Résumé
Objective: COVID-19 has presented numerous epidemiological and clinical pictures from its beginning and much effort has been paid to detect the behavior of disease and its new types. Therefore, in this study, we aimed to compare the in-hospital survival time of Delta and Omicron variant patients admitted to the intensive care unit. Methods: This was a secondary data analysis of the QCOVICU data registry of 200 COVID-19 patients admitted to the ICU of Shahid Beheshti-Amir Al-Momenin Hospital of Qom City, in 2021. Likewise, time to event data, demographics, and baseline laboratory data was collected. Time of transfer to ICU, survivals, and possible predictors of hazards of death was compared within the variants of Omicron and delta. Results: Two hundred patients (62.98±19.94 years old, 94 females/106 males;100 Delta and 100 Omicron variant) participated in this study. Fifty percent of the population had died. Cross-tabulation showed comparable death rates among variants of delta and omicron (50.5% vs. 51%;p=0.999). There was a statistically significant higher time to ICU admission in Delta variant victims than in Omicron variant victims. The mean survival time of delta variant patients was 21.52 days (95% CI: 17.96 – 25.09) which was statistically higher than the mean survival of omicron patients (17.15 days, 95% CI: 13.65-20.64, p=0.018). The mean survival time of delta variant patients was statistically higher than omicron patients (21.52 vs. 17.15 days, p=0.018). Gender, age (years), and lymphocyte count were significant predictors of mortality based on the Cox regression analysis (P>0.05). There was a 5.9 times higher risk of mortality in females compared with males' gender after adjusting for other variables and a 5.6% increase in death risk with a 1-year increase in age, and a 31.8% decrease in death risk with a 1% lymphocyte percentage increase. Conclusion: Critically patients with Delta variant are getting ICU admitted later and withstand more days at ICU than Omicron patients. It seems that Omicron variant causes sudden deterioration of the patient's condition. © 2023 by SPC (Sami Publishing Company).
Résumé
Background: The outbreak of acute respiratory syndrome with novel coronavirus 2019 (COVID-19) in December 2019 in Wuhan, China, caused a worldwide outbreak of the disease. To treat the disease, some drugs were identified and introduced that did not show a significant effect on the recovery of the disease. Due to the need to manage inpatient beds, this study was conducted to evaluate the effectiveness of Remdesivir in the treatment of outpatients with moderate to severe COVID-19. Method(s): The present study was a retrospective cohort with a convenience sampling method. It was conducted by referring to the records of COVID-19 patients who were referred to the respiratory clinic of Shahid Beheshti Hospital as outpatients in the period from April to August 2021. Result(s): This study was conducted on 263 COVID-19 patients with a mean age of 51.16+/-14.39 years from 19 and 90 years old. Data were collected through a researcher-made checklist and analyzed using SPSS 20. Kolmogorov-Smirnov test, paired t-test, and Mc Nemar's test were used to evaluate the data. The significance level was considered at the level of 0.05. Conclusion(s): Findings revealed that no clear correlation was found between hospitalization and death rate compared to other patients. In our study, the risk factors for severe COVID-19 did not affect the rate of hospitalization or death of patients.Copyright © 2023 Bentham Science Publishers.
Résumé
Background and Objectives: Statins, which are primarily used for controlling blood cholesterol levels, have a well-known role in inhibiting the inflammatory process and reducing mortality rate of infectious diseases. This study aims to evaluate the effect of atorvastatin along with standard treatment protocol in hospitalized adults with COVID-19. Methods: This randomized controlled clinical trial was conducted on adults hospitalized due to COVID-19 infection at Shahid Beheshti Hospital in Qom, Iran from April to September 2020. They were randomly divided into groups of treatment (n=37, receiving atorvastatin 40 mg daily for 30 days plus standard treatment protocol) and control (n=37, receiving standard treatment protocol alone). The data were analyzed in SPSS v.22 software using chi-square, paired t-test, and ANOVA. P < 0.05 was statistically significant. Results: The CRP level in the atorvastatin-treated group decreased significantly such that there was a significant difference between the two groups after 30 days (P=0.01). There was no significant difference in Spo2 level on the discharge day. The length of hospitalization in the atorvastatin-treated group was significantly reduced compared to the control group (P < 0.05). Conclusion: The use of atorvastatin as an adjunctive treatment method, can significantly reduce the length of hospitalization and CRP level after 30 days in hospitalized patients.
Résumé
Objective: Since the outbreak of coronavirus disease 2019 (COVID-19), the triage of patients diagnosed with corona virus has been a very important issue. The aim of this study was to introduce a triage scoring system according to the clinical and para-clinical findings of patients in order to be admitted or discharged with COVID-19. Methods: After confirming the positive polymerase chain reaction (PCR) test for patients, we used a scoring system which included: the age of patient (less than 40 years and > 40 years), early vital signs at the time of admission, lab tests including C-reactive protein (CRP), white blood count (WBC), lactate dehydrogenase (LDH), D-dimer, chest imaging findings, comorbidity and shortness of breath. Results: The clinical score obtained for each variable in this scoring system was a number between 0 and 3. The total score was a minimum of 0 and a maximum of 17. A higher score indicated an increase in the intensity and the need for intensive care. These scores were classified into 3 groups: 0-4, 5-10 and above 10. In the next stage, patients were divided into three groups: mild, moderate and severe. In this regard, patients with mild symptoms were suggested to receive home quarantine and home treatment, patients with moderate symptoms were recommended hospitalization and medical care, and finally patients with severe symptoms were inclined to intensive care. Conclusion: In order to treat and manage patients with COVID-19, it is necessary to pay particular attention to clinical and para-clinical findings and prioritize these findings based on the severity and the condition of patients. © 2022, Kerman University of Medical Sciences. All rights reserved.