Does the plasma vitamin D level affect the severity of infection in COVID-19 patients of different age groups?

Purpose: SARS-CoV-2 has caused an on-going global pandemic of COVID-19 disease. Vitamin-D has an immunomodulatory effect on the disease by suppressing the adaptive immune system which can lead to a cytokine storm, and boosting the innate immune system. This study evaluated the relationship between both the clinical characteristics of COVID-19 patients and the severity of their infections, and their serum Vitamin D levels. Material and methods: Forty COVID-19 patients from the period April to July, 2020, and 46 healthy subjects from a similar period in 2019, were included. Serum Vitamin-D level, clinical findings, comorbidities, chest computed tomography findings, hematological and serum biochemistry analyzes of the patients were evaluated. Results: COVID-19 patients had a significantly lower mean serum 25(OH) Vitamin-D level (12.86±6.27 ng/ mL) than healthy subjects (25.4±12.7 ng/mL) (p<0.001). The prevalence of Vitamin D deficiency in COVID-19 patients was high, not only in the elderly, but also in middle age and young patients. Ground-glass opacification and paving stone sign were the most frequent patterns observed in chest-computed tomography (CT) images. There was a significant negative relationship between Vitamin-D deficiency and C-reactive protein (CRP) level (p=0.0243). In addition, a high CRP level was associated with abnormal CT findings (p=0.001). Conclusion: The authors conclude that determining the Vitamin-D level in COVID-19 patients and administering it at the appropriate dosage can reduce the severity and progression of COVID-19 disease by contributing to the regulation of the cytokine storm and pulmonary inflammatory response. © 2022, Pamukkale University. All rights reserved.

Early laboratory hematological parameters associated with COVID-19 mortality in an Amazonian population of Peru

COVID-19 has a significant impact on the hematopoietic system and hemostasis. Leukocytosis, lymphopenia, and thrombocytopenia are associated with increased severity and even death in COVID-19 cases. Objective: The aim is to examine the laboratory results of COVID-19 patients from a hospital in the Peruvian Amazon and their clinical prognosis. Material and Methods: An analytical cross-sectional study was carried out whose purpose was to identify the laboratory tests of patients with COVID-19 and mortality in a hospital in Ucayali, Peru during the period from March 13 to May 9, 2020, selecting a total of 127 with Covid-19. Mean and the standard deviation was described for age, leukocytes, neutrophils, platelets, RDW-SD;median and interquartile range for the variables lymphocyte, RN / L, fibrinogen, CRP, D-dimer, DHL, hematocrit, monocytes, eosinophils. Results: No differences were observed in this population regarding death and sex (OR: 1.31;95% CI 0.92 to 1.87), however, it was observed that, for each one-year increase, the probability of death increased by 4% (PR: 1.04, 95% CI 1.03 to 1.05). The IRR (Incidence Risk Ratio) analysis for the numerical variables showed results strongly associated with hematological values such as Leukocytes (scaled by 2500 units) ( IRR: 1.08, 95% CI 1.03 to 1.13), neutrophils (scaled by 2500 units) (IRR: 1.08;95% CI 1.03 to 1.13), on the contrary, it is observed that the increase of 1000 units in lymphocytes, the probability of dying decreased by 48% (IRR: 0.52;95% CI 0.38 to 071). Conclusions: Parameters such as leukocytes,neutrophils and D-dimer were statistically much higher in patients who died.

Laboratory Findings in Children with Excess Body Weight in Romania.

Background and Objectives: Childhood obesity has been increasing at a worrisome pace and emerging as a non-infectious pandemic in the pediatric population in recent years. Raising awareness on this problem is of utmost importance, in order to take action to control body weight from an early age. Materials and Methods: We performed a retrospective study among overweight or obese children evaluated on an outpatient basis in the Department of Pediatric Endocrinology of a tertiary care hospital in Bucharest Romania in 2021 in order to identify laboratory changes occurring according to age and sex. Results: A total of 268 children were included in the analysis, with a median age of 10.9 years (IQR: 8.3, 13.3 years); 61.8% were obese and 38.2% overweight. We identified a subclinical pro-inflammatory status characterized by increased neutrophil count (12.7%) and increased C-reactive protein (16.4%). Biochemically, we identified the highest increases for uric acid (35.4%). More than half of the children included in the study had dyslipidemia-specific changes: high low-density lipoprotein cholesterol (LDL) (50.0%), low high-density lipoprotein cholesterol (HDL) (58.9%) and increased triglyceride levels (12.7%), especially children with a body mass-index (BMI) percentile above 95%. Increased thyroid stimulating hormone (TSH) was identified in 20.3% and low thyroxine (T4) level in 13.4%, especially in females. Conclusions: Early measures to control excess body weight are needed since preventing obesity is easier than treating it. However, this is often difficult to do in our country because parents frequently do not recognize the problem until it is advanced. Furthermore, doctors are not always adequately prepared and sometimes they do not have the support of the health systems to provide children in need with the adequate care. Educational strategies and awareness of issue should be revisited in current post-pandemic context that facilitates increase of obesity prevalence in children. Increase of efficient communication could be achieved by pointing to these objective findings.

Clinical Characteristics of the First 100 Patients of COVID-19 in Tobruk, Libya: A Brief Report From Low-Resource Settings.

OBJECTIVE: This study aims to report the clinical features of a cohort of patients with suspected coronavirus disease (COVID-19) from Tobruk, Libya, and reflect upon the diagnosis challenge in low-resource settings. METHODS: A descriptive report of the first 100 patients with suspected COVID-19 who have visited the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19 screening clinic at the National Centre for Disease Control in Tobruk, Libya. RESULTS: The most common presenting symptoms were fever (90%), cough (89%), dyspnea (85%), sore throat (79%), fatigue (78%), headache (64%), loss of smell (52%), loss of taste (53%), loss of appetite (43%), nausea and vomiting (26%), diarrhea (22%), and rhinorrhea (16%); 51% of the patients had lymphocytopenia, whereas 13% had thrombocytopenia. Bilateral infiltrates were the most common radiologic finding on chest X-ray (76%), and COVID-19 IgM and/or IgG antibodies were detected in 80% of the patients, whereas only 37% of the patients were tested positive by the reverse transcriptase polymerase chain reaction (RT-PCR). CONCLUSIONS: The disease continued its spread across the region. Fever, cough, and dyspnea were the main symptoms; 21% of the patients did not have any chest X-ray abnormalities. Initial negative results for either antibody testing or RT-PCR-testing for COVID-19 do not rule out the infection.

Clinical and Laboratory Evaluations of Patients Diagnosed as Having Multisystem Inflammatory Syndrome Associated with Coronavirus Disease 2019 in Children: A Single Center Experience from Konya

Objective Multisystem inflammatory syndrome in children (MIS-C), characterized by fever, inflammation, and multiorgan dysfunction, was newly defined after severe acute respiratory syndrome coronavirus 2 infection. The clinical spectrum of MIS-C can be classified as mild, moderate, and severe. We aimed to evaluate demographics, clinical presentations, laboratory findings, and treatment modalities of patients with MIS-C according to clinical severity. Methods We performed a retrospective study of patients who were diagnosed as having MIS-C between September 2020 and October 2021 in the Necmettin Erbakan University Meram Faculty of Medicine, Türkiye. Results A total of 48 patients (24 females and 24 males) with a median age at diagnosis of 10.3 years (range: 42 months-17 years) were enrolled, the most common clinical severity of MIS-C was moderate. The common presentations of patients were fever (97%), nonpurulent conjunctivitis (89.6%), rashes (81.3%), fatigue (81.3%), strawberry tongue (79.2%), and myalgia (68.8%). The most common laboratory findings were lymphopenia (81.2%), thrombocytopenia (54.1%), elevated D-dimer levels (89.5%), C-reactive protein (CRP;100%), procalcitonin (97%), erythrocyte sedimentation rate (87.5%), ferritin (95.8%), interleukin 6 (IL-6) (86.1%), and probrain natriuretic peptide (pro-BNP) (97%). High levels of CRP, procalcitonin, pro-BNP, and urea were associated with the severity of MIS-C (p < 0.05). Fifteen of the patients were found to have pulmonary involvement. Ascites were the most common finding on abdominal ultrasonography (11 patients) and were not seen in a mild form of the disease. During the study period, two patients died. Conclusion It is important to make patient-based decisions and apply a stepwise approach in treating patients with MIS-C due to the increased risk of complications and mortality. © 2022. Thieme. All rights reserved.

Clinical manifestations and laboratory findings and mortality rate of kidney transplant recipients infected with COVID-19

Introduction: The emergence of a novel coronavirus (COVID-19) in late December 2019 and its rapid global spread has led World Health Organization (WHO) to introduce it as a very dangerous pandemic. People with underlying disease and a history of organ transplantation are at higher risk for COVID-19 disease compared with healthy people. Objectives: In the present study, clinical and laboratory manifestations in the patients with COVID-19 with a history of kidney transplantation has been investigated. Patients and Methods: This study conducted on 103 COVID-19-positive kidney transplant patients as a descriptive epidemiological study. Clinical and laboratory symptoms of hospitalized renal transplanted patients have been assessed. Statistical analysis of the collected data conducted using SPSS (Statistical Package for Social Sciences, version 22). Results: This study consisted of 103 COVID-19 patients with a history of kidney transplant, of which 64 males (62.1%) and 39 females (37.9%) with an average age of 48.5 ± 13.1 years. The most common clinical manifestations were headache (67%) and shortness of breath (66%). Elevated lactate dehydrogenase (LDH) levels, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) has been observed in 100%, 98.1% and 93.2% of patients, respectively. In 12.6% and 41.7% of patients, the degree of lung involvement was above 75% and 50%-75%, respectively. Moreover, 79.6% of patients has been discharged after improved, while 20.4% of patients died. Conclusion: We found, kidney transplantation may increase COVID-19-related mortality when compared to COVID-19-related mortality in the general population. [ FROM AUTHOR]

Clinical characteristics and outcome of Covid-19 illness and predictors of in-hospital mortality in Saudi Arabia.

BACKGROUND: Patients' race and ethnicity may play a role in mortality from Covid-19. Studies in China, the US, and Europe have been conducted on the predictors of Covid-19 mortality, yet in the EMR countries, such studies are scarce. Therefore, we aimed to describe the hospitalization rate, ICU-admission, and in-hospital mortality of Covid-19 and predictors of in-hospital mortality in Saudi Arabia. METHODS: E-medical records were examined for all Covid-19 patients diagnosed in five tertiary hospitals affiliated with the Saudi-National Guard-Health Affairs during March 21, 2020, and September 12, 2021, based on a positive SARS-CoV-2 RT-PCR test, (n = 35,284). Data were collected on patients' characteristics, comorbidities, laboratory findings, hospitalization, ICU admission, and in-hospital and overall mortality. Logestic regressions were used to identify the independent predictors of in-hospital mortality. The best laboratory parameters cut-off values to predict in-hospital mortality were identified using the area under the receiver operating characteristic curve (AUC). Significance was considered at p < 0.05. RESULTS: Of all 35,284 Covid-19 patients, 81.8% were adults and 21.7% were hospitalized. Compared to non-hospitalized patients, hospitalized patients were more of female gender (52.1% versus 47.3%, p < 0.001) and had higher mean age (p < 0.001), higher mean BMI (p < 0.001), and higher rates of: diabetes (p < 0.001), hypertension (p < 0.001), ischemic heart disease (p < 0.001), cancer (p < 0.001), COPD (p < 0.001) and asthma (p = 0.011). The study showed 3.1% overall case-fatality, 20.3% ICU admission rate, and 9.7% in-hospital mortality. Predictors of in-hospital mortality among adult patients were; patients' age ≥ 70 years (OR = 6.93, 95% CI 1.94-24.79), ischemic heart disease (OR = 1.80, 95% CI 1.05-3.09), ICU admission (OR = 24.38, 95% CI 15.64-38.01), abnormal C-reactive protein "CRP" (OR = 1.85, 95% CI 1.08-3.16), abnormal D-dimer (OR = 1.96, 95% CI 1.15-3.36), lymphopenia (OR = 2.76, 95% CI 2.03-3.3.76), high neutrophil count (OR = 2.10, 95% CI 1.54-2.87), and abnormal procalcitonin (OR = 3.33, 95% CI 1.88-5.90). The best laboratory parameters cut-off values to predict in-hospital mortality were CRP > 72.25 mg/L (AUC = 0.64), D-dimer > 1125 µg/L (AUC = 0.75), neutrophils count > 5,745 × 10^9/L (AUC = 0.70), lymphocytic count < 1.10 × 10^9/L (AUC = 0.72), and procalcitonin > 0.18 ng/mL (AUC = 0.76). CONCLUSIONS: Rates of hospitalization, ICU-admission, in-hospital mortality and overall case fatality were nearly comparable to the rates in western countries. Early interventions are necessary for high-risk Covid-19 patients, especially elderly patients and those with cardiac diseases.

Clinical and Laboratory Evaluations of Patients Diagnosed as Having Multisystem Inflammatory Syndrome Associated with Coronavirus Disease 2019 in Children: A Single Center Experience from Konya

Objective Multisystem inflammatory syndrome in children (MIS-C), characterized by fever, inflammation, and multiorgan dysfunction, was newly defined after severe acute respiratory syndrome coronavirus 2 infection. The clinical spectrum of MIS-C can be classified as mild, moderate, and severe. We aimed to evaluate demographics, clinical presentations, laboratory findings, and treatment modalities of patients with MIS-C according to clinical severity.Methods We performed a retrospective study of patients who were diagnosed as having MIS-C between September 2020 and October 2021 in the Necmettin Erbakan University Meram Faculty of Medicine, Turkey.Results A total of 48 patients (24 females and 24 males) with a median age at diagnosis of 10.3 years (range: 42 months-17 years) were enrolled, the most common clinical severity of MIS-C was moderate. The common presentations of patients were fever (97%), nonpurulent conjunctivitis (89.6%), rashes (81.3%), fatigue (81.3%), strawberry tongue (79.2%), and myalgia (68.8%). The most common laboratory findings were lymphopenia (81.2%), thrombocytopenia (54.1%), elevated D-dimer levels (89.5%), C-reactive protein (CRP;100%), procalcitonin (97%), erythrocyte sedimentation rate (87.5%), ferritin (95.8%), interleukin 6 (IL-6) (86.1%), and probrain natriuretic peptide (pro-BNP) (97%). High levels of CRP, procalcitonin, pro-BNP, and urea were associated with the severity of MIS-C ( p < 0.05). Fifteen of the patients were found to have pulmonary involvement. Ascites were the most common finding on abdominal ultrasonography (11 patients) and were not seen in a mild form of the disease. During the study period, two patients died.Conclusion It is important to make patient-based decisions and apply a stepwise approach in treating patients with MIS-C due to the increased risk of complications and mortality.

"Delirium and COVID-19": From Symptomatology to Laboratorial and Neuroimaging Findings'

Introduction: The infection caused by the SARS-CoV-2 virus called COVID-19 may affect not only the respiratory system but also the central nervous system (CNS). Delirium is a frequent and serious condition in COVID-19 patients and may be caused by the direct invasion of the CNS or the induction of CNS inflammatory mediators or by indirect effects due to the systemic inflammatory status, other organ failure, prolonged mechanical ventilation time, immobilization but also social isolation. We aim to critically review literature reporting this syndrome in patients infected by the SARSCoV-2 virus with a particular emphasis on reported clinical, laboratorial and neuroimaging findings. Method(s): A state-of-the-art literature review was performed using PubMed, Embase and Web of Knowledge using the following keywords: delirium, COVID-19, SARS-Cov-2, neuroimaging, laboratorial findings. Result(s): More than 50% of patients with COVID-19 may present with delirium and in about 20% of the cases this is the primary presentation of the disorder. Previous data suggests that these patients may show a higher frequency of certain symptoms such as agitation, myoclonus, abulia, and alogia. Some distinct neuroinflammatory syndromes have been identified in patients presenting with delirium associated with the virus, namely, autoimmune encephalitis, Acute Disseminated Encephalomyelitis (ADEM) and stroke showing its potential for CNS involvement. Many of these patients present normal brain imaging, EEG and CSF findings but others have more specific laboratorial changes such as elevated creatinine kinase, elevated D-dimer levels, abnormal coagulation parameters and positive SARS-Cov-2 PCR in CSF or meningeal enhancement, ischemic stroke and perfusion changes in MRI imaging.

Comparison of clinical, radiological and laboratory findings in discharged and dead patients with COVID-19

Background: Coronavirus disease 19 (COVID-19) is a recently described infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Iran was the first country where the SARS-Cov-2 was detected in the Middle East. In the current study, we aimed to evaluate the clinical, radiological and laboratory findings in hospitalized COVID-19 confirmed cases in Iran. Methods: The clinical manifestations, radiological data, laboratory findings, and the underlying diseases of the patients with COVID-19 were obtained from electronic medical records. Next, this information was compared in discharged and dead patients. Results: Overall, 4028 patients with COVID-19 including 3088 discharged, 778 dead, and 162 still hospitalized patients were enrolled in this study. The highest percentage of people who recovered (55%) was between 30 and 60 years old and the highest percentage of deaths (74.4%) was more than 60 years old. Based on demographic data, 50.05% were female and 49.95% were male. Clinical evaluations revealed that dyspnea (56.9%), cough (31.4%) and fever (17.8%) were the most manifestations. Comorbidities were significantly higher in the dead group. Laboratory analysis revealed abnormalities in lymphocyte count (LYM), erythrocyte sedimentation rate (ESR), and inflammatory biomarkers such as C-reactive protein (CRP). The most prevalent computed tomography (CT) scan data were ground-glass opacity (GGO) (30.5%) and consolidation (9.4%). Conclusions: Laboratory parameters and clinical and radiological findings help to evaluate the follow-up of the disease in patients. Age and comorbidities are factors that predispose people to COVID-19. Further research is needed to evaluate the effects of various factors on the progression of COVID-19 infection.

Acute COVID-19 Syndrome Predicts Severe Long COVID-19: An Observational Study.

Introduction Tissue damage, chronic dysfunction, and symptoms that last more than 12 weeks are hallmarks of long-term chronic opportunistic viral infection (COVID-19), and the disease may have a permanent, relapsing/remitting, or gradually improving course. This study aimed to determine the risk factors of severe long COVID-19. Methods In October 2021, primary care clinics enrolled consenting 18- to 89-year-olds to complete an online questionnaire on self-diagnosis, clinician diagnosis, testing, symptom presence, and duration of COVID-19. Long COVID-19 was identified if symptoms were beyond 12 weeks. Patients with long-lasting COVID-19 symptoms were assessed using multivariable regression to identify potential predictors of severe long COVID-19. Results Of the 220 respondents, 108 (49%) patients were self- or clinician-diagnosed with COVID-19 or had a confirmed positive laboratory test result. Patients aged >45 years and with at least 15 COVID-19 symptoms were 5.55 and 6.02 times, respectively, more likely to acquire severe long COVID-19. Most patients with severe and moderate post-acute COVID-19 syndrome had no relevant comorbidities (p=0.0402; odds ratio [OR]=0.4; 95% confidence interval [CI]=0.18-0.98). Obesity was a significant predictor (p=0.0307; OR=6.2; 95% CI=1.1-33.2). Conclusion The simultaneous presence of 15 or more COVID-19 symptoms, age >45 years, and obesity were related to a higher probability of severe long COVID-19.

Correlation between thorax computed tomography findings and clinical and laboratory data on patients with coronavirus disease 2019

OBJECTIVE: We investigated the correlation between computed tomography (CT) scores, laboratory findings, and clinical symptoms in patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: Clinical, laboratory, and thorax CT findings on the admission of 121 patients with COVID-19 were retrospectively evaluated. CT scores based on lobe involvement and CT patterns (i.e., ground-glass abnormalities, consolidation, and crazy-paving patterns) were estimated, and the relationship between CT score and symptomatic (e.g. fever, cough) versus asymptomatic (e.g., inflammation, coagulation, liver and kidney function) clinical laboratory findings were statistically analyzed. RESULTS: Sixty-eight of 121 patients (56%) were symptomatic;53 (44%) were asymptomatic. The CT scores of symptomatic patients, especially those with coughing and dyspnea, were statistically higher (2 [0–9] vs. 0 [0–1];P < 0.001). Erythrocyte sedimentation rate, C-reactive protein, ferritin, D-dimer, fibrinogen, aspartate aminotransferase, lactate dehydrogenase, glucose, prothrombin time and alanine amino transferase values were correlated with CT scores (ρ = 0.638, P < 0.001, ρ = 0.512, P < 0.001;ρ = 0.325, P = 0.001;ρ = 0.452, P < 0.001;ρ = 0.525, P < 0.001;ρ = 0.379, P < 0.001;ρ = 0.445, P < 0.001;ρ = 0.332, P < 0.001, ρ = 0.296, P = 0.003;ρ = 0.222, P = 0.015, respectively). Albumin values were negatively correlated with CT scores (ρ = −0.398, P < 0.001). CONCLUSION: CT scores may help clinicians evaluate the severity of COVID-19 pneumonia and thus help in managing the disease.

Clinical, Laboratory and Radiological Parameters of Covid 19 Pneumonia: A Single-Centered Retrospective Observational Study in Pune, India

Background: The severe acute respiratory syndrome coronavirus called the novel coronavirus caused the pandemic coronavirus disease 19 (COVID-19). All over the world, SARS-CoV-2 pneumonia is causing significant short-term morbidity and mortality, but the medium-term impact on lung function and quality of life of affected patients is still unknown. Aims: To assess clinical, laboratory, and radiological parameters of COVID-19 Patients and to correlate radiological findings and disease severity among patients. Methodology: In this retrospective observational study a total of 630 patients with radiologically confirmed pneumonia and COVID-19 RT PCR positive were included from a tertiary care centre in Pune, Maharashtra, following their voluntary informed consent. Patients underwent clinical, laboratory, and radiological investigations. Results: It was observed that the majority 174 (27.6%) were in the age group of 31 to 40 years and male predominance was observed compared to female. The majority of the patients 314 (49.8%) had mild, 232 (36.8%) were moderate and 84 (13.3%) had severe illness as per CT scores (HRCT Chest score). Mean BSL levels were 181 ± 81.44, mean pulse rate was 94.03 ± 14.93 bpm, mean respiratory rate was 22.84 ± 3.71cpm, systolic blood pressure was 129.09 ± 13.18 mmHg, diastolic blood pressure was 82.80 ± 9.67mmHg and mean temperature was 98.56 ± 1.67 °F. The mean ferritin levels were 181 ± 81.44, the mean LDH level was 94.03 ± 14.93, mean HbA1C was 7.45 ± 1.68. The mean NLR was 5.51 ± 2.41, the mean WBC count was 7238.38 ± 4942.23 and the mean hematocrit was 39.69 ± 4.80. The mean D dimer level was 402.29 ± 424.70, median levels were 260 (170-450). 503 (79.8%) had CRP levels more than 5 and 127 (20.2%) had levels less than 5. The mean duration of hospital stay was 9.18 days ± 4.34 days. Majority 570 (90.5%) had fever, 493 (78.3%) had cough, 286 (45.4%) had breathlessness, 66 (10.5%) had sore throat. Other symptoms include vomiting, and loose motion in 17 (2.7%). Among 630 subjects included in the present study, the majority 584 (92.7%) have recovered/were discharged from the hospital and 46 (7.3%) succumbed to the illness. The mean SGOT and SGPT levels were 44.86± 31.29 and 43.60 ± 31.25 respectively. Mean serum creatinine and BUN levels were 0.87± 0.80 and 13.96 ± 9.46 respectively. The mean values of pulse rate, systolic blood pressure, diastolic blood pressure, respiratory rate and temperature showed an increasing trend across the grades of severity. Conclusion: We concluded that age, gender, blood sugar level, blood pressure, clinical symptoms, comorbidities, inflammatory biomarkers and CT severity score were independently associated with the severity and mortality based on our findings. [ FROM AUTHOR]

Evaluation of Clinical Manifestations, Laboratory Findings and Outcome of Children with Covid-19

Background: Coronavirus, a common infectious disease in the 21st century, has not been studied enough in children. Therefore, this study aimed to investigate the clinical manifestations, laboratory findings, and outcomes of children with Covid-19 admitted to Shahid Beheshti Hospital in Kashan during 2020-2022.Method: In this retrospective cohort study, the medical records of children with covid-19 referred to Shahid Beheshti hospital in Kashan between February 2020 and March 2022 were reviewed. The information extracted from the patient's medical records included demographic variables, clinical characteristics, laboratory findings, and the outcome of covid-19. The collected data were analyzed through SPSS 16, using descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (chi-square test and ANOVA).Result: The findings of 271 children (159 boys;52% of the age group <= 5 years) showed that fever (57.6%), cough (39.9%), nausea-vomiting (31.7%), and diarrhea were the most common clinical symptoms. Also, the majority of patients were in the abnormal range in terms of Monocyte (89.3%), PTT (84.7%), Lymphocyte (83.6%), Neutrophil (80.4%), and LDH (74.5%). Pulmonary involvement was present in 12.5% of children. Finally, four children (1.5%) died. Conclusion: Severity of lung involvement and the outcome of the covid-19 disease (admission to the ICU and death) among children were at a low level, and in fact, it shows the better condition of children than adults in relation to this disease.

Real-world effectiveness and protection of SARS-CoV-2 vaccine among patients hospitalized for COVID-19 in Xi'an, China, December 8, 2021, to January 20, 2022: A retrospective study.

Introduction: In December 2021, a large-scale epidemic broke out in Xi'an, China, due to SARS-CoV-2 infection. This study reports the effect of vaccination on COVID-19 and evaluates the impact of different vaccine doses on routine laboratory markers. Methods: The laboratory data upon admission, of 231 cases with COVID-19 hospitalized from December 8, 2021 to January 20, 2022 in Xi'an, including blood routine, lymphocyte subtypes, coagulative function tests, virus specific antibodies and blood biochemical tests were collected and analyzed. Results: Of the 231 patients, 21 were not vaccinated, 158 were vaccinated with two doses and 52 with three doses. Unvaccinated patients had a higher proportion of moderate and severe symptoms than vaccinated patients, while two-dose vaccinated patients had a higher proportion than three-dose vaccinated patients. SARS-CoV-2 specific IgG levels were significantly elevated in vaccinated patients compared with unvaccinated patients. Particularly, unvaccinated patients had lower counts and percentages of lymphocytes, eosinophils and CD8+ T-lymphocytes, and elevated coagulation-related markers. In addition, vaccination had no effect on liver and kidney function. Conclusions: Vaccination against SARS-CoV-2, inducing high IgG level and increased CD8+ T cells and eosinophils, and regulating coagulation function, can significantly attenuate symptoms of COVID-19, suggesting that the vaccine remains protective against SARS-CoV-2.

Effect of Laparoscopic Sleeve Gastrectomy on Quality of Life in Morbid Obese Patients: a Systematic Review and Meta-Analysis

Purpose:determine the effect of sleeve gastrectomy on the quality of life of obese patients. Method: The initial search was based on relevant keywords in the electronic databases PubMed, Scopus, Web of Science, EBSCO and Embase between 2013 to September 2021. The mean difference was calculated with 95% confidence interval (CI) by fixed effect model and inverse variance method. Meta-analysis was performed Result: Three RCT studies, two Prospective studies and one Retrospective study have been included in present article. Mean of Weight and BMI were 126.16 +/- 22.9 kg and 45.45 +/-.21 kg/m(2). Mean differences of quality of life after laparoscopic sleeve gastrectomy in Morbid Obese patients was 21.75 (MD, 95% CI 20.54, 22.96). Conclusion:result indicate an improvement in patients' quality of life after one year of laparoscopic sleeve gastrectomy (p=0.00) and improvement in quality of life is observed in all questionnaires.

The Prevalence of Frailty Syndrome and Its Associated Factors among Elderly Hospitalized in Firoozabadi Hospital

Background: Frailty Syndrome is one of the most common and important syndromes related to the elderly that plays an essential role in the quality of life and health status of the elderly. This study aimed to investigate the prevalence of Frailty syndrome and its associated factors in individuals over 55 years of age referred to the clinic of Firoozabadi Hospital in Rey in 2019-2020. Method: It is a descriptive cross-sectional study carried out on individuals over 55 years of age referred to the clinic of Firoozabadi Hospital in Rey, Tehran, in 2019-2020. 200 elderly individuals were selected by the purposive sampling method and entered the study. To collect the required information, a demographic questionnaire, Pittsburgh Sleep Quality Questionnaire, and Frailty-Fried phenotype criteria were implemented. After collecting the data, it was entered into SPSS software version 20. In descriptive statistics, mean and standard deviation, and inferential statistics due to non-normality of data, Spearman correlation coefficient and logistic regression were utilized to assess variables. Results: The mean age of participants was 69.72 +/- 7.897 years, and 72.5% of the participants were female. The average body mass index of the participants was 27.58 +/- 12.30 square meters. The 21.10 percentage of Frailty and 44.20% pre-frailty were respectively. There is a statistically significant positive correlation between Fried's criteria with a history of antipsychotic medication(r = 0.241, p = 0.004), congestive heart failure (r = 0.220, p = 0.009), history of falls (r = 0.283, p = 0.001) and poor sleep quality (r = 0.240, p = 0.004). A history of congestive heart disease, falls, and poor sleep quality have been found as predictive factors of fertility syndrome in the elderly. These variables indicate the increased incidence chance of fertility syndrome in the elderly. The mean sleep quality score in the elderly was higher than the pre-elderly and showed poorer sleep quality in this group (p <0.001). Conclusion: According to the study's findings, the prevalence of Frailty symptoms in the elderly population was close to 40%, which can be considered a high prevalence. Therefore, early identification and diagnosis of Frailty syndrome can prevent the adverse consequences. It is necessary to provide appropriate and comprehensive interventions to reduce the adverse effects of Frailty syndrome among the elderly population.

From Death anxiety to death awareness: An exploration of the lived experience of Iranian hospitalized patients in critical care units who witnessed unsuccessful cardiopulmonary resuscitation

Introduction: This study was conducted to explore the lived experience of hospitalized patientsin critical care units (CCUs) who witnessed an unsuccessful resuscitation. Methods: The participants in this interpretive phenomenology study were ten hospitalized patients in CCUs selected through purposive sampling. The data were collected through unstructured interviews and analyzed using van Manen's approach. Results: Two main themeswere identified along with the subthemes including (1) deathanxiety (perception of the shadow of death, thinking about mourning and sympathize thinking about death);and (2) death awareness (mind-meditation self-discourse, spiritual-religious dialectic with God, and avoiding the consequences of thinking about death). Conclusion: Witnessingan unsuccessful resuscitation acted as a boundary situation and stressor for the fellow patients and led to mortality salience as well as the experience of death anxiety.Understanding how patients manage and reduce this death anxiety is necessary in order to provide appropriate clinical support during medical decision-making.

Laboratory Findings in Different Disease Status of COVID-19 Admitted Patients at Dilla University Referral Hospital Treatment Center, South Ethiopia.

Background: Millions were infected and many were dying because of the coronavirus disease 2019, since its emergence. The patients experience asymptomatic, mild, moderate, severe and critical disease with varying signs and symptoms. Decreased lymphocytes and abnormal liver and renal function tests are common among COVID-19 patients. Severe and critical cases show higher number of white blood cells, and neutrophils. However, studies showed different laboratory findings in different disease status. Therefore, this study investigated laboratory findings of COVID-19 admitted patients at Dilla University Referral Hospital treatment center, South Ethiopia. Methods: A retrospective study design was conducted on 220 patients confirmed by real time polymerase chain reaction, and admitted to Dilla University Referral Hospital treatment center from September 2020 to July 2021. Data were collected from the patients' record, and analyzed by GraphPad Prism version 8.0.1.244 software. Descriptive statistics were used to analyze the frequency while independent t-test was used to compare means of each parameter for each disease status. Results: Of the 220 study cases, 120 (54.5%) were severe, 89 (40.5%) were moderate and 11 (5.0%) were mild. One hundred forty (71.1%) of the 197 laboratory tested cases, 87 (77.7%) of severe, and 49 (64.5%) of the moderate cases had neutrophils above normal range. However, 134 (68.0%) of them, 82 (73.2%) of severe and 49 (64.5%) of moderate cases showed decreased lymphocyte level. Most of the cases showed an increased level of aspartate transaminase, alanine transaminase, alkaline phosphatase, total bilirubin, and total calcium. There was statistically significant mean neutrophils (p=0.04), number of white blood cells (p= 0.02), and creatinine level (p=0.00) difference between severe and mild cases. Conclusion: Most of the severe COVID-19 patients showed increased neutrophils, liver function tests; and decreased lymphocytes; suggesting higher inflammation and lymphopenia. Therefore, patients with severe and critical disease status require close follow-up.

Comparison of clinical, radiological and laboratory findings in discharged and dead patients with COVID-19.

Background: Coronavirus disease 19 (COVID-19) is a recently described infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Iran was the first country where the SARS-Cov-2 was detected in the Middle East. In the current study, we aimed to evaluate the clinical, radiological and laboratory findings in hospitalized COVID-19 confirmed cases in Iran. Methods: The clinical manifestations, radiological data, laboratory findings, and the underlying diseases of the patients with COVID-19 were obtained from electronic medical records. Next, this information was compared in discharged and dead patients. Results: Overall, 4028 patients with COVID-19 including 3088 discharged, 778 dead, and 162 still hospitalized patients were enrolled in this study. The highest percentage of people who recovered (55%) was between 30 and 60 years old and the highest percentage of deaths (74.4%) was more than 60 years old. Based on demographic data, 50.05% were female and 49.95% were male. Clinical evaluations revealed that dyspnea (56.9%), cough (31.4%) and fever (17.8%) were the most manifestations. Comorbidities were significantly higher in the dead group. Laboratory analysis revealed abnormalities in lymphocyte count (LYM), erythrocyte sedimentation rate (ESR), and inflammatory biomarkers such as C-reactive protein (CRP). The most prevalent computed tomography (CT) scan data were ground-glass opacity (GGO) (30.5%) and consolidation (9.4%). Conclusions: Laboratory parameters and clinical and radiological findings help to evaluate the follow-up of the disease in patients. Age and comorbidities are factors that predispose people to COVID-19. Further research is needed to evaluate the effects of various factors on the progression of COVID-19 infection.

Antecedentes: La enfermedad por coronavirus de 19 (COVID-19) es una enfermedad infecciosa recientemente descrita causada por el síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2). Irán fue el primer país de Oriente Medio donde se detectó SARS-Cov-2. En el estudio actual, nuestro objetivo fue evaluar los hallazgos clínicos, radiológicos y de laboratorio en pacientes hospitalizados con confirmación de COVID-19 en Irán. Métodos: Se obtuvieron las manifestaciones clínicas, los datos radiológicos, los hallazgos de laboratorio y las enfermedades subyacentes de los registros clínicos electrónicos. Seguidamente, se comparó esta información con los pacientes dados de alta y fallecidos. Resultados: A nivel global, se incluyó en este estudio a 4.028 pacientes con COVID-19, de los cuales 3.088 habían recibido el alta, 778 habían fallecido, y 162 seguían hospitalizados. El mayor porcentaje de recuperaciones (55%) se produjo entre las personas de 30 a 60 años, y el mayor porcentaje de muertes (74,4%) se dio en los mayores de 60 años. Sobre la base de los datos demográficos, el 50,05% fueron mujeres y el 49,95% varones. Las evaluaciones clínicas revelaron que la disnea (56,9%), la tos (31,4%) y la fiebre (17,8%) fueron las manifestaciones más prevalentes. Las comorbilidades fueron significativamente más elevadas en el grupo de fallecidos. Las analíticas revelaron anomalías en cuanto a recuento linfocitario, tasa de sedimentación eritrocitaria (ESR), y biomarcadores inflamatorios tales como proteína C reactiva (PCR). Los datos procedentes de la tomografía computarizada (TC) fueron opacidad en vidrio esmerilado (GGO) (30,5%) y consolidación (9,4%). Conclusiones: Los parámetros de laboratorio y los hallazgos clínicos y radiológicos ayudan a evaluar el seguimiento de la enfermedad en los pacientes. La edad y las comorbilidades son factores que predisponen a las personas a la COVID-19. Es necesaria más investigación para evaluar los efectos de los diversos factores en la progresión de la infección por COVID-19.