RESULTS: Our data demonstrated a rate of 5.62% (273 out of 4854 cases) infection among HCW, with a mean age of 35 years and a dominance of female cases (146 cases: 53.5%). The majority of infected cases were among nurses (51.3%), while the most case infection rate (CIR) was among physicians (27 positive cases out of 842 performed test (3.2%)). Also, the highest rate of infection was in the emergency rooms (30.6%). Also, 35.5% of the patients were asymptomatic and the most frequent clinical features among symptomatic patients were myalgia (46%) and cough (45.5%). Although 5.5% were admitted to hospitals, there were no reports of ICU admission. Furthermore, 10.3% of the cases reported transmitting the infection to family and friends. Regarding safety precautions, 1.6% didn't wear masks and 18.7% didn't use gloves in work environments. CONCLUSION: HCWs are among the highest groups at risk of infection during the COVID-19 pandemic; therefore, evaluating infection rates and associated features is necessary to improve and adjust protective measures of these vulnerable, yet highly essential group.


Subject(s)
COVID-19/epidemiology , Health Personnel/statistics & numerical data , Adult , Aged , Asymptomatic Infections/epidemiology , COVID-19/diagnosis , COVID-19/transmission , Cross-Sectional Studies , Female , Hospitalization/statistics & numerical data , Humans , Incidence , Iran/epidemiology , Male , Middle Aged , Personal Protective Equipment/statistics & numerical data , SARS-CoV-2 , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL