Noncommunicable disease, clinical course and COVID-19 prognosis: results based on I-core registry

Background:There are no data on the association between clinical course and comorbidity in Iranian patients with COVID-19.Aims:To determine noncommunicable disease (NCD), clinical characteristics and prognosis of patients hospitalized with COVID-19 in Isfahan, Islamic Republic of Iran.Methods:This multicentric retrospective observational study was performed on all patients hospitalized with COVID-19 in Isfahan from 17 February to 6 April 2020. We recruited 5055 patients. Data on clinical course and comorbid NCDs such as hypertension, coronary heart disease (CHD), diabetes mellitus (DM), cancer, chronic kidney disease (CKD) and chronic respiratory disease (CRD) were collected. Statistical analyses were done by Mann–Whitney U, χ2 and logistic regression tests using Stata version 14.Results:DM and hypertension were the most prevalent comorbidities in patients with positive and negative reverse transcription polymerase chain reaction (RT-PCR). Odds ratio (95% confidence interval) of mortality-associated factors was significant for DM [1.35 (1.07–1.70)], CHD [1.58 (1.26–1.96)], CRD [2.18 (1.58–3.0)], and cancer [3.55 (2.42–5.21)]. These results remained significant for cancer after adjustment for age, sex and clinical factors. Among patients with positive RT-PCR, death was significantly associated with CRD and cancer, while this association disappeared after adjustment for all potential confounders. There was a significant association between NCDs and higher occurrence of low oxygen saturation, mechanical ventilation requirement and intensive care unit admission after adjustment for age and sex.Conclusion:The presence of NCDs alone did not increase mortality in patients with COVID-19, after adjustment for all potential confounders including clinical factors.

The process of identifying key uncertainties in the orthotics and prosthetics education foresight.

INTRODUCTION: Medical sciences effects on people's health; therefore, it is necessary to identify all threats, opportunities, and challenges in its policy and planning particularly in the education field. The orthotics and prosthetics (O and P) field of study has great importance alongside other rehabilitation sciences due to its preventive status, therefore, the purpose of this study is to investigate the role of key factors and, subsequently, identifying uncertainties to compile and plot a bright and planned future for O and P education system. MATERIALS AND METHODS: At first, the key factors seemed to be influential improving the education and training quality of O and P students, were identified, weighted and ranked. All these steps were based on documentations and opinions of elites and deans of O and P through a semi-structured interview. Then, the final list of key factors and extracted drivers was placed and analyzed in cross-impact matrix by MicMac software. RESULTS: Among the initial list of key factors and drivers which identified 45 elements; 19 key factors and drivers scored the highest. Among 238 evaluable relationships in the cross-impact matrix, 123 relationships (51.6% of total matrix volume) are 0, which means that factors do not affect each other and are not affected either. Two key factors were identified as critical uncertainties out of 19 key factors. CONCLUSION: Achieving education development without a dynamic and active planning system is not possible. "Community-based education" and "government financial support" were identified as critical uncertainties of O and P future education system.