Showing 28 results for Covid-19
Razieh Behzadmehr, Ariana Rasekhi , Banafsheh Zeinali-Rafsanjani , Alireza Rasekhi,
Volume 81, Issue 5 (8-2023)
Abstract
Background: Several typical and atypical findings have been observed in Covid-19 high-resolution computer tomography (HRCT). To our knowledge, there is no study investigating the relationship between the presence of nodules in Covid-19 patients and the patient's condition. Therefore, the present study assessed the frequency of pulmonary nodules in Covid-19 patients according to their condition.
Methods: This cross-sectional study assessed the medical images of the patients referred to three university-affiliated centers (Nemazi, Ali Asghar and Shahid Faghihi Hospital) to perform Covid-19 HRCT from April to September 2020. The centers have been named H1, H2, and H3. Patients who were referred to these centers had good, poor, and fair conditions, respectively. The history of patients was assessed carefully. Patients' demographic information, nodule shape, number, size, location, presence of cavitation, and GGO around the nodule were assessed and recorded.
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Results: Overall, 20576 patients (mean age=46.75±16.64 years old) were included in the study. Only 2.1% of cases had solid nodules. Most of them (96.76%) were accompanied by a GGO (halo sign), and only 10.42% were associated with a cavity. The good condition, patients showed significantly more solid nodules (3.46%) than others. In size of the nodules in good-condition patients (1.8 cm) is significantly larger than in fair-condition (1.22 cm) or poor condition patients (1.15 cm). 79.86%, 12.5%, and 7.64% of nodules were multiple, dual/triple, and single, respectively.
Conclusion: The frequency of nodules in the HRCTs of good-condition patients was significantly higher than in fair- or poor-conditionpatients; they also had more multiple and larger-sized nodules. The Pearson-coefficient test also revealed a small negative correlation between the presence of nodules and the patient's condition. It seems the presence of nodules indicates higher immunity to viral infections. In the follow-up, it was revealed that people who had nodules were not hospitalized in the ICU. Further study is needed to prove this point.
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Nazli Farnoosh, Shahram Seyfi, Khadijeh Ezoji, Asadollah Shakeri, Kayvan Latifi, Parviz Amri Male ,
Volume 81, Issue 8 (11-2023)
Abstract
Background: Noninvasive ventilation (NIV) has been used as one of the most promising methods to treat hypoxic respiratory failure in COVID-19.
Methods: In this study, the clinical outcomes of 80 patients with acute respiratory failure caused by COVID-19 were evaluated. The disease was confirmed in two methods: clinical and radiographic confirmation of disease in patients with an acute respiratory infection (highly suspected) or in some cases with a positive PCR test. The rate of discharge from the ICU without the need for intubation was evaluated as the primary outcome and based on that, the patients were divided into two groups: NIV failure and NIV success. Mortality rate, length of stay in ICU, frequency of intubated patients and laboratory factors of patients as secondary outcomes in two groups were compared.
Results: Regarding the outcome of death and discharge, there was a statistically significant difference between the two groups. Therefore, all patients with corona who were admitted to ICU and received NIV and were intubated due to non-responsiveness to NIV died and the patients were discharged from the hospital without intubation. All the patients investigated in this study, had received antiviral, antibiotic, and glucocorticoid treatment during hospitalization. In this study, the patients who were in the NIV success group and were not intubated had a lower mean age compared to the group without NIV success (54 vs. 67 years, respectively). The number of white blood cells in the NIV success group was 3945.28±10011.21 and in the group without NIV success was 9242.38±17296.16, which was statistically significant (P=0.004). The number of blood neutrophils in the successful and unsuccessful NIV groups was 12.19±83.04 and 4.31±89.49, respectively (P=0.034). The mean APACHEII score in patients in the NIV success group (11.07±5.05) was significantly lower than the group without NIV success (20.16±4.96).
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Conclusion: Mortality was higher in the intubated group than in the NIV group. The combination of APACHEII score and respiratory rate one hour after receiving NIV can predict success with NIV.
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Mahnaz Safari, Pooneh Rahimi, Akram Sadat Tabatabaee Bafroee,
Volume 81, Issue 8 (11-2023)
Abstract
Background: Understanding the complex processes of the immune system in dealing with the covid-19 infection, which is probably related to polymorphisms in cytokine and chemokine genes, can explain the pro-inflammatory condition of patients. Accordingly, in the present study, the correlation between the frequency of single nucleotide polymorphisms in the pro-inflammatory IFNAR2 gene and the severity of the disease of COVID-19 was investigated.
Methods: This research was reviewed by the ethics committee of the Pasteur Institute of Iran and was approved by this committee with the ethics code IR.PII.REC.1400.042. and continued from December 2021 to November 2022. This study was conducted on 954 patients with COVID-19, who were divided into two groups: those who recovered and those who died. COVID-19 infection in all 954 volunteers has been confirmed through rtReal Time-PCR of oropharyngeal or nasopharyngeal swabs.After taking blood samples from patients and extracting DNA, IFNAR2 gene was amplified using specific primers. Then RFPL method and Cac8I restriction enzyme were used to investigate rs2236757 polymorphisms in IFNAR2 gene. Genotype of people was determined according to the pattern of formed bands. The results were statistically analyzed using SPSS software.
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Results: Calculation of genotypic frequency of rs2236757 polymorphism in IFNAR2 gene showed that in general 21% of cases had AA genotype, 47% GA genotype and 32% GG genotype. The allelic frequency of this polymorphism showed that 56% of cases had G allele and 44% had A allele. In investigating the correlation of rs2236757 polymorphism in IFNAR2 gene with the severity of the disease of Covid-19, the OR value for the GG genotype was equal to 1, which indicates the absence of the role of this polymorphism in the severity of the disease. On the other hand, A allele was significantly more in recovered people than in deceased people, and the value of OR<1 also confirmed this issue.
Conclusion: The results showed that rs2236757 in the IFNAR2 gene is related to the reduction of disease severity, which indicates the important role of genes related to inflammatory responses, as well as the role of genetic variants of these genes in the severity of COVID-19.
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Ameneh Javanmard, Alireza Salehan,
Volume 81, Issue 10 (1-2024)
Abstract
Background: Coronaviruses were discovered in 1960. Large-sized living organisms from the Coronaviridae family, with single-stranded RNA of animal origin. Coronaviruses in humans can cause mild respiratory illness or severe respiratory illness. In 2020, the World Health Organization declared COVID-19 a global pandemic. The aim of this study is to use the Jaccard similarity coefficient to determine the similarity of COVID-19 behavior patterns in different seasons of the year.
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Methods: This study used machine learning systems and similarity metrics to determine the behavior pattern of COVID-19 in different seasons of the year. The location of research was the Mousa ibn Ja'far Hospital in Mashhad, and the time was from May 2020 to August 2021. The symptoms of affected patients were compared with the compiled dataset, and the similarity of patients was prepared in a similarity matrix, and the Jaccard correlation coefficient was calculated on the data. Finally, the analysis of strains from the beginning of emergence to the latest strain was examined. The performance indicators of the algorithm in the Jaccard similarity method showed a recall metric with a value of 0.94, a precision metric with a value of 1, an F1 score with a value of 0.86, and remove accuracy metric with a value of 0.76. The most important factors in the investigation include white blood cells, platelets, RT-PCR, CT SCAN, shortness of breath, fever, SPO2, and respiratory rate.
Results: The transmission of the COVID-19 virus depends on several factors, including human interaction. The evidence of the collected data shows that people with COVID-19 have low lymphocyte count and it is very consistent with the results of recent studies. Due to the lack of a dataset, a comparative study was conducted and a dataset was collected.
Conclusion: This study, leveraging machine learning algorithms, identified a clear seasonal correlation in the spread of COVID-19. Considering geographical and seasonal variations among patients, distinct symptoms were observed in each season corresponding to the prevalent strain during that period.
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Shayda Barat, Khosro Iranfar, Mahsa Ghanbari,
Volume 81, Issue 10 (1-2024)
Abstract
Background: Mucormycosis is a rare and aggressive opportunistic fungal infection that has grown significantly in recent years. This infection is rarely seen in healthy people. Mucormycosis usually appears as an acute infection with manifestations in the rhino-cerebral, pulmonary and skin areas, and sometimes its manifestations can be seen as a widespread infection. The special importance of mucormycosis is due to its high mortality rate, which leads to death in 75 to 80 percent of cases. The specific susceptibility of some patients to mucormycosis points to the importance of iron absorption in the pathogenesis of mucormycosis, therefore, we decided to investigate the relationship between serum iron and ferritin levels and mucormycosis disease in patients with underlying factors predisposing to COVID-19.
Methods: This study is a case-control type, in which patients with mucormycosis after contracting COVID-19 and also with a history of diabetes mellitus as the case group and patients with COVID-19 and a history of diabetes mellitus are considered as the control group and the serum level of iron and ferritin will be measured and compared in both groups and the outcome of the study will be determined based on the obtained results.The study took place in hospitals of the Kermanshah university of medical sciences in the Kermanshah city from March 2021 to March 2022.
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Results: In this study, 38 patients were examined in two groups of patients with mucormycosis along with COVID-19 and diabetes in the case group and patients with COVID-19 and diabetes in the control group with an average age of 63 years. In this study, there was no significant difference between the average age in the two studied groups. However, a significant difference was observed between serum iron and ferritin levels in two groups.
Conclusion: Hyperferritinemia is considered not only as an indicator of the systemic inflammatory process in the infection of COVID-19, but also indicates an increase in free iron level, which, as a result, contributes to the growth and spread of the fungus (mucormycosis).
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Shima Heydari , Mohammad Nasrollahi, Mohammad Khodashenas Roudsari,
Volume 81, Issue 11 (1-2024)
Abstract
Background: Studies of viral pandemics in the past, as well as studies of patients with sepsis, have shown that there is a direct relationship between the occurrence of AKI with disease severity and mortality, prognosis and outcomes. Considering that the COVID-19 disease is a novel pandemic and there is not enough information on the occurrence of AKI with COVID outcomes and its consequences, especially in Iran, it is necessary to conduct research in this field.
Methods: This is a retrospective study on 310 Covid patients hospitalized in the internal medicine, critical care and infectious disease ward of Birjand Valiasr Hospital from 20 March 2020 until 20 March 2021. Data were collected from the hospital's health information unit. The information was collected including demographics, underlying diseases, vital signs, laboratory information, and imaging and type of respiratory support. Finally, data was analyzed by SPSS V.22.
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Results: 310 patients with an average age of 51.9 ± 17.4 participated in this study, 58.4% of them were male. The prevalence of acute kidney injury in patients was 7.4%. There was a significant relationship between acute kidney injury and the COVID severity, so that the COVID severity increases with the occurrence of acute kidney injury. There was a significant relationship between COVID outcomes and acute kidney injury, so that a higher mortality rate was observed in patients with acute kidney injury. No significant relationship was found between the occurrence of acute kidney injury and the score of pulmonary involvement. Patients with hypertension were more tent to experience acute kidney injury. Also, patients with acute kidney injury have more leukocytosis compared to patients without acute kidney injury. In this study, no significant relationship was observed between lymphocyte count and acute kidney injury. This study showed that the level of serum CRP and BUN are significantly higher in patients with acute kidney injury.
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Conclusion: Acute kidney injury in hospitalized patients with COVID-19 is not common but had a significant effect on disease severity and outcomes.
Fatemeh Najafi, Masoumeh Amiri Delui, Maryam Moradi , Parastoo Sarkhosh, Zahra Rezaian, Farnoosh Sharifymood, Fateme Kameli ,
Volume 82, Issue 1 (3-2024)
Abstract
Background: one of the most common and important complications of COVID-19 is cough. The present study was designed with the aim of comparing the effect of althaea officinalis and eucalyptus nebulizer on the severity of cough in COVID-19 patients.
Methods: in this randomized clinical trial, from January 2022 to June 2022, 36 patients with COVID-19 were selected and randomly divided into three groups. Next, the severity of cough was recorded two hours before the intervention based on the visual analogue (VAS) in both groups until the patient was admitted to the hospital, then, one cc aqueous extract of althaea officinalis with five cc Normal Saline for the althaea officinalis group and four cc aqueous extract eucalyptus whit five cc Normal Saline for the eucalyptus group, were nebulized once a day for 15 minutes. Two hours after the intervention, the intensity of cough was again recorded in two groups. This intervention continued until the hospitalization of the patients. No intervention was done for the control group. The data was analyzed with Spss software at a significance level of less than 0.05.
Results: In this study before the intervention, there was no statistically significant difference between the three groups in terms of cough intensity (p>0.05), but after the intervention on the second and third days, there was a statistically significant difference between the three groups in terms of cough intensity. The rate of reduction in cough severity in althaea officinalis group was higher than the other two groups (p<0.05). Also, the results of Friedman's test indicated that althaea officinalis and eucalyptus nebulizers incense improved the severity of cough in patients over time.
Conclusion: the use of althaea officinalis and eucalyptus nebulizer improved the severity of cough in patients with COVID-19, but althaea officinalis nebulizer had a greater effect on cough severity compared to eucalyptus. It is suggested to use althaea officinalis nebulizer as well as eucalyptus as a treatment method along with other treatment methods.
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Erfan Dehghani, Pezhman Bagheri, Zahra Montaseri , Niloofar Sohrabi , Mehdi Sharafi ,
Volume 82, Issue 1 (3-2024)
Abstract
Background: COVID-19 is one of the most recent known human infections that has resulted in a global pandemic, causing high rates of morbidity and mortality worldwide. This study evaluated the clinical and epidemiological characteristics of the waves of the corona epidemic within a university surveillance system in southern Iran.
Methods: This cross-sectional study analyzed data from 24,132 individuals with Covid-19 in the registered waves from the beginning of the Corona epidemic from March 2020 to March 2021 in one of the southern universities of Iran. Information on age, gender, number of infections, severity, hospitalization, recovery rate, dominant strain, and compliance with protocols separately for each wave from 2020 to 2021 was collected from the University's databases. After calculating the cumulative incidence rate, mean and standard deviation and drawing graphs, chi-square, Mann-Whitney and one-way ANOVA were used in SPSS26 at a significance level of 5%.
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Results: The cumulative incidence of the disease was 11.36%, with a relative frequency of hospitalization at 11.7% and an average hospital stay of Seven days. The highest percentage of protocol compliance was applied in the initial waves. The highest frequency of infection was in the third wave, where men were more infected than women in all waves except the 4th and 5th waves. High blood pressure was the most common underlying disease in patients and the most lung involvement was observed in the fifth wave. Most of the patients have recovered, and the highest rate of recovery was observed in the sixth wave. Significant associations were found between hospitalization duration, underlying conditions, and clinical symptoms across different waves (P<0.001). Systemic symptoms were the most common, and there was a notable difference in radiological findings between waves (P<0.001).
Conclusion: The findings of this study emphasize the significant impact of underlying diseases and the severity of clinical symptoms on hospitalization outcomes. They also highlight the need for appropriate evidence-based management strategies and consideration of clinical changes and radiological patterns when evaluating diseases in different groups.
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