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1.
Eur Rev Med Pharmacol Sci ; 25(24): 7847-7857, 2021 12.
Article in English | MEDLINE | ID: covidwho-1603341

ABSTRACT

OBJECTIVE: The Islamic Republic of Iran has displayed one of the highest rates of COVID-19 infection in the world and the highest rate of mortality in the Middle East. Iran has used a stringent package of preventive health measures to mitigate the spread of infection, which however has negatively affected individuals' physical and psychological health. This study aimed at examining whether physical-activity (PA) behavior, anxiety, well-being, and sleep-quality changed in response to the COVID-19-related public health restrictions enforced in Iran. PATIENTS AND METHODS: An online questionnaire was disseminated to adults residing in Iran from November 17, 2020, to February 13, 2021 (~88 days), during Iran's strictest public health restrictions. Main outcome measures included Godin-Shephard Leisure-Time Exercise Questionnaire, General Anxiety Disorder-7, Mental Health Continuum-Short Form, and Pittsburgh Sleep Quality Index. RESULTS: A total of 3,323 adults (mean age 30±11 years, 54.3% female) participated in the survey. Firstly, the restrictions generally reduced PA behavior: (a) among inactive participants (IPs), 60.6% became less active vs. 5.1% who became more active; and (b) among active participants (APs), 49.9% became less active vs. 22.8% who became more active. Secondly, PA behavior was associated with higher well-being and sleep quality during the restrictions: (a) APs reported higher (or lower) levels of well-being and sleep quality (or anxiety) than did IPs; and (b) among IPs as well as among APs, the more active the participants, the greater (or lower) the levels of well-being and sleep quality (or anxiety). CONCLUSIONS: This study showed the beneficial role of PA behavior for well-being, anxiety, and sleep quality during the COVID-19 restrictions, whereas such restrictions appeared to decrease PA participation. Active lifestyle should be then encouraged during the COVID-19 outbreak while taking precautions.


Subject(s)
Anxiety/epidemiology , COVID-19/prevention & control , Exercise/statistics & numerical data , Quarantine/standards , Adolescent , Adult , Anxiety/diagnosis , COVID-19/epidemiology , COVID-19/transmission , Female , Humans , Iran/epidemiology , Male , Pandemics/prevention & control , Quarantine/statistics & numerical data , Self Report/statistics & numerical data , Young Adult
2.
BMC Psychiatry ; 21(1): 529, 2021 10 26.
Article in English | MEDLINE | ID: covidwho-1593475

ABSTRACT

BACKGROUND: The COVID-19 pandemic as a global mental health crisis has affected everyone, including students. The present study aimed to determine and investigate the relationship between health locus of control and perceived stress in students of Bushehr University of Medical Sciences (southern Iran) during the outbreak of COVID-19. METHODS: The present cross-sectional study examined 250 students of Bushehr University of Medical Sciences. We performed simple random sampling and utilized the demographic information form, Multidimensional Health Locus of Control scale (MHLCS) by Wallston, and Perceived Stress Scale (PSS) by Cohen to collect data. We analyzed data using the SPSS, Pearson correlation coefficient, and the hierarchical regression model with an error level of 5%. RESULTS: The mean perceived stress was 30.74 ± 8.09, and 92.4% of the students had moderate and high stress levels. Among the components of the health locus of control, the internal health locus of control (IHLC) had the highest mean in students (27.55 ± 3.81). Furthermore, the internal health locus of control (R = - 0.30, P < 0.001) had a significant inverse relationship, with perceived stress and the chance health locus of control (CHLC) (R = 0.30, P < 0.001) had a significant direct relationship. In the final regression model, the health locus of control and all the variables predicted 22.7% of the perceived stress variation in students during the COVID-19 period. CONCLUSION: The results indicated that the internal health locus of control was associated with a reduction of perceived stress, and the powerful others health locus of control (PHLC) was related to its increase in students during the COVID-19 pandemic. Given the uncertain future, in the present work, universities are suggested to design web-based educational interventions alongside the curriculum to further strengthen the internal health locus of control and thus help reduce their perceived stress.


Subject(s)
COVID-19 , Cross-Sectional Studies , Depression , Disease Outbreaks , Humans , Internal-External Control , Iran/epidemiology , Pandemics , SARS-CoV-2 , Stress, Psychological/epidemiology , Students , Universities
3.
Front Public Health ; 9: 753048, 2021.
Article in English | MEDLINE | ID: covidwho-1590788

ABSTRACT

Background: The rapidly growing imbalance between supply and demand for ventilators during the COVID-19 pandemic has highlighted the principles for fair allocation of scarce resources. Failing to address public views and concerns on the subject could fuel distrust. The objective of this study was to determine the priorities of the Iranian public toward the fair allocation of ventilators during the COVID-19 pandemic. Methods: This anonymous community-based national study was conducted from May 28 to Aug 20, 2020, in Iran. Data were collected via the Google Forms platform, using an online self-administrative questionnaire. The questionnaire assessed participants' assigned prioritization scores for ventilators based on medical and non-medical criteria. To quantify participants' responses on prioritizing ventilator allocation among sub-groups of patients with COVID-19 who need mechanical ventilation scores ranging from -2, very low priority, to +2, very high priority were assigned to each response. Results: Responses of 2,043 participants, 1,189 women, and 1,012 men, were analyzed. The mean (SD) age was 31.1 (9.5), being 32.1 (9.3) among women, and 29.9 (9.6) among men. Among all participants, 274 (13.4%) were healthcare workers. The median of assigned priority score was zero (equal) for gender, age 41-80, nationality, religion, socioeconomic, high-profile governmental position, high-profile occupation, being celebrities, employment status, smoking status, drug abuse, end-stage status, and obesity. The median assigned priority score was +2 (very high priority) for pregnancy, and having <2 years old children. The median assigned priority score was +1 (high priority) for physicians and nurses of patients with COVID-19, patients with nobel research position, those aged <40 years, those with underlying disease, immunocompromise status, and malignancy. Age>80 was the only factor participants assigned -1 (low priority) to. Conclusions: Participants stated that socioeconomic factors, except for age>80, should not be involved in prioritizing mechanical ventilators at the time of resources scarcity. Front-line physicians and nurses of COVID-19 patients, pregnant mothers, mothers who had children under 2 years old were given high priority.


Subject(s)
COVID-19 , Adult , Aged , Aged, 80 and over , Child, Preschool , Female , Health Care Rationing , Humans , Infant , Iran/epidemiology , Male , Middle Aged , Pandemics , Public Opinion , SARS-CoV-2 , Surveys and Questionnaires , Ventilators, Mechanical
4.
Front Public Health ; 9: 728904, 2021.
Article in English | MEDLINE | ID: covidwho-1597989

ABSTRACT

Background: Several studies indicate a high prevalence of depression around the world during the period of the COVID-19 pandemic. Using a valid instrument to capture the depression of an individual in this situation is both important and timely. The present study aims to evaluate the psychometric properties of the Persian version of the Center for Epidemiological Studies Depression Scale (CES-D) among the public during the COVID-19 pandemic in Iran. Method: This is a cross-sectional study that was conducted in the Iranian population (n = 600) from April to July 2020. A two-part online form was used: sociodemographic characteristics and depression items (CES-D). The construct validity and internal consistency reliability of the scale were evaluated. Result: The results of the exploratory factor analysis illustrated two factors with 43.35% of the total variance of the depression were explained. Confirmatory factor analysis indicated that this model fits well. Internal consistency reliability was evaluated, and it was acceptable. Conclusion: The findings demonstrated that, in the Iranian sample, this depression scale yielded two factors (somatic and positive affects) solutions with suitable psychometric properties.


Subject(s)
COVID-19 , Cross-Sectional Studies , Humans , Iran/epidemiology , Pandemics , Psychometrics , Reproducibility of Results , SARS-CoV-2 , Surveys and Questionnaires
5.
BMC Public Health ; 21(1): 2056, 2021 11 10.
Article in English | MEDLINE | ID: covidwho-1574565

ABSTRACT

BACKGROUND: Older adults duo to circumstances of aging such as relationship losses, medical morbidities, and functional declines, are prone to social isolation and loneliness more than any other age group. Furthermore, with The recent outbreak of the COVID-19 pandemic and the need to quarantine, the possibility of feelings of loneliness, especially in older adults, became an important nursing priority. Therefore, it is important to quickly identify loneliness and respond appropriately to prevent, reduce, or treat it. The aim of this study was to translate the De Jong Gierveld loneliness scale into Persian for older adults. METHODS: The sample was 400 adults aged 65 and older with a mean age of 71.32 (SD= ± 6.09) years. Recruitment and data collection was done via online methods. The original scale was translated into Persian using the World Health Organization (WHO) protocol of forward-backward translation technique. Face validity and content validity; was followed by exploratory and confirmatory factor analysis. Lastly, reliability was assessed using the Average Inter-Item Correlation, Cronbach's alpha, and McDonald's Omega. RESULTS: The results showed that the Persian version of the loneliness scale had two factors namely social loneliness (5 items) and emotional loneliness (3 items) and the combined score explained 45.66% of the total variance of this scale. In addition, all goodness of fit indices confirmed a two factors model fit and all of the reliability indices were excellent. CONCLUSIONS: The Persian version of the loneliness scale is useful and suitable for detecting social loneliness and emotional loneliness in older Iranian adults.


Subject(s)
COVID-19 , Loneliness , Aged , Humans , Iran/epidemiology , Pandemics , Psychometrics , Reproducibility of Results , SARS-CoV-2 , Surveys and Questionnaires
6.
BMC Public Health ; 21(1): 1919, 2021 10 22.
Article in English | MEDLINE | ID: covidwho-1561006

ABSTRACT

BACKGROUND: With the unprecedented expansion of COVID-19 in the world since December 2019, Iran's health system, like other countries, faced various challenges in managing the disease, which led to numerous experiences and lessons learned. This study was conducted to identify these challenges regarding unique political, economic, and cultural issues, which could help other countries with similar situations. METHODS: The present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and focused group discussions with 60 key persons who were selected purposefully, including policymakers, health care workers, and affected people by the disease, and the review of all available national reports between February 21, 2020, and March 22, 2021. The data collection and analysis were done simultaneously. RESULTS: Identified critical challenges for the management of COVID-19 in the health system were limited evidence and scientific controversies, poor social prevention and social inequalities, burnout and sustained workload among healthcare workers, improper management of resources and equipment, the lack of a guideline for contact tracing, and patient flow management, and mental health problems in the community. CONCLUSIONS: According to our results, measures should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on precise contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease, and also transparency of social inequalities in the face of risk factors of the COVID-19. Also, the social protection programs should become a vital tool for policymakers and supporting the vulnerable groups using the capacity of the community and international cooperation to develop a vaccine, which is difficult to procure due to the sanctions.


Subject(s)
COVID-19 , Pandemics , Humans , Iran/epidemiology , Qualitative Research , SARS-CoV-2
7.
Work ; 68(4): 969-979, 2021.
Article in English | MEDLINE | ID: covidwho-1557738

ABSTRACT

BACKGROUND: Professionalism, stress and demographic factors are the three key influences in nurses' intention to provide care. OBJECTIVES: This study examined the levels of work intention, stress and professionalism of nurses and determine the relationship between nursing work intention and factors in response to COVID-19. METHODS: This cross-sectional study was conducted on 362 nurses from COVID-19-devoted hospitals in Iran. A self-administered electronic-based questionnaire was developed and used to determine levels of stress, professionalism, and nursing intention. Multiple regression analysis was carried out to analyze the correlation between nursing intention with respect to stress and professionalism. RESULTS: The overall stress, professionalism, and nursing intention scores were 48.56, 21.46, and 17.83 respectively. There were significant differences in nursing intention scores between gender, marital status, and having training groups (p < 0.05). The regression analysis revealed that nursing intention had a significant relationship with older age (p < 0.001,S.E = 1.11,B = 17.02), higher income level (p < 0.001,S.E = 1.81,B = 6.98), having previous training (p = 0.008,S.E = 1.22,B = 3.27), higher stress level (p < 0.001,S.E = 2.37,B = -21.39), and high professionalism level (p < 0.001,S.E = 1.16,B = 11.99). CONCLUSION: Having an adequate staff requirement plan, planning appropriate training for nurses, and proactive psychological support are crucial to prevent burnout and continue to provide nursing services.


Subject(s)
Burnout, Professional/psychology , COVID-19/psychology , Disease Outbreaks , Intention , Nursing Staff, Hospital/psychology , Professionalism , Aged , Burnout, Professional/epidemiology , Cross-Sectional Studies , Humans , Iran/epidemiology , Job Satisfaction , SARS-CoV-2 , Surveys and Questionnaires
8.
BMC Infect Dis ; 21(1): 1185, 2021 Nov 25.
Article in English | MEDLINE | ID: covidwho-1538061

ABSTRACT

BACKGROUND: The first confirmed cases of COVID-19 in Iran were reported in Qom city. Subsequently, the neighboring provinces and gradually all 31 provinces of Iran were involved. This study aimed to investigate the case fatility rate, basic reproductive number in different period of epidemic, projection of daily and cumulative incidence cases and also spatiotemporal mapping of SARS-CoV-2 in Alborz province, Iran. METHODS: A confirmed case of COVID-19 infection was defined as a case with a positive result of viral nucleic acid testing in respiratory specimens. Serial interval (SI) was fitted by gamma distribution and considered the likelihood-based R0 using a branching process with Poisson likelihood. Seven days average of cases, deaths, doubling times and CFRs used to draw smooth charts. kernel density tool in Arc GIS (Esri) software has been employed to compute hot spot area of the study site. RESULTS: The maximum-likelihood value of R0 was 2.88 (95%, CI: 2.57-3.23) in the early 14 days of epidemic. The case fatility rate for Alborz province (Iran) on March 10, was 8.33% (95%, CI:6.3-11), and by April 20, it had an increasing trend and reached 12.9% (95%,CI:11.5-14.4). The doubling time has been increasing from about two days and then reached about 97 days on April 20, 2020, which shows the slowdown in the spread rate of the disease. Also, from March 26 to April 2, 2020 the whole Geographical area of Karj city was almost affected by SARS-CoV-2. CONCLUSIONS: The R0 of COVID-19 in Alborz province was substantially high at the beginning of the epidemic, but with preventive measures and public education and GIS based monitoring of the cases,it has been reduced to 1.19 within two months. This reduction highpoints the attainment of preventive measures in place, however we must be ready for any second epidemic waves during the next months.


Subject(s)
COVID-19 , Epidemics , Geographic Information Systems , Humans , Iran/epidemiology , Likelihood Functions , SARS-CoV-2
9.
Transbound Emerg Dis ; 68(6): 3405-3414, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1532918

ABSTRACT

Since its first detection in 1998, avian influenza virus (AIV) subtype H9N2 has been enzootic in Iran. To better understand the evolutionary history of H9N2 viruses in Iran, we sequenced 15 currently circulating H9N2 viruses from domestic poultry during 2017-2019 and performed phylogenetic analysis of complete genome sequences. Phylogenetic analyses indicated that the Iranian H9N2 viruses formed multiple well-supported monophyletic groups within the G1-lineage of H9N2 virus. Our analysis of viral population dynamics revealed an increase in genetic diversity until 2007, corresponding to the multiple introductions and diversification of H9N2 viruses into multiple genetic groups (named Iran 1-4 subgroups), followed by a sudden decrease after 2008. Only the Iran 4 subgroup has survived, expanded, and currently circulates in Iran. The H9N2 viruses possessed many molecular markers associated with mammalian adaption in all gene segments, except neuraminidase gene. Considering the presence of mammalian host-specific markers, the public health threat of H9N2 viruses continues. Molecular analysis showed that Iranian H9N2 strains have continued to evolve and recent strains have multiple amino acid changes and addition of potential N-glycosylation on the antigenic sites of haemagglutinin. Continued antigenic and molecular surveillance of H9N2 viruses in poultry and mammals would be required to monitor further increments in viral evolution and their potential threat to public health.


Subject(s)
Influenza A Virus, H9N2 Subtype , Influenza in Birds , Animals , Chickens , Evolution, Molecular , Influenza A Virus, H9N2 Subtype/genetics , Influenza in Birds/epidemiology , Iran/epidemiology , Phylogeny , Poultry
10.
Prehosp Disaster Med ; 36(6): 676-683, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1526027

ABSTRACT

BACKGROUND: Some studies in countries affected by the coronavirus disease of 2019 (COVID-19) pandemic have shown that the missions of Emergency Medical Service (EMS) have changed during the COVID-19 pandemic, and the rate of death and out-of-hospital cardiac arrest (OHCA) has been increased due to the direct and indirect effects of COVID-19. OBJECTIVE: The aim of this study was to determine the effect of the COVID-19 pandemic on the process of EMS missions, death, and OHCA. METHODS: This cross-sectional study was performed in Tehran, Iran. All conducted missions in the first six months of the three consecutive solar years of March 21 until September 22 of 2018-2020, which were registered in the registry bank of the Tehran EMS center, were assessed and compared. Based on the opinion of experts, the technician's on-scene diagnoses were categorized into 14 groups, and then death and OHCA cases were compared. RESULTS: In this study, the data of 1,050,376 missions performed in three study periods were analyzed. In general, the number of missions in 2020 was 17.83% fewer than that of 2019 (P < .001); however, the number of missions in 2019 was 30.33% more than that of 2018. On the other hand, the missions of respiratory problems, cardiopulmonary arrest, infectious diseases, and poisoning were increased in 2020 compared to that of 2019. The raw number of OHCA and death cases respectively in 2018, 2019, and 2020 were 25.0, 22.7, and 28.6 cases per 1,000 missions. Of all patients who died in 2020, 4.9% were probable/confirmed COVID-19 cases. The history of heart disease, hypertension, diabetes, and respiratory disease in patients in 2020 was more frequent than that of the other two years. CONCLUSION: This study showed that the number of missions in the Tehran EMS in 2020 were decreased compared to that of 2019, however the number of missions in 2019 was more than that of 2018. Respiratory problems, infectious diseases, poisoning, death, and OHCA were increased compared to the previous two years and cardiovascular complaints, neurological problems, and motor vehicle collisions (MVCs) in 2020 were fewer than that of the other two years.


Subject(s)
COVID-19 , Cardiopulmonary Resuscitation , Emergency Medical Services , Out-of-Hospital Cardiac Arrest , Cross-Sectional Studies , Humans , Iran/epidemiology , Out-of-Hospital Cardiac Arrest/epidemiology , Out-of-Hospital Cardiac Arrest/therapy , Pandemics , SARS-CoV-2
11.
Public Health ; 202: 84-92, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1517448

ABSTRACT

OBJECTIVES: The aim of this study was to identify risk factors of in-hospital mortality among diabetic patients infected with COVID-19. STUDY DESIGN: This is a retrospective cohort study. METHODS: Using logistic regression analysis, the independent association of potential prognostic factors and COVID-19 in-hospital mortality was investigated in three models. Model 1 included demographic data and patient history; model 2 consisted of model 1, plus vital signs and pulse oximetry measurements at hospital admission; and model 3 included model 2, plus laboratory test results at hospital admission. The odds ratios (ORs) and 95% confidence intervals (95% CIs) were reported for each predictor in the different models. Moreover, to examine the discriminatory powers of the models, a corrected area under the receiver-operating characteristic curve (AUC) was calculated. RESULTS: Among 560 patients with diabetes (men = 291) who were hospitalised for COVID-19, the mean age of the study population was 61.8 (standard deviation [SD] 13.4) years. During a median length of hospitalisation of 6 days, 165 deaths (men = 93) were recorded. In model 1, age and a history of cognitive impairment were associated with higher mortality; however, taking statins, oral antidiabetic drugs and beta-blockers was associated with a lower risk of mortality (AUC = 0.76). In model 2, adding the data for respiratory rate (OR 1.07 [95% CI 1.00-1.14]) and oxygen saturation (OR 0.95 [95% CI 0.92-0.98]) slightly increased the AUC to 0.80. In model 3, the data for platelet count (OR 0.99 [95% CI 0.99-1.00]), lactate dehydrogenase (OR 1.002 [95% CI 1.001-1.003]), potassium (OR 2.02 [95% CI 1.33-3.08]) and fasting plasma glucose (OR 1.04 [95% CI 1.02-1.07]) significantly improved the discriminatory power of the model to AUC 0.86 (95% CI 0.83-0.90). CONCLUSIONS: Among patients with type 2 diabetes, a combination of past medical and drug history and pulse oximetry data, with four non-expensive laboratory measures, was significantly associated with in-hospital COVID-19 mortality.


Subject(s)
COVID-19 , Hospital Mortality , Aged , COVID-19/mortality , Diabetes Mellitus, Type 2 , Female , Humans , Iran/epidemiology , Male , Middle Aged , Referral and Consultation , Retrospective Studies , Risk Factors
12.
Stud Health Technol Inform ; 285: 173-178, 2021 Oct 27.
Article in English | MEDLINE | ID: covidwho-1502265

ABSTRACT

COVID-19's rapid spreads has caused a global pandemic. On 19th February 2020, Iran reported its first confirmed cases of infections in Qom City and the number of diagnosed cases and the death toll rose exponentially in March [1-3]. Managing the disease, which is considered a pandemic according to the World Health Organization (WHO) [4], requires definite approaches differing according to various factors in each country, which may also lead to (in)effective dealing with the disease. In addition, using international data and information, and WHO advice, especially in the crisis and therapeutic procedures, is one of the best crisis management strategies [5]. For every plan by governances, the first step is collecting information on epidemic distribution for the purpose of isolating provinces and cities at a national scale. Thus, Ministry of Health and Medical Education of Iran (MOHME) attempted to collect the minimum required data on the infection-affected patients based on medical records and epidemiological factors, such as demographic data (gender, age and national code), exposure history (close contact with the infected, suspect patients or even having traveled) and signs and symptoms (fever, cough, shortness or difficulties in breathing, fatigue, anorexia, hemoptysis, sputum production, dyspnea, Myalgia, Pharyngalgia, nausea, vomiting, Diarrhea, Headache, Abdominal pain, Dizziness, etc.). Therefore, to ensure accuracy and validity, and to speed up data collection in an area, Information Technology (IT) tools were required [6]. In this regard, developing an information system with a simple format and user-friendly interface in the shortest possible time was the aim. This study presents the local information system developed in March 2020, which has been registering hospitalized Covide-19-affected patients in Iranian hospitals up till now. In other words, this paper introduces features and procedures of one of the national systems as a health registry that includes clinical information on admitted Covid-19 patients in Iranian hospitals from admission to discharge or death. This system is supported by MOHME, and along with outpatient Point of Care Information Systems (POCS), feeds the national and international pandemic reports and decisions.


Subject(s)
COVID-19 , Data Collection , Hospitals , Humans , Information Systems , Iran/epidemiology , SARS-CoV-2
13.
BMC Health Serv Res ; 21(1): 1169, 2021 Oct 28.
Article in English | MEDLINE | ID: covidwho-1496166

ABSTRACT

BACKGROUND: Human resources management plays an important role in social development and economic growth. Absence from work due to health problems can make obstacles to the growth of economy. This study conducted aimed to estimate the absenteeism costs of COVID-19 among the personnel of hospitals affiliated to Mashhad University of Medical Sciences in Mashhad, Iran. METHODS: This cross-sectional study was conducted between February 19, 2020, and September 21, 2020. The absenteeism costs were calculated using the human capital approach. Finally, we applied the linear regression to assess the impact of variables on the lost productivity of absenteeism due to COVID-19 among the personnel of hospitals affiliated to Mashhad University of Medical Sciences. RESULTS: The results of this study showed that 1958 personnel had COVID-19. The total of absenteeism days in our study were 32,209 days, with an average of 16.44 absenteeism days. Total costs due to absenteeism were estimated to be nearly $1.3 million, with an average of $671.4 per patient. The results of regression model showed that gender (male), age (> 50 years), employment Type (non-permanent) and monthly income had a positive relationship with the absenteeism cost. Also, there are a negative significant relationship between absenteeism cost with job (physicians) and work experience. CONCLUSIONS: Absenteeism costs of COVID-19 in the hospitals of Mashhad University of Medical Sciences represent a significant economic burden. The findings of our study emphasize the emergency strategies to prevent and control COVID-19 among the healthcare workers. It can decrease the economic impacts of COVID-19 and improve human resources management during the COVID-19 pandemic.


Subject(s)
Absenteeism , COVID-19 , Cost of Illness , Cross-Sectional Studies , Health Personnel , Hospitals , Humans , Iran/epidemiology , Male , Middle Aged , Pandemics , SARS-CoV-2
15.
BMC Pulm Med ; 21(1): 338, 2021 Oct 29.
Article in English | MEDLINE | ID: covidwho-1486570

ABSTRACT

Severe coronavirus disease 2019 (COVID-19) accompanies hypercytokinemia, similar to secondary hemophagocytic lymphohistiocytosis (sHLH). We aimed to find if HScore could predict disease severity in COVID-19. HScore was calculated in hospitalized children and adult patients with a proven diagnosis of COVID-19. The need for intensive care unit (ICU), hospital length of stay (LOS), and in-hospital mortality were recorded. The median HScore was 43.0 (IQR 0.0-63.0), which was higher in those who needed ICU care (59.7, 95% CI 46.4-72.7) compared to those admitted to non-ICU medical wards (38.8, 95% CI 32.2-45.4; P = 0.003). It was also significantly higher in patients who died of COVID-19 (105.1, 95% CI 53.7-156.5) than individuals who survived (41.5, 95% CI 35.8-47.1; P = 0.005). Multivariable logistic regression analysis revealed that higher HScore was associated with a higher risk of ICU admission (adjusted OR = 4.93, 95% CI 1.5-16.17, P = 0.008). The risk of death increased by 20% for every ten units increase in HScore (adjusted OR 1.02, 95% CI 1.00-1.04, P = 0.009). Time to discharge was statistically longer in high HScore levels than low levels (HR = 0.41, 95% CI 0.24-0.69). HScore is much lower in patients with severe COVID-19 than sHLH. Higher HScore is associated with more ICU admission, more extended hospitalization, and a higher mortality rate. A modified HScore with a new cut-off seems more practical in predicting disease severity in patients with severe COVID-19.


Subject(s)
COVID-19/diagnosis , Severity of Illness Index , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/mortality , COVID-19/pathology , COVID-19/therapy , COVID-19 Testing , Child , Child, Preschool , Critical Care/statistics & numerical data , Cytokine Release Syndrome/diagnosis , Cytokine Release Syndrome/virology , Female , Hospital Mortality , Hospitalization , Humans , Infant , Iran/epidemiology , Length of Stay/statistics & numerical data , Logistic Models , Male , Middle Aged , Predictive Value of Tests , Prognosis , Prospective Studies , Survival Analysis , Young Adult
17.
Arch Iran Med ; 24(9): 713-721, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1485772

ABSTRACT

BACKGROUND: The emergence and fast spread of coronavirus disease 2019 (COVID-19) threatens the world as a new public health crisis. Little is known about its effects during pregnancy. This study aimed to investigate the clinical manifestations of COVID-19 on maternal and neonatal outcomes. METHODS: In this systematic review, PubMed, Scopus, Web of Science, and Google Scholar databases were searched focusing on pregnancy and perinatal outcomes of COVID-19. RESULTS: The initial search yielded 1236 articles, from which finally 21 unique studies, involving 151 pregnant women and 17 neonates, met the criteria. Mean ± SD age of included mothers and mean ± SD gestational age at admission were 30.6 ± 6.2 years and 30.8 ± 8.9 weeks, respectively. The common symptoms were fever, cough, fatigue, dyspnea and myalgia. The mortality rates of pregnant women and neonates were 28 out of 151 (18.5%) and 4 out of 17 (23.5%), respectively. Most of the neonates were preterm at the time of delivery. Three neonates had positive RT-PCR test on the first day after birth and three others on day two. On the average, neonate's PCR became positive on day 4 for the first time. CONCLUSION: Early diagnosis of COVID-19 is crucial due to the possibility of the prenatal complications. Strict prevention strategies may reduce the risk of mother to infant transmission.


Subject(s)
COVID-19/transmission , Infectious Disease Transmission, Vertical , Pregnancy Complications, Infectious/virology , Adult , COVID-19/mortality , Female , Gestational Age , Humans , Infant, Newborn , Infant, Premature , Iran/epidemiology , Pregnancy , Pregnancy Complications, Infectious/mortality
18.
BMC Womens Health ; 21(1): 366, 2021 10 17.
Article in English | MEDLINE | ID: covidwho-1484309

ABSTRACT

BACKGROUND: Women are among the susceptible groups to Coronavirus disease-19 (COVID-19) in Ardabil, north-west of Iran, despite the current global status. The underlying causes of high incidence and fatality rate of women in Ardabil are not fully understood. Hence, this study aimed to investigate the healthy behaviours in women of Ardabil and its relationship with COVID-19 mortality. METHODS: We conducted a case-control study to compare the adherence to health protocols and behaviours with respect to COVID-19 between the infected (261 patients) and healthy (515 persons) women. Health protocols and behaviours such as using mask, gloves, disinfectants, history of travelling and contacting, and attending various gatherings and places during the COVID-19 pandemic along with demographic variables were defined as independent variables, and COVID-19 death rate was defined as the dependent variable. Multivariable logistic regression methods were used to explore the risk factors associated with COVID-19 mortality. RESULTS: Chi-square and Fisher tests showed significant differences between infected and healthy women in terms of history of contact and traveling (p < 0.05), wearing mask (p < 0.001), going to work place (p < 0.001), and attend public gatherings (p = 0.038). Multivariable logistic regression disclosed that the age group over 80 years: 8.97 times (95% CI 2.27-29.85), women with underlying chronic diseases: 4.14 times (95% CI 1.61-10.64), and obese women: 3.01 times (95% CI 1.04-6.03) were more likely to die from COVID-19 than other women. CONCLUSION: Considering the high incidence and mortality rate in Ardabil women due to COVID-19 and the corresponding health behavioural factors, special emphasis should be given to the increase of women awareness on the importance of healthy behaviours, diet, and life-style.


Subject(s)
COVID-19 , Pandemics , Aged, 80 and over , Case-Control Studies , Female , Health Behavior , Humans , Iran/epidemiology , SARS-CoV-2
19.
BMC Public Health ; 21(1): 1934, 2021 10 24.
Article in English | MEDLINE | ID: covidwho-1484308

ABSTRACT

BACKGROUND: Coronavirus disease (COVID-19) pandemic has become one of the biggest challenges to global health and economy. The present study aimed to explore the factors related to preventive health behaviors during the COVID-19 pandemic in Khuzestan Province, South of Iran, using the Health Belief Model (HBM). METHODS: The present cross-sectional study was conducted in the period between July 2020 and September 2020. A total of 1090 people from Khuzestan province participated in the study. The data collection method included a multistage cluster sampling method with a random selection of provincial of health centers. The questionnaire collected socio-demographic information and HBM constructs (e.g., perceived susceptibility, perceived severity, perceived benefits and barriers, cues to action, and COVID-19 preventive behaviors). Data were analyzed using ANOVA, t-test, hierarchical multiple linear regression, and SPSS version 22. RESULTS: The mean age of the participants was 35.53 ± 11.53, more than half of them were female (61.6%) and married (65.3). The results showed that 27% of the variance in the COVID-19 preventive behaviors was explained by HBM constructs. The regression analysis indicated that female gender (ß = 0.11), perceived benefits (ß = 0.10), perceived barriers (ß = - 0.18), external cues to action (ß = 0.25), and internal cues to action (ß = 0.12) were significantly associated with COVID-19 preventive behaviors (p < 0.05). CONCLUSION: Designing an educational intervention on the basis of HBM might be considered as a framework for the correction of beliefs and adherence to COVID-19 behavior. Health information campaigns need to (1) emphasize the benefits of preventive behaviors including avoiding the likelihood of getting a chronic disease and complications of the disease, (2) highlight the tips and advice to overcome the barriers (3) provide cues to action by means of showing various reminders in social media (4) focusing on adoption of COVID-19-related preventive behaviors, especially among men.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Female , Health Belief Model , Humans , Iran/epidemiology , Male , SARS-CoV-2
20.
J Environ Public Health ; 2021: 9081491, 2021.
Article in English | MEDLINE | ID: covidwho-1484111

ABSTRACT

Background: This study was conducted to evaluate the anti-SARS-CoV-2 IgM and IgG antibodies among healthcare workers in Guilan. Methods: This cross-sectional study was conducted on 503 healthcare workers. Between April and May 2020, blood samples were collected from the healthcare workers of Razi Hospital in Rasht, Guilan, Iran. Enzyme-linked immunosorbent assay (ELISA) was used for the detection and quantitation of anti-SARS-CoV-2 IgM/IgG antibodies by using kits made by Pishtaz Teb Company, Tehran, Iran. Results: From a total of 503 participants, the result of the anti-SARS-CoV-2 IgM antibody test was positive in 28 subjects (5.6%) and the anti-SARS-CoV-2 IgG antibody test was positive in171 subjects (34%). Participants in the age group of 35-54 years were significantly more likely to have a positive anti-SARS-CoV-2 antibody test than the age group of 20-34 years (odds ratio = 1.53, 95% CI: 1.04-2.25, P=0.029). Also, physicians were significantly more likely to have a positive antibody test than office workers (odds ratio = 1.92, 95% CI: 1.04-3.54, P=0.037). The wide range of symptoms was significantly associated with the positive anti-SARS-CoV-2 antibody test. The most significant association was observed between fever and a positive anti-SARS-CoV-2 antibody test (odds ratio = 3.03, 95% CI: 2.06-4.44, P < 0.001). Conclusion: The results of the current study indicated that the seroprevalence of COVID-19 was high among healthcare workers of Guilan Province. It seems that this finding was due to the earlier exposure to COVID-19 and the lack of awareness and preparedness to deal with the pandemic in Iran, compared to other countries.


Subject(s)
Antibodies, Viral , COVID-19 , Health Personnel , SARS-CoV-2 , Adult , Antibodies, Viral/blood , COVID-19/epidemiology , COVID-19/immunology , Cross-Sectional Studies , Female , Health Personnel/statistics & numerical data , Humans , Iran/epidemiology , Male , Middle Aged , SARS-CoV-2/immunology , Seroepidemiologic Studies , Young Adult
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