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Background: Of all teenage deaths caused by coronavirus disease 2019 (COVID-19), 47% occurred in children aged 0-9. Like many other infectious diseases, reducing mortality in children requires widespread vaccination. Despite the availability of the COVID-19 vaccine, a large percentage of children have not received the vaccine. Objective(s): This survey aimed to study parents' reluctance to receive the COVID-19 vaccine for their children in Shiraz, Iran. Method(s): An online questionnaire was sent to parents whose 5 to 11-year-old children had received no COVID-9 vaccine through the health educators of primary schools in Shiraz, Iran. The questionnaire contained demographic questions and 16 beliefs about COVID-19 vaccination that were answered as yes/no. Result(s): We assessed 1093 respondents, including 49.5% (n = 542) male and 50.5% female students' parents. The mean number of wrong beliefs was 7.21 +/- 2.80 in parents who had boys and 7.78 +/- 2.95 in girls' parents. Also, 78.6% of participants had at least five wrong beliefs or excuses for not vaccinating their children. Notably, 82.8% of mothers and 84.3% of fathers were vaccinated with 2-3 doses against COVID-19. The most common wrong beliefs were probable vaccines' side effects in the future, the undesirable effect of vaccination on children's growth, and the awful effect of the vaccine on fertility, with a prevalence of 82.7%, 81.2%, and 76.7%, respectively. Conclusion(s): This study identified that most participants believed that COVID-19 vaccines have side effects for their children and unfavorable effects on children's growth and infertility.Copyright © 2023, Author(s).
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Background: Serological studies can demonstrate pathogen circulation in regional populations and reflect public health mea-sures' effectiveness during different pandemic phases. By late November 2021, coinciding with the third pandemic wave, the sero-prevalence of SARS-CoV-2 spike IgG antibodies among the Iranian population was 32.63%. Objective(s): This study aimed to assess the Iranian population's seroprevalence during the fifth pandemic wave by analyzing donated blood samples. Method(s): This population-based cross-sectional study was conducted on Iranian blood donors referred to all 31 main provincial capitals between August 2021 and September 2021. The participants selected through quota sampling were asked to complete a questionnaire on socio-demographics and coronavirus disease 2019 (COVID-19)-related information. Also, SARS-CoV-2 spike IgG antibodies were measured in serum samples using SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) kits. The seroprevalence was weighted based on the gender and age groups of the population and then adjusted for test performance. Result(s): Totally 3,339 blood donors participated in this study. The overall population-weighted seroprevalence adjusted for test performance was 52.67% (95% confidence interval (CI): 50.14-55.21). Seroprevalence was higher among participants with a high school diploma (55.45%, 95% CI 50.61-60.29), a positive history of close contact with COVID-19 patients (65.23%, 95% CI 60.83-69.63), and previous positive COVID-19 PCR tests (86.51%, 95% CI 82.32-90.7). Conclusion(s): More than half of the study population was exposed to SARS-CoV-2, indicating a 1.7-fold increase in the seroprevalence between late November 2020 and mid-September 2021. Our finding illuminated the pattern of Iran's fifth wave of the pandemic.Copyright © 2023, Author(s).
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Objective: Suicide is one of the leading causes of death in the world. The present research aimed to investigate the moderating role of thwarted belongingness, perceived burdensomeness, and suicidal capability in suicidal ideation, behavior, and attempts among the Iranian population. Method(s): The data were analyzed using cross-sectional regression models. The population of this study included 600 students of the University of Mohaghegh Ardabili. The tools used to collect the data in this study were the Patient Health Questionnaire-2, the Depressive Symptom Index-Suicidality Subscale (DSI-SS), the Suicide Attempt Questionnaire, the Interpersonal Needs Questionnaire (IPTS), the Suicide Capacity Scale-3, the Adverse Childhood Experiences, the Generalized Anxiety Disorder Questionnaire, and the Suicidal Behaviors Questionnaire-Revised. Result(s): The results of this study showed that there was an interaction between thwarted belongingness and perceived burdensomeness in suicidal behavior and DSI-SS. The results also showed that the acquired and practical capability subscales (suicidal capability) strengthen the relationship between suicidal behavior and the DSI-SS, on the one hand, and suicide attempt, on the other hand. Conclusion(s): The findings of the study showed that the interpersonal theory of suicide can pave the way to prevent suicidal ideation and behavior in Iranian society, and it is recommended that Iranian practitioners apply the theory in practice.Copyright © 2022 Yerkure Tanitim ve Yayincilik Hizmetleri A.S.. All rights reserved.
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Background: The outbreak of coronavirus disease 2019 (COVID-19) has caused stress and anxiety for various parts of society all over the world. This concern and stress are not limited to being affected by COVID-19 because this condition has also caused changes in people's lifestyles. Objective(s): The purpose of this study was to design and evaluate the validity and reliability of the COVID-19-related stressors questionnaire and determine the contribution of each of the stressors to the prediction of mental health in the Iranian population. Method(s): This descriptive-analytical and correlational study was performed on 301 volunteers living in Tehran, Iran. Due to the prevalence of COVID-19, questionnaires were distributed by convenience sampling method and online conduction. The instruments used in the present study were the researcher-made questionnaire on Iranians' COVID-19-related stressors (ICRS) and the mental health questionnaire general health questionnaire (GHQ-12). Content validity (qualitative and quantitative), face validity, structural validity (exploratory factor analysis), Cronbach's alpha, and logistic regression were used to analyze the data. Statistical analysis was performed by SPSS version 24 and AMOS24 software. Result(s): In exploratory factor analysis, the final 25 items were obtained in seven factors with an explanation of 66.25% variance. The results of logistic regression analysis showed that worrying about changing economic status, getting COVID-19 and change in lifestyle increased the chance of developing mental health disorder up to 1.29 (OR = 1.29), 1.28 (OR = 1.28), and 1.18 times (OR = 1.18), respectively. The variable of changing family interactions reduces the chance of developing a mental health disorder by 0.85 times (OR = 0.85). Conclusion(s): The COVID-19-related stressors questionnaire is valid and can be used in future research. Identifying the most im-portant stressors associated with the COVID-19 pandemic and determining each contribution to mental health prediction will help health policymakers to make better decisions.Copyright © 2023, Author(s).
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Introduction: It seems that Multiple sclerosis (MS) patients are at the higher risk for COVID-19 implications due to the use of immunomodulatory or immunosuppressive treatments. Obesity as a risk factor may lead to more adverse consequences. Relationship between obesity and COVID-19 risk and outcome in Iranian MS patients still remains unclear. We aimed to investigate the impact of BMI as a modifiable risk factors on the risk and outcomes of COVID-19 in Iranian patients with MS. Material(s) and Method(s): A cross-sectional study was conducted in the Sina hospital, Tehran, Iran. MS patients were asked to complete an online questionnaire in the google form format. Demographic information, clinical data consisting of MS disease-related factors, COVID-19-related factors, and anthropometric information were collected. In total, 492 patients were filled the questionnaire. BMI was categorized considering WHO's standard classification as underweight (BMI<18.5), normal weight (BMI>=18.5 and <25), overweight (BMI>=25 and <30), obesity type I (BMI>=30 and <35), and obesity type II (BMI>=35) (3). Result(s): The mean age was 36.7+/-8.2 and 395(80.3%) of them were women. 350(71.1%) of participants were suffered from RRMS. The most received MS drugs was Rituximab (36.0%). The mean BMI was 24.3+/-4.5 kg/m2. 234(47.6%) participants reported COVID-19 infection during the pandemic. 465(94.5%) of them were two doses vaccinated and 15(3%) of them were one-dose vaccinated. The odds ratio of COVID-19 infection was significantly 4.41 times more than the normal group in the type 2 obesity category (OR:5.41;95%CI:1.00-29.09) in the fully adjusted regression model. COVID-19 severity was significantly different in BMI groups (P:0.02), So that 11(8.6%) patients in normal weight group and 4(50%) of patients in type II obesity group were hospitalized due to COVID-19 infection. Respiratory symptoms (P:0.05) and gastrointestinal symptoms (P<0.01) were more prevalent among types I and II of obesity. On the other hand, no one in the obesity type I and II reported COVID-19 infection without any symptoms (P:0.04). Conclusion(s): The results of current study support that obesity could play a key role in susceptibility to COVID-19 infection and symptoms severity in MS patients. One of the issues that emerge from these findings is recommended that neurologists pay more attention on patients' BMI during this pandemic.Copyright © 2022
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Background: Tuberculosis (TB) is considered one of the most infectious diseases in the world. In this study, we intended to examine the epidemiology of tuberculosis by MIRU-VNTR to define the changes that occur in the transmission of tuberculosis in the region during the COVID-19 era. A total of 120 Mycobacterium tuberculosis isolates were collected from sputum samples of patients referred to East Azerbaijan Center TB from December 2020 to August 2021. Demographic information such as age, sex, place of birth, previous TB history, and relevant medical data was collected. The proportion method was performed for drug susceptibility testing, and the PCR-based MIRU-VNTR method was applied to identify molecular epidemiology relationships. Result(s): The isolates were collected from 78 male (65%) and 39 female (32.5%) Iranian patients and 3 (2.5%) Azerbaijani patients. Ninety-three distinct patterns were identified including 15 clustered patterns and 36 unique patterns. The largest cluster was composed of seven isolates. Furthermore, one cluster with 5 members, four clusters with 3 members, and nine clusters with 2 members. In MIRU-VNTR typing, 75 clusters belonged to the Tabriz region and just 3 to the Republic of Azerbaijan. All isolates were sensitive to rifampin, isoniazid, and ethambutol. Conclusion(s): Results of the current study showed COVID-19 pandemic had a direct effect on the transmission and diagnosis of tuberculosis. Less diagnosis and less clustering can indicate public controls and hygiene, and the use of masks had a direct effect on the transmission and diagnosis of tuberculosis. However, misidentification and less focus on other respiratory infections are expected during the pandemic. Studies on the co-infection of COVID-19 and tuberculosis and the role of mask and sanitization against TB are strongly recommended. Copyright © 2023, The Author(s).
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Background: Rumors concerning various aspects of the fight against COVID-19, vaccination, in particular, have become one of the main challenges for managers and policymakers who have to deal with different aspects of the disease. This necessitates the recognition of the factors that influence the prevention and spread of these rumors. Objective(s): The current study aimed to investigate the link between health literacy among adults and their acceptance of COVID-19 vaccination rumors in Iran. Method(s): This cross-sectional study was conducted from November 15 to December 15, 2021, in different provinces of Iran. The study population included Iranian adults, aged 18 years and older, who were selected using the snowball sampling method. The data collection tools involved two questionnaires: the Health Literacy Questionnaire, which consists of 33 items, and the COVID-19 Vaccine Rumor Questionnaire which assesses 17 rumors related to COVID-19 vaccination collected from various news sources. Result(s): The number of completed questionnaires was 1158 out of 2163 questionnaire visits (74% response rate). Univariate analysis showed that health literacy had a statistically significant association with sociodemographic variables of gender, marital status, ethnicity, place of residence, and level of education. The results of data analysis also demonstrated a significant correlation between the average of rumors' acceptance and the sociodemographic variables of gender, marital status, ethnicity, place of residence, and level of education. The results of the Pearson correlation coefficient test showed a significant and negative relationship between health literacy and rumor belief (P= 0.000, r=-0.590), indicating that those with a higher level of health literacy had a lower level of rumor acceptance. Conclusion(s): Based on the findings of the present study, health literacy has a significant effect on reducing the credibility of rumors and other misinformation among community members. Macro-level decisions and policies are needed to improve factors such as health literacy and can help individuals identify and track rumors and make decisions based on reliable information on vaccination. Copyright © 2022, Author(s).
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Background: Now that the majority of the population has been immunized with two-dose vaccines, debates over the third booster dose have been raised. We studied the viewpoint of cases with multiple sclerosis (MS) on this matter. Method(s): In a cross-sectional study, a google form containing questions about participants' characteristics, the history of coronavirus disease 2019 (COVID-19) infection and vaccination, and opinions on the third dose was designed. Result(s): Of 1067 responders, only 16 (1.5%) were not vaccinated at all. The most used vaccine type was Sinopharm BBIBP COVID-19 vaccine (BBIBP-CorV) (n = 1002, 93.9%). Generally, 58 (5.4%) cases were hospitalized due to COVID-19. Of those with full vaccination, 134 (13.3%) got COVID-19 infection after the second dose. Only 13 participants (1%) did not agree with the third dose, while 564 (53.0%) believed that a booster dose was needed. Of all, 488 (45.7%) declared that they did not have a final idea and would follow the instructions by the experts. A significant association was found between not receiving the first two doses and not believing in the third dose (P = 0.001). 692 patients declared their reasoning for the importance of the third dose. All the cases who thought the administered vaccine was not efficient enough had received Sinopharm BBIBP-CorV. Those who got infected after full vaccination were more uncertain about the efficacy of the vaccine [odds ratio (OR): 2.6, 95% confidence interval (CI): 1.6-4.2]. Conclusion(s): It seems that the majority of the Iranian patients with MS expect the authorities to administer a third booster dose, especially if scientifically validated. Copyright © 2022 Iranian Neurological Association, and Tehran University of Medical Sciences Published by Tehran University of Medical Sciences.
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Background: Despite all of the research on the risk factors for severe COVID-19, there are still many unknowns about the course of COVID-19 in various populations. Inevitable exposure of dialysis patients, one of the more vulnerable groups for infectious diseases, to COVID-19 concerns many researchers. Furthermore, studies on the mortality rate and risk factors regarding dialysis patients are somewhat inconsistent. Also, it has been suggested that factors such as ethnicity can contribute to that matter. Objectives: We aimed to evaluate the mortality rate of dialysis patients who contracted COVID-19 in the Iranian population. Methods: In this cross-sectional study, we presented the experiences of 4 dialysis centers with a total of 309 dialysis patients (Tehran, Iran) during the COVID-19 pandemic to assess the mortality rate and associated risk factors. Results: Among 309 dialysis patients, 58 patients contracted the disease, and the total mortality rate in this study was 41%. It was observed that although the guidelines for screening patients were similar in these 4 centers, the centers with regular COVID-19 screening for staff members had much lower mortality and infection rate. The most common symptoms in patients were fever, dry cough, and chills. Furthermore, comorbidities such as diabetes can also increase the risk of mortality. Conclusions: This study, along with other studies, can be utilized in developing guidelines for dialysis centers in the COVID-19 pandemic and future pandemics.
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Background: The first COVID-19 case was reported in December 2019 in China. The number of infected cases increased rapidly, and COVID-19 became a public health issue worldwide. The high transmission rate and global spreading of COVID-19 caused public anxiety and may lead to unfavorable effects on psychological health. Objectives: This study evaluated the COVID-19 impact on the public anxiety, knowledge, and behavior of Iranians. Methods: We used a web-based cross-sectional survey and collected data from 1627 volunteers. Demographic information, anxiety self-reporting, Generalized Anxiety Disorder 7-Item Scale (GAD-7), and COVID-19–related knowledge were evaluated. Results: Among the participants, the dominant GAD-7 score was mild, and the self-reporting level of anxiety was 5.28/10. Women and younger people reported higher anxiety than men and older groups. Further, 69.76% of participants had good knowledge, and among them, the level of education had a positive effect on knowledge, while sex and age did not have any effect. Social media and applications were the most common source of information. Conclusions: Our study showed that Iranians’ anxiety was at the medium level, and their high knowledge level about COVID-19 could affect this reduction;however, we should not ignore that less anxiety makes the matter less essential.
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Complications are increasingly recognized with SARS-CoV-2, the causative pathogen for COVID-19. Various mechanisms have been proposed to justify the cause of seizures in Covid-19 patients. To our knowledge, 13 cases of status epilepticus (SE) associated with COVID-19 have been reported so far. Here, we present a single-center case series, including the clinical, laboratory, and imaging characteristics, and the EEG and the outcome of SE in 5 Iranian patients with laboratory-confirmed SARS-CoV-2 virus. SE was para-infectious in four patients and post-infectious in one other patient. In Three patients, the causes of seizure were included severe hyponatremia, acute ischemic stroke, and meningoencephalitis. However, in two other patients, no specific reason for seizure was found, but there are possibilities for lesser-known mechanisms of Covid-19 that play roles in developing SE. Two of the patients recovered, and three patients, older and with higher comorbidities, failed to recover and died.
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Background: Frequent waves of corona virus disease (COVID-19) and lack of specific drugs against that, warrant studies to reduce the morbidity and mortality of this pandemic disease. In this study, we investigated the association between influenza vaccination and the severity and outcome of COVID-19 disease in Iranian patients living in the North. Methods: This retrospective case-control study was performed on186 patients with COVID-19 infection between March and April, 2020. Patients with positive PCR were divided into two groups of case and control;Patients with moderate to severe and normal to mild lung involvement, respectively. The lung opacities in all of the 5 lobes were evaluated on chest CT images using a CT severity scoring system. The history of influenza vaccination during the fall of 2019-2020 was determined by a phone call. Statistical analysis was done using the chi-square test, student’s t-test, and logistic regression. The significance level was p<0.05. Results: The mean age of patients was 54.67±15.05years. Most patients had pulmonary manifestations including ground-glass opacity (57%), consolidation (80%) and pleural effusion (3.2%). Adjusting for age, gender, and history of underlying disease, vaccination is an effective factor in the severity of pulmonary involvement (AOR=0.39;95%CI: (0.21, 0.73);P=0.003). Furthermore, the chance of ICU admission decreased via influenza vaccination (OR=0.21, P=0.001). Conclusion: The results showed that the severity of COVID-19 pulmonary involvement and outcome as ICU admission, and severe symptoms in patients with history of influenza vaccination were significantly lower than those without history of vaccination. This strategy can be used to prevent and reduce the complications of COVID-19.
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Background: A novel Coronavirus first emerging in Wuhan, China, was named severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 is known as Coronavirus disease 2019 (COVID-19). HIV-1 infected individuals may be at risk of COVID-19. Objectives: This cross-sectional study evaluated the SARS-CoV-2 infection rate and COVID-19 prevalence among Iranian HIV-1-infected people. Methods: The study was conducted on 155 HIV-1-infected patients from June 2020 to October 2020. COVID-19 Ab (IgG) was detected using an enzyme immunoassay in serum specimens. Furthermore, nasopharyngeal and oropharyngeal specimens were collected. Then, the genomic RNA of SARS-CoV-2 was detected using a real-time polymerase chain reaction (RT-PCR). Clinical symptoms of the studied participants with and without COVID-19 were examined. Results: Of 155 HIV-1-infected individuals, 12 (7.7%) had positive real-time PCR results for SARS-CoV-2. Out of 12 (7.7%) patients with COVID-19, four (33.3%) were males. Anti-COVID Ab (IgG) was detected in 10 (6.5%) participants, of whom eight (80.0%) were males. The most common COVID-19 clinical symptoms, including dry cough, fever, runny nose, anosmia, and hypogeusia, were observed in seven (58.3%), five (41.7%), five (41.7%), five (41.7%), and five (41.7%) patients with COVID-19, respectively. Conclusions: A recent study has shown that the risk of SARS-CoV-2 infection in HIV-infected individuals is similar to that in the general population.
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In order to provide the optimal respiratory protection for the users;particularly, the frontline healthcare workers (HCWs) while performing the aerosol-generating procedures (AGPs), it is required to conduct fit testing during the COVID-19 pandemic. A total of 90 HCWs (35 males and 55 females) of were participated in the study voluntarily. All participants were randomly allocated into six available filtering face-piece respirators (FFRs) with two kinds of styles (cup-shaped and flat-fold). Then, they underwent quantitative fit testing (QNFT) using the TSI PortaCount® respirator fit tester and qualitative fit testing (QLFT) procedures using the Moldex® Bitrex® fit test kit. The outcomes were the qualitative fit factors (QLFFs=100) and quantitative fit factors (QNFFs≥100). The overall passing rates of the QLFT and QNFT procedures were %35.17 and %29.33. One imported and domestic respirators had highest proportions of the QLFF (%48 and %45) and QNFF (%43 and 38%) and QNFF values of all. Furthermore, the mean FFs for the mentioned respirators were 120 and 103, respectively. Moreover, no significant difference was found between the whether females and males or between imported and domestic respirators by the passing rates (p>0.05). Overall, the passing rates obtained from both QNFT and QLFT procedures were low. One reason could be due to all studied respirators only came in one size or style. An optimal fit test panel should also be developed for the Iranian people to determine the appropriate face sizes and shapes in order to select the well-fitting respirator. Besides, the manufacturers are required make the respirators w
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Background: It seems that transplant recipients are at high risk for severe COVID-19, especially in the presence of comorbidities and immunosuppression. This study aimed to determine the effects of previous treatment with immunosuppressants and received dosage and the risk of COVID-19 severity and mortality in liver transplant recipients in various post-transplantation phases in the Iranian population. Methods: This was a cross-sectional study conducted among 24 patients in the post liver transplant course, who were referred to two transplant centers (Imam Reza and Montaseriyeh hospitals) affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, during 2020-2021. The demographic and clinical characteristics of the patients were recorded in a checklist, and the relation-ships between various variables were analyzed. Results: The majority of the post liver transplant patients (96%) were in the late phase of post-trans-plantation, and 8.3% of the cases expired. COVID-19 severity and mortality did not show a significant relationship with previous treatment with immunosuppressants and received dosage (P>0.05). In addition, there was no relationship between the symptoms of COVID-19 and immunosuppres-sant dosages, except for a headache. No significant correlation was found between immunosuppres-sants dosage and laboratory findings, and only prednisolone dosage was found to be correlated with heart rate (r=-0.62, P=0.03), BUN (r=-0.84, P=0.002), and D-dimer (r=-0.72, P=0.01). Conclusion: Severe SARS-CoV-2 infection was reported in the majority of liver transplant recipi-ents. The severity of COVID-19 was not related to previous treatment with immunosuppressants and received dosage.
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Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a new strain of RNA viruses causes coronavirus disease in human. Though some studies suggested different blood group types as risk factors for Coronavirus Disease 2019 (COVID-19) infection, the association between blood groups and the COVID-19 infection may not be the same in various societies with different genetic statuses. Also, no studies so far have investigated the relationship between COVID-19 severity and ABO blood groups in Iran and developing countries according to the World Health Organisation (WHO) criteria. Aim: To evaluate the association between blood types and the severity of COVID-19 infection. Materials and Methods: This cross-sectional study enrolled 171 patients infected with SARS-CoV-2 {49 severe (severe or critical) and 122 non severe (mild to moderate)}, who were admitted to hospitals of Mazandaran University of Medical Sciences, Sari, Iran from April 2020 to June 2020. To evaluate the distribution of the blood group, 171 COVID-19 patients were compared with the reported data of Iranian population blood groups. The severity of COVID-19 infection was determined based on WHO criteria including clinical symptoms, radiological findings, and signs of organ dysfunction. The associations between ABO blood groups and the severity of COVID-19, were evaluated using Pearson's Chi-square. Results: The distribution of the blood group in 171 patients with COVID-19 was not different compared to the reported general Iranian population blood group (p-value=0.344). Evaluation of the association between ABO blood groups and the severity of COVID-19 showed that patients with blood group type B developed severe COVID-19 infection compared to other blood types who showed mild or moderate conditions (p-value=0.048). Mortality due to COVID-19 was not statistically different between the ABO blood group and Rh (p-value=0.96, p-value=0.27 respectively), but the frequency of patients with Rh-negative that needed intubation and mechanical ventilation was higher compared to Rh-positive patients (p-value=0.003). Conclusion: A positive correlation was found between blood type B and COVID-19 severity. Also, mechanical ventilation was significantly more in Rh-negative patients.