The Psychometric Properties of Intention to Receive the COVID-19 Vaccine Scale Based on the Health Belief Model.

Acceptance of the SARS-CoV-2) COVID-19( vaccine is a very important factor to keep health workers safe. The study aimed to evaluate the psychometric properties of intention to receive the COVID-19 vaccine using a health belief model among health workers in Iran The study was a tools design study that was conducted in the period from February to March 2020, Iran Questionnaire items were designed using text review. The sampling method was multi-stage. Data were analyzed using descriptive statistics, confirmatory and exploratory factor analysis at a 95% confidence level using SPSS software version 16. The designed questionnaire had an appropriate content validity and internal consistency. Also, the exploratory factor analysis showed that a 5-factor structure was extracted and confirmatory factor analyses revealed that the conceptual five-factor structure of the measure had good fit indices. Reliability was evaluated using internal consistency. Cronbach Alpha coefficient was .82 and the intra-class correlation coefficient (ICC) was .9. It can be concluded that the instrument designed in the preliminary stage of psychometrics properties had good validity and reliability indicators. Also, the constructs of the health belief model well explain the determinants of the intention to receive the COVID-19 vaccine at the individual level.

Evaluation of the effectiveness of the modified nutrition risk in the critically ill (mNUTRIC) score in critically ill patients affected by COVID-19 admitted to the intensive care unit (ICU).

BACKGROUND: COVID-19 is a very harmful pandemic, and its recovery process is highly influenced by nutritional status; however, an appropriate nutritional scale has not yet been proposed for these patients. Therefore, the purpose of this study was to evaluate the effectiveness of the modified Nutrition Risk in the Critically ill (mNUTRIC) score in critically ill patients affected by COVID-19 admitted to the intensive care unit (ICU). MATERIAL AND METHODS: This was a cross-sectional study performed on 204 critically ill patients affected by COVID-19 admitted to the ICU wards. Evaluated indicators include the mNUTRIC Score as well as demographic, and biochemical indicators. RESULTS: A high percentage of COVID-19 patients (67.2%) had severe disease. Hospital and ICU stay (p > 0.001) and PH (p > 0.001) values were significantly lower in non-survivors than in survivors. mNUTRIC score (p > 0.001), PCO2 (p = 0.003), and CRP levels (p = 0.021) were significantly higher in non-survivors than survivors. mNUTRIC score had a direct correlation with age (p > 0.001), AST (p = 0.000), LDH (p = 0.026), and CRP (p = 0.014) and an inverse correlation with hospital duration (p = 0.031), albumin (p = 0.003) and PH (p < 0.001). Furthermore, there was a non-significant correlation between the mNUTRIC score and mortality chance (OR = 1.085, 95%CI [0.83, 1.42], p = 0.552). While, patients with more severe COVID-19 disease (OR = 8.057, 95%CI [1.33, 48.64], p = 0.023) and higher PCO2 (OR = 1.042, 95%CI [1.01, 1.08], p = 0.023) levels had higher odds of mortality. CONCLUSIONS: Our findings revealed that COVID-19 patients with higher CRP levels and lower PH had higher mortality and poor nutritional condition. Moreover, there was a non-significant association between the mNUTRIC score and mortality chance.

Determinants of COVID-19 vaccine acceptance in healthcare workers in Iran: National Survey.

BACKGROUND AND AIM: It seems that acceptance of COVID-19 vaccination is the most effective way to tackle the COVID-19 pandemic now. Health care workers (HCWs) are one of the most important groups who are at risk for COVID-19 infection. This study aimed to assess the COVID-19 vaccine acceptance among HCWs in Iran and its determinants. METHODS: A cross-sectional survey was carried out among 3600 HCWs in Iran. Data were collected through a self-administered questionnaire by a trained team from February to March 2021. Multi-stage cluster sampling method was used for selecting respondents of the study. Multivariate logistic regression analysis was used to determine the key factors of COVID-19 vaccine acceptance among participants. P-value < 0.05 was considered statistically significant. RESULTS: Out of the 3536 respondents, 2191 (62.1%) intended to uptake the COVID-19 vaccine. Only about 10 percent of respondents said they did not trust any vaccine (domestic or foreign). Willing to accept a COVID-19 vaccine was relatively high among males, doctors, and those who had a history of hospitalization due to COVID-19 infection. The multivariate regression analysis showed respondents who were 40-50 years (aOR: 1.56; 95% CI: 1.47-1.66), had a history of COVID-19 infection (aOR: 0.85; 95% CI: 0.83-0.88), and hospitalized due to COVID-19 infection (aOR: 2.18; 95% CI: 1.97-2.39), were significantly associated with vaccine acceptance (p < 0.05). CONCLUSION: Our study showed moderate acceptance of COVID-19 vaccination in the HCWs in the Islamic Republic of Iran. The most important factor in the acceptance of the COVID-19 vaccine by the health staff is having a history of hospitalization. Further training and justification of health personnel is needed to increase the acceptance of COVID 19 vaccine.

SARS-CoV-2 in domestic cats (Felis catus) in the northwest of Iran: Evidence for SARS-CoV-2 circulating between human and cats.

This study aimed to investigate the prevalence of COVID-19 in domestic cats, focusing on the disease in the northwest of Iran and then showing the natural transmission of SARS-COV-2 circulating between domestic cats and humans. After receiving ethic codes from Tehran University of Medical Sciences (IR.TUMS.VCR.REC.1399.303) and confirmed by the Center of Communicable Diseases Control (CDC) of Iran, 124 domestic cats were collected from the homes and only one hospital of Meshkin -Shahr district from northwestern Iran where SARS-CoV-2 patients were hospitalized and quarantined during 2020. Samples were prepared from fluid materials of oropharynx and nasopharynx. All samples were tested by real-time PCR (RT-PCR) using specific genes N and ORF1ab in Pasteur Institute of Iran, and then partial sequence analyses of S gene were performed. All collected cats were kept in separated cages until SARS-COV-2 infection was confirmed with the RT-PCR. RT- PCR Ct values of 123 collected cats were ≥40; thus, all of them showed negative results, but one of the collected cats with close contact with its owner, whom confirmed SARS-CoV-2 showed positive results with gene N(Ct=30) and gene ORF1ab (Ct=32). Furthermore, the positive pet cat showed respiratory and gastro-intestinal clinical manifestations, and its owner was infected with SARS-CoV-2 two weeks ago. Cats are susceptible animals to SARS-CoV-2 infection. Epidemiological evidence showed that SARS-COV-2 is able to transmit to healthy cats due to having close contact with its owner as a reverse zoonosis.

Evaluation of the effectiveness of the Nutritional Risk Screening System 2002 (NRS-2002) in COVID-19 patients admitted to the intensive care unit.

BACKGROUND: Nutritional status of patients with COVID-19 can affect the recovery process of patients; however, no nutritional scale was introduced to evaluate the nutritional status of the patients. Thus, the main objective of this study was to examine the usefulness of Nutritional status-2002 (NRS-2002) among COVID-19 patients admitted to the intensive care unit (ICU). MATERIAL AND METHODS: In this cross-sectional study, 73 patients with definitive corona diagnosis admitted to the ICUs of Al-Zahra hospital, Isfahan, Iran in October 2020 to January 2021 were recruited. Dietary intake, NRS-2002, demographic, anthropometric and biochemical indices of patients were recorded. RESULTS: The majority of patients were at risk for moderate (69.9%) to severe (12.3%) malnutrition. Daily calorie intake (P = .001) and albumin (P = .001) levels in deceased patients were significantly lower than the recovered group. A direct correlation between NRS-2002 and age (P < .001) and an inverse correlation with daily calorie intake (P = .002), albumin (P = .05) and PaO2 (P = .034) was found. Moreover, there is a strong correlation between NRS-2002 score and chance of death among COVID-19 patients (OR=34.5, 95%CI:(5.2 - 228.93), P-value<0.001). Likewise, the levels of bilirubin direct (OR=8, 95%CI:(1.30 - 49.38), P-value=0.025) and creatine-phosphokinase (OR=0.9, 95%CI:(0.99 - 1.00), P-value=0.035) have a significant direct association with chance of death. CONCLUSION: Results showed patients with COVID-19 admitted to the ICU did not have appropriate nutritional status and mortality was higher among patients with lower amounts of the serum albumin and daily calorie intakes. Furthermore, there is a strong association between the NRS-2002 index and the chance of mortality in these patients.

Probiotics/Prebiotics in Viral Respiratory Infections: Implication for Emerging Pathogens.

BACKGROUND: Viral respiratory infections could result in perturbation of the gut microbiota due to a probable cross-talk between lungs and gut microbiota. This can affect pulmonary health and the gastrointestinal system. OBJECTIVE: This review aimed to discuss the impact of probiotics/prebiotics and supplements on the prevention and treatment of respiratory infections, especially emerging pathogens. METHODS: The data were searched in PubMed, Scopus, Google Scholar, Google Patents, and The Lens-Patent using keywords of probiotics and viral respiratory infections in the title, abstract, and keywords. RESULTS: Probiotics consumption could decrease the susceptibility to viral respiratory infections, such as COVID-19 and simultaneously enhance vaccine efficiency in infectious disease prevention through the immune system enhancement. Probiotics improve the gut microbiota and the immune system via regulating the innate system response and production of anti-inflammatory cytokines. Moreover, treatment with probiotics contributes to intestinal homeostasis restitution under antibiotic pressure and decreasing the risk of secondary infections due to viral respiratory infections. Probiotics present varied performances in different conditions; thus, promoting their efficacy through combining with supplements (prebiotics, postbiotics, nutraceuticals, berberine, curcumin, lactoferrin, minerals, and vitamins) is important. Several supplements reported to enhance the probiotics' efficacy and their mechanisms as well as probiotics- related patents are summarized in this review. Using nanotechnology and microencapsulation techniques can also improve probiotics' efficiency. CONCLUSION: Given the global challenge of COVID-19, probiotic/prebiotic and following nutritional guidelines should be regarded seriously. Additionally, their role as an adjuvant in vaccination for immune response augmentation needs attention.

Spatial modeling, risk mapping, change detection, and outbreak trend analysis of coronavirus (COVID-19) in Iran (days between February 19 and June 14, 2020).

OBJECTIVES: Coronavirus disease 2019 (COVID-19) represents a major pandemic threat that has spread to more than 212 countries with more than 432,902 recorded deaths and 7,898,442 confirmed cases worldwide so far (on June 14, 2020). It is crucial to investigate the spatial drivers to prevent and control the epidemic of COVID-19. METHODS: This is the first comprehensive study of COVID-19 in Iran; and it carries out spatial modeling, risk mapping, change detection, and outbreak trend analysis of the disease spread. Four main steps were taken: comparison of Iranian coronavirus data with the global trends, prediction of mortality trends using regression modeling, spatial modeling, risk mapping, and change detection using the random forest (RF) machine learning technique (MLT), and validation of the modeled risk map. RESULTS: The results show that from February 19 to June 14, 2020, the average growth rates (GR) of COVID-19 deaths and the total number of COVID-19 cases in Iran were 1.08 and 1.10, respectively. Based on the World Health Organisation (WHO) data, Iran's fatality rate (deaths/0.1M pop) is 10.53. Other countries' fatality rates were, for comparison, Belgium - 83.32, UK - 61.39, Spain - 58.04, Italy - 56.73, Sweden - 48.28, France - 45.04, USA - 35.52, Canada - 21.49, Brazil - 20.10, Peru - 19.70, Chile - 16.20, Mexico- 12.80, and Germany - 10.58. The fatality rate for China is 0.32 (deaths/0.1M pop). Over time, the heatmap of the infected areas identified two critical time intervals for the COVID-19 outbreak in Iran. The provinces were classified in terms of disease and death rates into a large primary group and three provinces that had critical outbreaks were separate from the others. The heatmap of countries of the world shows that China and Italy were distinguished from other countries in terms of nine viral infection-related parameters. The regression models for death cases showed an increasing trend but with some evidence of turning. A polynomial relationship was identified between the coronavirus infection rate and the province population density. Also, a third-degree polynomial regression model for deaths showed an increasing trend recently, indicating that subsequent measures taken to cope with the outbreak have been insufficient and ineffective. The general trend of deaths in Iran is similar to the world's, but Iran's shows lower volatility. Change detection of COVID-19 risk maps with a random forest model for the period from March 11 to March 18 showed an increasing trend of COVID-19 in Iran's provinces. It is worth noting that using the LASSO MLT to evaluate variables' importance, indicated that the most important variables were the distance from bus stations, bakeries, hospitals, mosques, ATMs (automated teller machines), banks, and the minimum temperature of the coldest month. CONCLUSIONS: We believe that this study's risk maps are the primary, fundamental step to take for managing and controlling COVID-19 in Iran and its provinces.