Epidemiological features and consequences of COVID-19 in patients with and without gastrointestinal symptoms in southwestern Iran. A retrospective observational study.

Background and Aims: Some studies have shown that in addition to respiratory symptoms, gastrointestinal (GI) manifestations reported in patients with coronavirus disease 2019 (COVID-19). The aim of this study was to compare the epidemiological features and consequences of COVID-19 in patients with and without GI symptoms. Methods: This retrospective observational study concluded on 15,323 COVID-19 patients with GI symptoms and 95,724 patients without symptoms. All symptoms and comorbidities of the patients collected. To investigate the differences between qualitative variables in the two groups, χ 2 test was used. Logistic regression analysis also used to identify determinants of mortality in patients with COVID-19. Results: During the course of the study, 111,047 cases of COVID-19 occurred. Of these, 13.8% of patients had GI symptoms, and 9.9% of deaths due to COVID-19 occurred in these patients. The most common reported GI symptoms among COVID-19 patients were nausea, vomiting, and diarrhea. In addition, comorbidities, such as diabetes, cardiovascular disease, and thyroid disease were significantly higher in patients with GI symptoms. The result of multiple logistic regression showed that the chance of mortality is higher in a patient with COVID-19 who have dyspnea, fever, cough, hypertension, cardiovascular disease, diabetes, immunodeficiency, chronic kidney disease, thyroid disease, chronic pulmonary disease, and male gender. The chance of death was lower in people with GI symptoms. Conclusion: According to the findings of this study, nausea, vomiting, and diarrhea were the most common GI symptoms. Also, the chance of death is higher in people with co-morbidities such as cardiovascular diseases, diabetes, and high blood pressure. Therefore, it is necessary to follow these people closely.

Epidemiological Features and Outcomes of COVID-19 in Patients With and Without Cardiovascular Disease.

BACKGROUND: Cardiovascular diseases (CVDs) are known as an important group of risk factor for progression of the Coronavirus-19 disease (COVID-19). The present study compared epidemiological features and outcomes in COVID-19 patients with CVDs versus those without CVDs. METHODS: This is a retrospective study performed on 1497 patients with CVDs and 26926 patients without CVDs, all of whom were confirmed to have COVID-19. All clinical signs and comorbidities were investigated in the subjects. Mann-Whitney U test and Pearson's Chi-square test were applied to compare mortality between the groups. Logistic regression was used to identify the predictors of mortality among patients. RESULTS: The mean age of COVID-19 patients with underlying CVD was 60 years. Totally, about 5.3% of the individuals under study had CVD. Also, 21.6% of all deaths occurred in COVID-19 patients with CVD. Cough, fever, shortness of breath, muscle pain, and underlying diseases such as diabetes, hypertension, chronic liver and kidney disease, chronic lung disease, and immunodeficiency were significantly higher in patients with CVD than those without CVDs. The odds of death in COVID-19 patients were 1.9 times higher with underlying CVD, 2.1 times with diabetes, 3.4 times with hypertension, 1.9 times with immunodeficiency, and 2.3 times with chronic liver and kidney disease. CONCLUSION: CVDs are a serious threat to COVID-19 patients because they increase mortality among these patients. As a result, preventive and therapeutic strategies must be developed for these vulnerable groups, who will be prone to higher mortality.

Epidemiological characteristics of patients with COVID-19 in Southwest of Iran from February 19 to June 20, 2020.

Background: COVID-19 spread rapidly throughout the world and affected many people. The purpose of this study was to investigate the epidemiological characteristics of patients with COVID-19 in southwest of Iran from February 19 to June 20, 2020. Methods: In this retrospective study, the epidemiological characteristics of 7313 patients with COVID-19 in southwest of Iran were analyzed and reported from February 19, 2020, to the end of Jun,2020. Data were extracted from electronic records in hospitals. Sex ratio and mortality rate of the disease were calculated. A multiple logistic regression analysis was used to evaluate the factors affecting mortality. Results: From all patients studied, 3920 (53.5%) were men and 2066 (28.24%) were in the age 30 to 40 years age group. The case fatality rate of the disease based on the total number of patients (hospitalized and nonhospitalized) was 4.84%. The highest mortality rate was seen in patients with various cancers and in those aged over 80 years. The most common symptoms in patients were fever and cough, diabetes, hypertension, and cardiovascular diseases. Logistic regression results also showed that the chances of death in the 70-60 and 80-70 years age group were 5.94 (OR, 5.94; 95% CI, 2.14-16.43) and 8.63 (OR, 8.63, 95% CI, 3.09-24.14) compared to 10-20 years age group. Conclusion: These results indicate the need to increase primary care, provide the necessary equipment to treat patients, and more importantly, early identification of patients and treatment for them.

Epidemiological Features and Predictors of Mortality in Patients with COVID-19 with and without Underlying Hypertension.

BACKGROUNDS: Individuals with hypertension are at higher risk of COVID-19 infection and related mortality. This study was carried out to assess the epidemiological features and predictors of mortality in patients with COVID-19 with hypertension. METHODS: In this retrospective study, the epidemiological characteristics of two groups of patients with COVID-19 with hypertension (1927) and without hypertension (39030) were compared. Chi-square test was applied to evaluate the differences between qualitative variables in two study groups. Logistic regression was also used to determine predictors of mortality in patients with COVID-19 and in patients with COVID-19 with hypertension. RESULTS: The prevalence of hypertension in patients with COVID-19 was 4.7%, and 24.37% of COVID-19 related deaths occurred in these individuals. The average age of hypertension and nonhypertension patients was 61 and 37 years, respectively. Fever, cough, headache, anorexia, fatigue, and comorbid diseases, such as cardiovascular disease, chronic lung and kidney disease, diabetes, immunodeficiency disease, and thyroid disease, were significantly more frequent in people with hypertension than those without hypertension. The chances of mortality in patient with COVID-19 were 1.8 times higher in individuals with dyspnea, 1.25 in individuals with fever, 1.33 in individuals with cough, 3.6 in patients with hypertension, 2.21 in diabetics, and 2.2 in individuals with cardiovascular disease. Also, individuals with COVID-19 with hypertension that had dyspnea, immunodeficiency, and cardiovascular disease were at higher risk of mortality. CONCLUSION: Hypertension is a serious threat to patients with COVID-19. Therefore, in order to control these patients more precisely and reduce mortality in them, it is extremely important to develop prevention and treatment strategies.

Prevalence and determinants of diabetes and prediabetes in southwestern Iran: the Khuzestan comprehensive health study (KCHS).

BACKGROUND: The Middle East and North Africa (MENA) is postulated to have the highest increase in the prevalence of diabetes by 2030; however, studies on the epidemiology of diabetes are rather limited across the region, including in Iran. METHODS: This study was conducted between 2016 and 2018 among Iranian adults aged 20 to 65 years residing in Khuzestan province, southwestern Iran. Diabetes was defined as the fasting blood glucose (FBG) level of 126 mg/dl or higher, and/or taking antidiabetic medications, and/or self-declared diabetes. Prediabetes was defined as FBG 100 to 125 mg/dl. Multinomial logistic regression models were used to examine the association of multiple risk factors that attained significance on the outcome. RESULTS: Overall, 30,498 participants were recruited; the mean (±SD) age was 41.6 (±11.9) years. The prevalence of prediabetes and diabetes were 30.8 and 15.3%, respectively. We found a similar prevalence of diabetes in both sexes, although it was higher among illiterates, urban residents, married people, and smokers. Participants aged 50-65 and those with Body Mass Index (BMI) 30 kg/m2 or higher were more likely to be affected by diabetes [RR: 20.5 (18.1,23.3) and 3.2 (3.0,3.6)]. Hypertension [RR: 5.1 (4.7,5.5)], waist circumference (WC) equal or more than 90 cm [RR: 3.6 (3.3,3.9)], and family history [RR: 2.3 (2.2,2.5)] were also significantly associated with diabetes. For prediabetes, the main risk factors were age 50 to 65 years [RR: 2.6 (2.4,2.8)], BMI 30 kg/m2 or higher [RR: 1.9 (1.8,2.0)], hypertension and WC of 90 cm or higher [RR: 1.7 (1.6,1.8)]. The adjusted relative risks for all variables were higher in females than males, with the exception of family history for both conditions and waist circumference for prediabetes. CONCLUSIONS: Prediabetes and diabetes are prevalent in southwestern Iran. The major determinants are older age, obesity, and the presence of hypertension. Further interventions are required to escalate diabetes prevention and diagnosis in high-risk areas across Iran.

Therapeutic Efficacy of Aerobic Exercise Training along with Oak Husk Hydroalcoholic Extract for Amelioration of Inflammation in Obese Elderly Male Mice.

BACKGROUND: Fibrinogen and interleukin-1ß as a proinflammatory cytokine and interleukin-10 and nesfatin-1 as an anti-inflammatory cytokine have an important role in the development and prevention of systemic inflammation and incidence of obesity-induced diseases. Thus, this study is aimed at the interaction effects of aerobic training and oak husk hydroalcoholic extract consumption on plasma levels of fibrinogen, interleukin-1ß, nesfatin-1, and interleukin-10 in obese elderly male mice. MATERIALS AND METHODS: In this experimental study, 40 fat male mice were fed a high-fat diet for 4 weeks to induce obesity, and subsequently, they were divided randomly into four groups: control, supplement, exercise-placebo, and exercise-supplement. The training groups performed aerobic exercise 5 days a week for 6 weeks (approximately 80-75% VOmax 2). The supplement groups received a solution of oak husk hydroalcoholic extract at a dose of 20 milligram per kilogram of body weight for 6 weeks. Blood samples were taken 48 h after the last training session, and the levels of IL-10, fibrinogen, IL-1ß, and nesfatin-1 were measured. Data were analyzed using one-way ANOVA and LSD post hoc tests. RESULTS: The results showed that six-week training and oak husk hydroalcoholic extract consumption significantly increased the levels of IL-10 and nesfatin-1 in experimental groups (P < 0.001). Also, the levels of fibrinogen and IL-1ß decreased significantly in training groups. Averages between group variations of all indicators were statistically significant, and they were more meaningfully pronounced in the exercise-supplement group than other groups (P ≤ 0.05). CONCLUSIONS: Considering the results of the present study, the use of moderate aerobic exercise and oak husk hydroalcoholic extract is recommended to reduce the risk of obesity; it may also have a positive effect on inflammatory factors.

Epidemiological characteristics and outcomes of COVID-19 in diabetic versus non-diabetic patients.

Objectives and background: People with diabetes (PWD) are one of the high-risk groups for coronavirus disease 2019 (COVID-19) infection, increasing the disease mortality. This study was aimed to compare the epidemiological characteristics and outcomes of COVID-19 in diabetic versus non-diabetic individuals. Methods: In this retrospective observational study, the epidemiological characteristics of the two groups of diabetic (n=1365) and non-diabetic (n=15,026) subjects with definite diagnosis of COVID-19 in the southwestern region of Iran were compared. All clinical signs and comorbidities of the patients were evaluated. Chi-square test was used to examine the differences in qualitative variables between diabetic and non-diabetic groups. Results: Of 16,391 enrolled subjects, 8.3% had diabetes, and 28.3% of COVID-19-related deaths occurred in diabetics. Also, the mortality rate among diabetics was reported as 14.3%. The average age of diabetic patients and non-diabetic patients was 59 and 37 years, respectively. The odds of fever, cough, shortness of breath, headache, and underlying diseases, such as hypertension, cardiovascular disease, chronic lung disease, immune deficiency, and hyperlipidemia, were significantly higher in diabetic patients than in non-diabetics. Conclusion: Diabetes is associated with increased mortality rate in patients with COVID-19 and is considered as a major risk factor for COVID-19 infection, posing a major public health challenge for health policymakers in managing and controlling the disease. Therefore, development of prevention and treatment strategies aimed at reducing COVID-19 morbidity and mortality in diabetes patients is of significant importance.

Epidemiological characteristics and outcomes of COVID-19 in asymptomatic versus symptomatic patients.

Background: The clinical manifestations of COVID-19 are different, which can be attributed to asymptomatic carriers, acute respiratory disease and pneumonia with different severities. The aim of this study was to compare the epidemiological characteristics and outcomes of COVID-19 in patients with clinical symptoms versus asymptomatic patients. Methods: In this retrospective cohort study, the epidemiological characteristics of two groups of patients, with clinical symptoms (n = 38,630) and without clinical symptoms who were definitive cases of COVID-19 (n = 2,327) were investigated in the southwestern of Iran. Chi-square test was used to evaluate the differences between qualitative variables in the two study groups. Results: Of 40,957 patients with COVID-19, 2,327 (5.68%) were asymptomatic, of whom 1391 (59.77%) were males, 1841 patients (79.11%) had a history of contact with definite or suspected cases of COVID-19. Asymptomatic patients were older than symptomatic cases. Patients with clinical symptoms had higher mortality rate than asymptomatic patients (2.68% in symptomatic patients vs 0% in asymptomatic patients). Conclusion: According to the results of our study, the detected viral load in asymptomatic individuals was similar to that of symptomatic patients, indicating that asymptomatic infections can potentially transmit the disease. Therefore, screening and detection of asymptomatic cases is an important and key measure in prevention and early control of COVID-19 worldwide.

Anti-inflammatory properties of combined aquatic extract of Ferulago angulata boiss with aerobic exercise on pro-inflammatory indices in obese males.

BACKGROUND: The application of supplements, herbal extracts, and exercise training for treatment of diseases and reducing chronic inflammation has been increased progressively among people. Thus, the aim of this investigation was to study the combined aquatic extract of Ferulago angulata boiss with aerobic exercise on pro-inflammatory indices in obese males. MATERIALS AND METHODS: In this semi-experimental study, forty young obese men (mean and standard deviation of age 34.59 ± 2.24 years, body mass index (BMI) 33.14 ± 2.75 kg/m2) were selected by purposed sampling and were randomly divided into four equal groups (n = 10), training, training-supplementation, supplementation, and control. Participants in the supplementary groups received 50 mg/ml F. angulata extracts daily for 12 weeks. Aerobic training program included 12 weeks of training, 3 sessions/week, and each session was 20 min at 60%-%-70% of maximal oxygen consumption. Blood samples were taken from the participants 48 h before and after the intervention in fasting state. Data were analyzed using dependent t-test, one-way analysis of variance, and post hoc Tukey test at a significant level of P < 0.05. RESULTS: After 12 weeks of exercise and supplementation, levels of interleukin (IL)-6 (P = 0.001), IL-18 (P = 0.03), IL-1 ß (P = 0.001), tumor necrosis factor alpha (P = 0.001), weight (P = 0.001), BMI (P = 0.001), body fat percent (P = 0.001), and waist-hip ratio (P = 0.001) decreased significantly and the mean changes of these indicators in training + supplementation group were significantly augmented as compared to the other three groups. CONCLUSION: It appears that aerobic training plus F. angulata extract consumption have better effect on improvement of serum inflammatory factors in obese young men.

Corrigendum to "The relationship between knowledge of leadership and knowledge management practices in the food industry in Kurdistan province, Iran" [Data Brief 15 (2017) 155-159].

[This corrects the article DOI: 10.1016/j.dib.2017.09.031.].

Basic Occupational Health Services for Agricultural Workers in the South of Iran.

The agricultural sector has by far the world's largest labour force, there are more than one billion workers in this industry worldwide, which contains half of the total world labour force. On the other hand, agriculture is one of the most hazardous occupations, and many workers suffer occupational accidents and ill health each year. Farming and animal breeding are associated with exposure to a wide variety of risk factors, including zoonotic agents, dust, elements of the thermal environment, noise, vibration and chemicals. Although half of the world's population are economically active and spend at least one third of their time in the workplace, only 15% of the workers have access to basic occupational health services. According to a WHO report, Iran has a well-structured health care system through which basic health care services are available to the entire population, and health indicators in Iran have consistently improved. The agricultural health program in Iran is being carried out in the cities and rural areas, and occupational health services are mainly integrated into the health network. This paper aims to describe the health care system and basic occupational health services (BOHs) available to 5,300 agricultural enterprises with 8,380 employees in the cities of Abadan, Khorramshahr and Shadegan in the Abadan region (Abadan, Khoramshahr and Shadegan districts), in the south of Iran.

The relationship between knowledge of leadership and knowledge management practices in the food industry in Kurdistan province, Iran.

The aim of this study was to identify the relationship between the knowledge of leadership and knowledge management practices. This research strategy, in terms of quantity, procedure and obtain information, is descriptive and correlational. Statistical population, consist of all employees of a food industry in Kurdistan province of Iran, who were engaged in 2016 and their total number is about 1800 people. 316 employees in the Kurdistan food industry (Kurdistan FI) were selected, using Cochran formula. Non-random method and valid questions (standard) for measurement of the data are used. Reliability and validity were confirmed. Statistical analysis of the data was carried out, using SPSS 16. The statistical analysis of collected data showed the relationship between knowledge-oriented of leadership and knowledge management activities as mediator variables. The results of the data and test hypotheses suggest that knowledge management activities play an important role in the functioning of product innovation and the results showed that the activities of Knowledge Management (knowledge transfer, storage knowledge, application of knowledge, creation of knowledge) on performance of product innovation.

Risk factors accelerating hypothyroidism in pregnant women referred to health centers in Abadan, Iran.

The present work contains data obtained during the analysis of pregnant women referred to Abadan Health Centers Organization (Abadan HCO) with confirmed acute hypothyroidism diagnosis. From among all pregnant women referred to Abadan HCO, 600 were chosen consisting of 120 pregnant women from each of the health centers in quintuple areas. In this paper, the effects of family history, occupation, death, abortion, type of diabetes, smoking, lithium consumption, allergy, radiotherapy, ovarian cysts (OC) and oral contraceptive pills (OCP) consumption have been studied (Yassaee et al., 2014) [1]. After completion of the questionnaires by the patients, the obtained coded data were fed into ECSELL software. Statistical analysis of the data was carried out using Special Package for Social Sciences version 16 (SPSS 16).

Genetic Variants of Cytochrome b-245, Alpha Polypeptide Gene and Premature Acute Myocardial Infarction Risk in an Iranian Population.

BACKGROUND: Oxidative stress induced by superoxide anion plays critical roles in the pathogenesis of coronary artery disease (CAD) and hence acute myocardial infarction (AMI). The major source of superoxide production in vascular smooth muscle and endothelial cells is the NADPH oxidase complex. An essential component of this complex is p22phox, that is encoded by the cytochrome b-245, alpha polypeptide (CYBA) gene. The aim of this study was to investigate the association of CYBA variants (rs1049255 and rs4673) and premature acute myocardial infarction risk in an Iranian population. METHODS: The study population consisted of 158 patients under the age of 50 years, with a diagnosis of premature AMI, and 168 age-matched controls with normal coronary angiograms. Genotyping of the polymorphisms was performed by the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). RESULTS: There was no association between the genotypes and allele frequencies of rs4673 polymorphism and premature acute myocardial infarction (P>0.05). A significant statistical association was observed between the genotypes distribution of rs1049255 polymorphism and AMI risk (P=0.037). Furthermore, the distribution of AA+AG/GG genotypes was found to be statistically significant between the two groups (P=0.011). CONCLUSIONS: Our findings indicated that rs1049255 but not rs4673 polymorphism is associated with premature AMI.