Mojtaba Yousefi Zoshk; Melika Zamanian; Melika Farshidianfar; Alireza Masoumi; Mohammad Mobin Mirimoghaddam; Elahe Bakhshi; Anoush Azarfar
Abstract
The coronavirus disease 2019 (COVID-19) has afflicted individuals of all ages, which has a high rate of morbidity and fatality. Although most children with COVID-19 infection experience minor symptoms, a growing proportion of COVID-19 infections in children are linked to a novel multisystem inflammatory ...
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The coronavirus disease 2019 (COVID-19) has afflicted individuals of all ages, which has a high rate of morbidity and fatality. Although most children with COVID-19 infection experience minor symptoms, a growing proportion of COVID-19 infections in children are linked to a novel multisystem inflammatory syndrome with Kawasaki disease-like clinical features. Multisystem inflammatory syndrome in children (MIS-C) is a novel hyperinflammatory syndrome that can impact about any organ system. The most frequent symptoms are fever and gastrointestinal disorders, although neurologic and dermatologic manifestations are also well-documented. The clinical symptoms of MIS-C coincide with those of Kawasaki disease, toxic shock syndrome, and shock syndrome, making diagnosis challenging. Elevated inflammatory markers are common in MIS-C patients, and an abnormal echocardiogram or electrocardiogram may be present. Intravenous immunoglobulin, anticoagulation, and corticosteroids should all be considered in the treatment of MIS-C patients. Even those with significant cardiovascular involvement, the majority of patients recover without complications. Echocardiographic follow-up is required as coronary aneurysms have been documented. This narrative review is to review the epidemiology, pathophysiology, clinical presentations, laboratory findings, diagnostic criteria, and treatment options for MIS-C patients in order to increase pediatricians’ knowledge of this novel syndrome.
Maryam Dastfan; Ali Madadi Mahani; AmirAli Moodi Ghalibaf; Farid Poursadegh; Fariba Rezaeetalab; Ali Shamshirian; Mahnaz mozdorian
Abstract
Background:The Coronavirus disease 2019 (COVID-19) pandemic has posed significant challenges to healthcare systems worldwide. This cross-sectional study aimed to investigate the relationship between inflammatory markers, liver enzymes, lung involvement severity, and mortality in 841 COVID-19 patients ...
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Background:The Coronavirus disease 2019 (COVID-19) pandemic has posed significant challenges to healthcare systems worldwide. This cross-sectional study aimed to investigate the relationship between inflammatory markers, liver enzymes, lung involvement severity, and mortality in 841 COVID-19 patients admitted to Imam Reza Hospital affiliated to the Mashhad University of Medical Sciences, Mashhad, Iran.Methods:The study included demographic information, physical and clinical symptoms, laboratory findings, computed tomography (CT) scan scores, and final outcomes. Results:The mean age of the patients was 58.23±16.44 years, and 39.2% were female. The most common underlying disease was hypertension (51.3%), and the most frequent symptom at presentation was shortness of breath (87.1%). The mortality rate was 33.8%. The results showed a significant direct correlation between CRP levels and LDH levels (r=0.129, p<0.001), as well as between CRP levels and CT scores (r=0.322, p<0.001). There was also a significant inverse correlation between CRP levels and patients' SPO2 (r=-0.309, p<0.001). ESR levels had no significant correlation with SPO2, LDH, AST, ALT, or CT scores. Expired patients had significantly lower SPO2 levels (p<0.001) and ALT (p=0.044), while CRP (p<0.001), LDH (p<0.001), and CT scores (p<0.001) were significantly higher compared to discharged patients.Conclusions:The findings suggest that serum CRP levels at admission can be used as a predictive factor for the severity of lung involvement and mortality in COVID-19 patients. Liver damage was also associated with worse clinical outcomes. ESR levels had no significant relationship with lung involvement severity and mortality, possibly due to the delay in ESR elevation in response to inflammation.
Zahra khorasanchi; Mohammad Vahedifard; Kimia Mohammadhasani; Yasamin Sharifan; Zahra Dehnavi; Ramtin Naderian; Ali Jafarzadeh Esfehani; Payam Sharifan; Reza Zare-Feyzabadi; Gordon A. Ferns; Majid Ghayour
Abstract
Introduction: The pandemic of COVID-19 created a psychological response. So, the psychological function of COVID-19 patients is an important subject that forces us to follow up with them.Aim: Assess the correlation between vitamin D serum concentrations and psychological functions such as insomnia, stress, ...
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Introduction: The pandemic of COVID-19 created a psychological response. So, the psychological function of COVID-19 patients is an important subject that forces us to follow up with them.Aim: Assess the correlation between vitamin D serum concentrations and psychological functions such as insomnia, stress, and depression through the COVID-19 pandemicMethods: In this cross-sectional study, blood samples from 120 COVID-19 patients (61 males and 59 females) who had more than 30 years, were taken. Also, 25(OH)D Serum level of COVID-19 patients was analyzed. The Insomnia Severity Index (ISI), Depression anxiety stress scales (DASS), and the Short Form Health Survey (SF-36) were used to analyze insomnia, anxiety, stress, quality of life, and depression.Results: The relationship between temperature (p=0.039), PCO2 (p=0.022), and serum vitamin D level was significant. Additionally, there was a significant correlation between stress (p=-0.023, OR=0.389, 95% CI for OR=0.047, 0.843), depression (p=0.012, OR=0.659, 95% CI for OR=0.476, 0.913), and the concentration of serum vitamin D.Conclusion:This study recommends that vitamin D supplementation improve psychological state in COVID-19 patients.
sayyed Majid sadrzadeh; Reza Khoshbakht; Seyed Mohammad Mousavi; Elnaz Vafadar Moradi; Behrang Rezvani Kakhki; Mansoore Sadat Moosavi; Mahdis Ghavidel
Abstract
Introduction: This study investigated the serum levels of Covid-19 IgM-IgG antibodies in three exposure groups in the Shahid Hasheminejad Hospital in Mashhad, Iran.Methods: Between March 2020 and March 170, 2021 serum samples were taken from hospital personnel. To determine the levels of COVID-19 IgM-IgG ...
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Introduction: This study investigated the serum levels of Covid-19 IgM-IgG antibodies in three exposure groups in the Shahid Hasheminejad Hospital in Mashhad, Iran.Methods: Between March 2020 and March 170, 2021 serum samples were taken from hospital personnel. To determine the levels of COVID-19 IgM-IgG antibodies, we used the ELISA method (Pishgaman kit). Results were categorized as negative if they were less than 0.9, borderline if they were between 0.9 and 1.1, and positive if they were greater than 1.1. We used SPSS version 26 to evaluate the data. The exposure groups were separated into low (first group), moderate (second group), and high-risk (third group) levels.Results: 53 members of the 170 staff belonged to the first group, 51 to the second, and 66 to the third. There were 135 patients with negative IgG, 13 with IgG in the borderline range, and 22 with positive IgG. Furthermore, 9 individuals exhibited a positive IgM, while one had a borderline range IgM and 160 a negative IgM. In the first group, 56.6% of personnel reported cough, 5.9% of personnel in the second group had fever, and 24.2% of personnel in the third group experienced shortness of breath.Conclusion:The findings from this research indicated that there was no clear association between working in wards with higher risks and increased IgG and IgM levels. However, the results did reveal that being in wards with a high number of COVID-19 patients could result in more fever symptoms.
Negar Moghadas; MohammadReza Afzalzadeh
Abstract
Coronavirus disease 2019 (COVID-19) is one of the most significant medical problems of the century. Mucormycosis infection is one of the devasting problems associated with this disease. Brain abscess associated with these conditions may have very poor prognosis, and prompt diagnosis as well as treatment ...
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Coronavirus disease 2019 (COVID-19) is one of the most significant medical problems of the century. Mucormycosis infection is one of the devasting problems associated with this disease. Brain abscess associated with these conditions may have very poor prognosis, and prompt diagnosis as well as treatment of it is of paramount importance. In this study, we introduce a diabetic middle-aged man who was treated with corticosteroids due to COVID-19, and affected by rhinocerebral mucormycosis. Due to eye chemosis, brain MRI was performed which showed a silent abscess in temporal lobe with no neurological symptoms. After ten weeks of treatment, serial endoscopic sinus surgery and antifungal therapy, the invasive fungal sinusitis and brain abscess healed without debilitating sequala. We introduced this case as an educational example of brain involvement in mucormycosis. Although very rare, due to possible fatal sequalae, brain abscess should be considered as a probable complication of mucormycosis even if the patient has no neurological symptom.
Shaghayegh Rahmani; Farideh Namvar; Ali khakshour; Roohie Farzaneh; Fateme Tara; Rana kolahi ahari
Abstract
According to the World Health Organization (2022), severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is liable for more than 572 million cases worldwide and more than six million deaths globally. It has been reported that pregnancy can change the disease manifestations such ...
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According to the World Health Organization (2022), severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is liable for more than 572 million cases worldwide and more than six million deaths globally. It has been reported that pregnancy can change the disease manifestations such that gastrointestinal symptoms, which are common in pregnant women, are difficult to distinguish from COVID-19 related complications. Hence, in isolated cases of gastrointestinal or liver forms of COVID-19, diagnosis might be delayed. Previous studies have suggested that serious complications of COVID-19 in pregnancy are associated with a higher body mass index (BMI), gestational diabetes, and older age; thus, this population should be considered as high risk. In this article, we summarized previously published evidence about pregnant women with COVID‐19 and liver dysfunction.
Alireza Sedaghat; Amene Raouf-Rahmati; Katayoun Samadi; Farida Daneshvar Mozaffari; Ahmad Nemati; Benyamin Fazli
Abstract
Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: ...
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Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: This retrospective study included a total of 191 confirmed COVID-19 patients aged ≥18 who were admitted to an intensive care unit in the northeast of Iran in 2020. Clinical, therapeutic, and laboratory findings were recruited. The data were analyzed using SPSS software (version 23) through the Mann-Whitney U test, Chi-Square test, independent sample t-test, as well as a single variable and multivariable logistic regression.Results: Out of a total of 191 hospitalized patients, 137 (71.7%) survived and 54 (28.2%) expired. The mean age of non-survived patients was 17 years higher than that of survived patients (P<0.0001). Hypertension, diabetes, and coronary and pulmonary diseases were significantly related to mortality (OR: 3, 2.8, 21.4, and 5.4, respectively; P<0.05). Respiratory rate >24/min, heart rate>125/min, platelet count <100*109/L, creatinine >133 μmol/L, LDH >245 U/L, WBC count >10*109/L, lymphocyte count <0.8*109/L and D-dimer >1 μg/mL were frequently observed in non-survivor patients (P<0.05). Most of the patients had an abnormality on chest radiographs, and bilateral pulmonary infiltration was the dominant chest radiograph abnormality in these patients. Moreover, consolidation and ground-glass opacification were observed more frequently in non-survived patients (P<0.05). More than 57% of severe cases required non-invasive and invasive mechanical ventilation before they died, while it was 1% in survived cases (P<0.05).Conclusion: Older age, previous comorbidities such as diabetes, hypertension, coronary and pulmonary diseases, lymphopenia, leukocytosis, increased respiratory rate, creatinine, LDH, and D-dimer levels were related to a poor prognosis and mortality in patients with SARS-CoV-2 infection.
Behnaz Hatami; Omid Shoraka; Asef Younesi; Gelayol Bavafa; Melika Zamanian; Niloofar Nikpasand; Amirhossein Mohammadzade; Sara Naghizadeh Kashani; Anoush Azarfar; Mojtaba Yousefi Zoshk
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a novel syndrome in children following the coronavirus disease 2019 (COVID-19) pandemic, which has similar symptoms to Kawasaki disease or toxic shock syndrome. The most prevalent symptoms in MIS-C patients are fever and gastrointestinal symptoms, ...
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Multisystem inflammatory syndrome in children (MIS-C) is a novel syndrome in children following the coronavirus disease 2019 (COVID-19) pandemic, which has similar symptoms to Kawasaki disease or toxic shock syndrome. The most prevalent symptoms in MIS-C patients are fever and gastrointestinal symptoms, with substantial cardiac complications. Cardiac involvement is frequently reported in MIS-C patients and includes arrhythmia, coronary artery aneurysm and dilation, conduction abnormalities, and ventricular dysfunction. Cardiogenic or vasodilatory shock may develop in patients with severe MIS-C, necessitating inotropic support, fluid resuscitation, mechanical ventilation, and extracorporeal membrane oxygenation. Empirical therapies have attempted to reverse the inflammatory response, and steroids or intravenous immunoglobulin have all been commonly used. Most children will survive with prompt diagnosis and appropriate treatment, but since the disease's outcomes are unclear, long-term follow-ups are necessary. This narrative review summarizes the available studies regarding cardiac involvement in MIS-C cases as well as clinical considerations for cardiac examination and follow-up.
Reza Jafarzadeh Esfehani; Mohammad ali khalilifar; Hadi Esmaeili Gouvarchinghaleh; Gholam Hossein Alishiri; Alireza Shahriary
Abstract
Introduction:Among various proposed pathologic mechanisms during the coronavirus disease 2019 (COVID-19) pandemic, overproduction of autoantibodies is not widely studied. Antiphospholipid antibodies (aPLs) are target proteins that have affinity toward charged phospholipids. APLs are thought to have pro-thrombotic ...
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Introduction:Among various proposed pathologic mechanisms during the coronavirus disease 2019 (COVID-19) pandemic, overproduction of autoantibodies is not widely studied. Antiphospholipid antibodies (aPLs) are target proteins that have affinity toward charged phospholipids. APLs are thought to have pro-thrombotic potentials that increase during thromboembolism. The present systematic review and meta-analysis aimed to evaluate the relationship between serum aPLs level and COVID-19 mortality, severity, and thrombotic events.Methods: This systematic review and meta-analysis was conducted on all open access published articles in Medline, Scopus and Google Scholar. Studies evaluating individuals over the age of 18 years who were diagnosed with COVID-19 and had positive aPLs; and provided data on mortality or thrombotic events were included. Results: Of the initially identified 512 articles, 22 studies (overall 1462 patients) were finally included in the analysis. The prevalence of positive aPLs was 48.1%. Among the 372 patients with positive aPLs, 156 patients (41.9%) had severe COVID-19 that indicated a significant relationship between COVID-19 severity and aPLs positivity (p<0.05). The prevalence of thrombotic events in aPLs positive patients was 26.3% that indicated a significant relationship between aPLs positivity and the development of thrombotic events (p=0.03). APLs positivity was related to anytime mortality in COVID-19 patients (p=0.01).Conclusion: The present review demonstrated that aPLs are linked to COVID-19 severity and thrombotic events but not short-term mortality. Further studies with longer follow up periods are warranted.
kamila Hashemzadeh; Ali Esparham; Farnoosh Ebrahimzadeh; Konstantinos Triantafyllias; Zahra Mirfeizi; Maryam Sahebari; Mohammad Hassan J Joker; Mandana Khodashahi; Masoumeh Salari; Bita Abbasi; Delaram Omidvar; Mahtab Ghaemi; Hassan Mehrad-Majd
Abstract
Introduction: Health care systems all over the world face numerous challenges as a result of the rapid spread of the COVID-19 virus that has resulted in increased mortality rates. About 40% of ICU-admitted COVID-19 patients were not severely ill at the time of admission. Thus, by using appropriate ICU ...
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Introduction: Health care systems all over the world face numerous challenges as a result of the rapid spread of the COVID-19 virus that has resulted in increased mortality rates. About 40% of ICU-admitted COVID-19 patients were not severely ill at the time of admission. Thus, by using appropriate ICU admission predictors, clinicians can identify potential critical patients early on. It can also result in suitable resource allocation and consideration for these patients. Therefore, the current study was done with the aim of identifying clinical characteristics and laboratory data that could predict ICU admission in cases with COVID-19.Methods: This two-center retrospective observational study was done in Imam Reza and Ghaem Hospitals, Mashhad, Iran. Overall, 334 COVID-19 patients who referred to these hospitals from February to May 2020 were enrolled in this study. The participants were separated into two groups according to ICU admission status. All demographic, clinical, and paraclinical information were extracted from the medical records of the patients. Results: The present study composed of 88 ICU and 246 non-ICU-admitted COVID-19 patients. No significant differences were found in age between the two groups of patients (P=0.154). Multivariate regression analysis revealed that higher levels of CRP (OR=1.01, 95%CI 1.001-1.010, P=0.016), WBC (OR=1.11, 95% CI 1.01-1.22, P=0.03), and HRCT scores (OR=1.08, 95%CI=1.01-1.16, P=0.037) were linked to higher odds of ICU admission.Conclusion: This study suggests that higher levels of CRP, WBC, and LDH, as well as the HRCT score at the time of admission, were potential independent predictors of ICU admission during inpatient treatment in COVID-19 patients.
Anuj Singh; Naveen Khargekar; Divya Khanna; Ashish Kumar Sharma
Abstract
Stigma and disease have an ancient relation. Since disease is being considered as the curse of God and patients of contagious diseases is considered as disease spreader facing the social rejection. Wreak havoc of COVID-19 across the globe has desolated the mindset of common man, fear, anxiety and ignorance ...
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Stigma and disease have an ancient relation. Since disease is being considered as the curse of God and patients of contagious diseases is considered as disease spreader facing the social rejection. Wreak havoc of COVID-19 across the globe has desolated the mindset of common man, fear, anxiety and ignorance of community fuelling the social discrimination. The patient can recover the physical wound or diseases but stigma strikes the soul of victim that debilitates the will for survival. Stigma does not only affect the patients only but also the front line warriors excruciating the global emergency. Psychological distress mitigation is still missing in COVID-19 coping strategies. This article is intended to provide an overview of social-stigmatization faced by different sets of population as well as to draw attention over mental health component assimilation in therapeutic measures of COVID-19. To ensure the physical, mental and social wellbeing of the individual, community and society as whole.
Mohaddeseh Sadat Moghaddam; Niyusha Torabzadeh Khorasani; Reza Assaran Darban; Hamid reza Rahimi
Abstract
Acute respiratory Syndrome (SARS) is an uncommon respiratory illness that is transmitted primarily by respiratory droplets or direct contact with an infected person. The COVID-19 initially appeared in late 2019 in Wuhan, China, and spread everywhere around the globe. Earlier in 2003, the coronavirus ...
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Acute respiratory Syndrome (SARS) is an uncommon respiratory illness that is transmitted primarily by respiratory droplets or direct contact with an infected person. The COVID-19 initially appeared in late 2019 in Wuhan, China, and spread everywhere around the globe. Earlier in 2003, the coronavirus was known due to the human SARS-CoV virus, which infected 8,000 people and caused 800 deaths in southeast Asia and Canada. It should be mentioned that in 2012, another coronavirus, called Middle East respiratory syndrome coronavirus, infected Saudi Arabia and 27 other countries. The SARS-CoV2 belongs to a family of viruses called Coronaviruses that can infect bats, birds, pigs, cows, and different mammals. Some plant extracts are shown to inhibit microorganism replication and may be utilized in medication to treat infectious and non-infectious diseases, one of which is chamomile. chamomile medicinal plant, that has 120 biologically active compounds, the most necessary of which are flavonoids, like apigenin and luteolin, that are shown to possess antiviral activity.
Mohammad Reza Rouhbakhsh Zahmatkesh; Saman Soleimanpour; Zahra Mirfeizi; Nasrin Milani
Abstract
The coronavirus disease 2019 (COVID-19), which has spread to many countries, is so severe that it progresses rapidly to acute respiratory failure. Therefore, in our paper, we aimed to describe and evaluate the most practical laboratory pro-inflammatory factors to predict the course of severe COVID-19 ...
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The coronavirus disease 2019 (COVID-19), which has spread to many countries, is so severe that it progresses rapidly to acute respiratory failure. Therefore, in our paper, we aimed to describe and evaluate the most practical laboratory pro-inflammatory factors to predict the course of severe COVID-19 cases.Given the physiopathology of COVID-19 and the consequent immune system hyperactivity, we started to investigate the background pathology of these occurrences aiming to find the prognostic laboratory factors in COVID-19 cases. All reviews focused on the potential cellular and molecular mechanisms causing the cytokine storm in viral diseases, and several studies approved applicable laboratory parameters for COVID-19 patients. Based on our data, increased CRP level, LDH, serum ferritin, creatine kinase (CK), higher D-dimer and FDP levels, IL-6, cardiac troponin I and longer PT can be potential markers for predicting the course of infection; particularly, D-dimer, which was elevated to five times the original count in severe cases. Apart from that, the severe cases showed lymphopenia, neutrophilia, thrombocytopenia, and prolonged PTT. However, there was contradictory evidence about AST, ALT, BUN, and serum creatinine.The major cause of COVID-19 in critical patients was a cytokine storm; therefore, prognostic factors in the cytokine storm can also predict the prognosis of COVID-19. Thus, severe cases can be solved by early detection of these laboratory parameters.
Aradhana Bhargava; ASHISH JAIMAN; HITESH LAL; MOHIT KUMAR PATRALEKH
Abstract
Introduction: In this era of social distancing, dependence on electronic gadgets and devices is ever increasing. Possibility of transmission of COVID -19 from these devices cannot be ruled out. Currently, prevention is the only antidote; considering the mounting evidence of transmission of COVID-19 virus ...
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Introduction: In this era of social distancing, dependence on electronic gadgets and devices is ever increasing. Possibility of transmission of COVID -19 from these devices cannot be ruled out. Currently, prevention is the only antidote; considering the mounting evidence of transmission of COVID-19 virus primarily through respiratory droplets and fomites. Gadgets are one of the most frequently touched appliances; being often used during or after patient examination, while handling specimens or during various patient procedures. Collecting data regarding mobile sanitization is prudent at these times. The aim of this systematic review is to summarize published evidence on mobile sanitization in these COVID times.Methods: PubMed search on “COVID and mobile phone” revealed only 4 articles related to this topic; therefore we have assimilated data from various organizations, websites and articles and have suggested methodology for sanitization of mobile phones and other gadgets.Results: Infection control practices which include information, communication, education and evaluation are the pre-eminent weapons in the fight against hospital transmitted SARS-CoV-2. Minimizing mobile phone usage, sanitizing them with endorsed biocidal agents and advancements in the field of ultraviolet cabinets is a priority.Conclusion: At the same time we shouldn’t forget that sanitization is only one aspect of prevention of this disease; maintaining hand hygiene, use of masks and social distancing must be followed at all times.