The Effectiveness of Laboratory Parameters in Predicting the in-Hospital Mortality of Iranian Patients with Coronavirus Disease 2019 (COVID-19).

Background: The novel coronavirus 2019-nCoV (now SARS-CoV-2) has spread globally and affected healthcare systems worldwide. Due to lack of long-term immunization and effective specific treatments for the COVID-19 disease, there is a need of identifying the patients who are at the risk of a fatal outcome, according to the available epidemiological data and laboratory parameters. Objective: Thus, we aimed to evaluate the prognostic value of epidemiological data and laboratory para-meters for in-hospital case fatality in patients with COVID-19. Materials and Methods: A retrospective cohort of patients with COVID-19 admitted to the Shahid Mostafa Khomeini Hospital of Ilam University of Medical Sciences from February 29 until March 29, 2020 was performed. Epidemiologic data and laboratory results were collected. Univariate and multivariate logistic regression models were performed to evaluate the prognostic value of the laboratory parameters for in-hospital death. Results: A total of 256 Iranian COVID-19 patients were included in the evaluation; 38 of them died, resulting in a in-hospital case-fatality rate of 14.8%. The univariate analysis showed that advanced age [OR=1.04, 95% CI: 1.02, 1.06, P=0.001], smoking [OR=4.041, 95% CI: 1.546-10.563, P=0.004], white blood cells [OR=0.941, 95% CI: 0.904-0.980, P =0.003] and hematocrit [OR=1.060, 95% CI: 1.009-1.113, P=0.020] were positively associated with the risk of a fatal outcome. Multivariate logistic regression analysis revealed that COVID-19 patients with an elevated white blood cell count and elevated hemoglobin level had 1% and 9% greater risk of an in-hospital death for each elevated unit [OR=1.07; 95 %CI: 1.024-1.088, P =0.002 and OR=1.379; 95% CI 0.064-1.788, P =0.015, respectively]. Conclusions: An increase in white blood cell count and an increase in hemoglobin level might be indepen-dent risk factors for in-hospital death in Iranian patients with COVID-19. Further studies are necessary in order to conferm the prognostic value of the variables discussed.

Claims and reasons about mild COVID-19 in children.

The elderly form the main risk group in the coronavirus disease 2019 (COVID-19) pandemic, and age is recognized as a major risk factor for the severity of infection and mortality of COVID-19. The severity of the infection in children is milder than in adults. Although the pathophysiology of COVID-19 is not fully understood, several possible factors and mechanisms have been suggested for the lower severity of infection in children.

COVID-19 reinfection: prolonged shedding or true reinfection?

The SARS-CoV-2 pandemic is underway and millions of people have been infected. A large number of patients with COVID-19 have recovered and been discharged. While a number of recovered patients test positive again or even have a recurrence of clinical symptoms. Some researchers believe that a positive retest is related to the long-term persistence of the virus in the body, although there is some evidence in favor of reinfection. In this study, we focus more on the possible reasons for positive retesting, antibody responses, and review of possible reinfection case reports.

Transmission routes for SARS-CoV-2 infection: review of evidence.

There is no specific treatment for SARS-CoV-2, and all infection control strategies are based on breaking the transmission chain of virus. The high transmission rate of SARS-CoV-2 has raised many questions about the possible routes of infection transmission. Due to uncertainty of the main transmission routes, the infection control policies faced with more challenges. The possible main route of transmission is thought to be the close contact and respiratory droplets. Therefore, it is necessary to maintain physical distance and using the face mask. Another routes of transmission are through contaminated surfaces as well as airborne, fecal-oral transmission.

The prevalence of human bocavirus in <2-year-old children with acute bronchiolitis.

Acute bronchiolitis is one of the most common lower respiratory tract infections in children with less than 2 years of age. Nowadays, molecular methods provide an opportunity to better understand the etiology of bronchiolitis. Several viral agents including Respiratory syncytial virus (RSV), Rhinovirus, Parainfluenza and Human bocavirus (HBoV) are responsible for acute bronchiolitis. There are growing studies on the prevalence of HBoV in patients with bronchiolitis. The present systematic review and meta-analysis were conducted to determine the pooled prevalence of HBoV in the respiratory samples of children with acute bronchiolitis. A literature search was conducted in the databases of PubMed, Scopus and Web of Science to recruit studies reporting the frequency of HBoV in <2-year-old children with acute bronchiolitis from 2005 to 2019. Only studies that used polymerase chain reaction (PCR)-based methods to detect the virus in nasopharyngeal samples were included. A total of 22 studies assessing 6751 cases were analyzed. According to the meta-analysis based on the random-effects model, the overall prevalence of HBoV in children with <2 years old was obtained 13% (95% CI: 0.09-0.17). Additionally, the rates of single (as the sole organism) and mixed (in combination with other viruses) HBoV infections were 4% and 9%, respectively. This study showed a high rate of HBoV detection in children with acute bronchiolitis. This should be considered as part of a diagnostic test panel for respiratory infections in children with bronchiolitis.

Report of five nurses infected with severe acute respiratory syndrome coronavirus 2 during patient care: case series.

The high prevalence of coronavirus disease 2019 (COVID-19) has received much attention all over the world. Nurses are in the first line of defence against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and are placed in a high-risk situation. This study aimed to report on infection with SARS-CoV-2 during patient care among nures in the Mostafa Khomini Hospital, Ilam, Iran. In this hospital 125 nurses were enrolled in the COVID-19 centre. Five out of 125 nurses (4%) who enrolled in the COVID-19 infection centre, developed COVID-19. They were first positive by real-time PCR but the CT scan was positive for only one of them. None of the infected nurses were hospitalized and all of them preferred to quarantine at home and receive the necessary care and treatment (oseltamivir, azithromycin and lopinavir/ritonavir). This study showed that, regardless of self caring, the nurses were exposed to the virus, because at the start of the SARS-CoV-2 outbreak in Iran, there was no special protection against this infection, so the nurses were placed at risk. This study also reported that receiving the necessary care and treatment at home was a good experience for nurses and can be used in some cases.