Somayeh Fazaeli; Mehdi Yousefi; Mohadeseh Sabethoseini Dokht
Volume 23, Issue 12 , 2021
Abstract
Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic increased the need for inpatient beds, indicating the need for hospitals to increase the efficiency of beds.
Objectives: This study aimed to increase hospital bed capacity using the implementation of Electronic Patient Discharge (EPD).
Methods: ...
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Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic increased the need for inpatient beds, indicating the need for hospitals to increase the efficiency of beds.
Objectives: This study aimed to increase hospital bed capacity using the implementation of Electronic Patient Discharge (EPD).
Methods: This qualitative-quantitative study was conducted in a tertiary care hospital using the pre-and post-intervention designs, and the main outcome was patient discharge time. By applying the Six Sigma model, including definition, measurement, analysis, improvement, and control, the patient discharge process was assessed and improved by some interventions such as EPD. All hospitalized patients with COVID-19 from 21 March 2020 to 22 July 2021 were examined for the post-intervention. In addition, data were collected from the hospital information system.
Results: By the use of EPD, patient discharge time decreased to 47.70% (from 10.19 h to 5.33 h) (P?<?0.000). According to the Sigma level, the yield and defects per million opportunities of the discharge process also increased to 55%.
Conclusion: Six Sigma methodology can be an effective change management tool to improve discharge time to cover the demand created during pandemics. According to the results of the present study and the obtained saved time, one bed is added to the hospital capacity for every five discharges.
Maliheh Dadgarmoghaddam; Mona Najaf Najafi; Alireza Ebrahimi; Ali Talaei; Neshat Najafnajafi; AmirAli Moodi Ghalibaf
Volume 23, Issue 11 , 2021
Abstract
Background: The potential impact of the novel coronavirus pandemic on social mental health has become a great concern, and the current situation can cause different mental disorders.
Objectives: According to the importance of mental health, this study was conducted to evaluate the mental health status ...
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Background: The potential impact of the novel coronavirus pandemic on social mental health has become a great concern, and the current situation can cause different mental disorders.
Objectives: According to the importance of mental health, this study was conducted to evaluate the mental health status of the general population of Iran in Razavi Khorasan Province, Iran.
Methods: An online survey was conducted and made available for the general population of Razavi Khorasan through the snowball sampling technique within a week. The demographic information, contact history with COVID-19, and physical symptoms history of COVID-19 were collected by the survey. To maintain the population's mental health status, the Depression, Anxiety, and Stress Scale-21, which was developed by Lovibond and Lovibond (1995), was used. To reduce the risk of bias, the online survey was supposed to be filled with a maximum of two members of a family. The data were analyzed in SPSS software (version 21) by calculating descriptive statistics and using the Chi-square test. The significance level was considered at the p-value of < 0.05 in all analyses.
Results: Finally, 461 responders from Razavi Khorasan Province were included in this study. In total, 41.8%, 32.1%, and 34.5% of the responders had depression symptoms, were in anxiety mood, and had stress symptoms, respectively. The ratio of men to women was approximately 1:2. Most participants were in the age range of 30-40 years, and the most frequent marital status was being single. Families with 3-5 members constituted 81.5% of the responders. Near one-third of the studied population had a bachelor's degree.
Conclusion: According to the results of our study, it is important to pay attention to the general populations mental health status during the COVID-19 pandemic and conduct protocols to prevent or reduce the risk of mental disorders that can be caused by the current situation.
Alireza Molaei; Mohammad Gholami Fesharaki
Volume 23, Issue 11 , 2021
Abstract
Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) ...
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Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) was estimated by multilevel poison regression method and then this estimation was compared to the historical trends to obtain total deaths related to COVID-19. Additionally, the geographic distribution of EMR has also been presented for Iran.
Methods: All-cause mortality rates of each province of Iran from March 21, 2013 to September 22, 2021 was downloaded from National Organization for Civil Registration (NOCR). The data of COVID-19 pandemic period (spring 1399 SH (Mar 20, 2020) to summer 1400 SH (Sep 22, 2021)) was removed from the data and then the multilevel poison model was applied to estimate all-cause mortality in this period. Then, EMR= (real deaths-expected death)/(real deaths) ratio was calculated.
Results: The results of this study showed that Irans EMR in COVID-19 pandemic was 36% (Male=35%, Female=36%, P-value=0.798). Our findings also revealed four category of EMR including low (EMR?30%, n=9), moderate (30 %< EMR?35%, n=8), high (35 %< EMR?40%, n=10) and very high (40 %< EMR, n=4) in different provinces.
Conclusion: Due to the diverse EMR in different provinces of Iran, the type of disease management of provinces with low and moderate EMR can be used as an appropriate model to control EMR in provinces with high and very high EMR.
Pegah Shakibnia; Razieh Heidari Ahmadi; Faezeh Fallah; Farnoosh Ebrahimzadeh; Amin Sadeghi Dosari; Ali Mojtahedi; Nayereh Hajipour; Maryam Sharifi Luyeh; Majid Taati Moghadam
Volume 23, Issue 11 , 2021
Abstract
Context: During the past three decades, the Middle East has experienced three major viral epidemics. Coronavirus disease 2019 (COVID-19) is a pulmonary disease which has been first reported in China in the early third decade of the 21st century and quickly infected people in Asia, the Middle East, and ...
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Context: During the past three decades, the Middle East has experienced three major viral epidemics. Coronavirus disease 2019 (COVID-19) is a pulmonary disease which has been first reported in China in the early third decade of the 21st century and quickly infected people in Asia, the Middle East, and the entire world. This pandemic is life-threatening and has caused widespread financial losses; however, the exact extent of the damage is still unclear.
Evidence Acquisition: This review study aimed to present the latest on the COVID-19 symptoms, pathogenicity, host immune responses, etiology and epidemiology, transmission routes in the Middle Eastern countries, especially Iran, and the role this country plays in the spread of the disease. The search was conducted using Google scholar, PubMed, Scopus, and ISI Web of Science to identify relevant studies published from 2019 to 2021.
Results: Many countries do not have sufficient equipment to prevent, identify, and treat the disease and still have major challenges in controlling this deadly virus. In Iran, a Middle Eastern country, people faced widespread disease and deaths due to the lack of facilities caused by heavy economic and political sanctions. These challenges affect not only Iran but also many neighboring countries. Over time, mutations in the SARS-CoV-2 virus led to the emergence of various variants of the virus, such as Alpha (B.1.1.7), Beta (B.1.351), Gamma (B.1.1.28.1), and Delta (B.1.617.2).
Conclusion: Different variants of SARS-CoV-2 virus pose a substantial menace to public health due to their high transmissibility and ability to escape the immune system. Recently, concerns have increased about the risk of hospitalization and the high spread rate of the COVID-19 delta variant.
Maryam Karimifard; Seyed Jalal Eshagh Hoseini; Ashraf Mohamadkhani; Malihe Akbari
Volume 23, Issue 10 , 2021
Abstract
Context: Subacute thyroiditis has been classified as an autoinflammatory condition and is mainly caused by a viral infection. According to the pathogenesis of SARS-CoV2 infection, which is mainly based on the uncontrolled inflammatory immune response, several studies have investigated the possible association ...
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Context: Subacute thyroiditis has been classified as an autoinflammatory condition and is mainly caused by a viral infection. According to the pathogenesis of SARS-CoV2 infection, which is mainly based on the uncontrolled inflammatory immune response, several studies have investigated the possible association between SARS-CoV2 and subacute thyroiditis. The present study aimed to review and organize the studies that have investigated the possible association between SARS-CoV2 and subacute thyroiditis.
Evidence Acquisition: Initially, we observed and provided evidence on the possible roles and mechanisms of SARS-CoV2 in inflammatory and autoimmune diseases, and then we discussed the findings on the association between subacute thyroiditis and SARS-CoV2 infection.
Results: Investigation of other autoimmune and inflammatory disorders, and previous studies on the role of viruses in the pathogenesis of subacute thyroiditis, as well as studies on the inflammatory mechanism of SARS-CoV2 infection support the hypothesis that SARS-CoV2 may initiate subacute thyroiditis.
Conclusions: The existing evidence suggests that subacute thyroiditis should be considered a late symptom of COVID-19.
Masoud Sadeghi; Zahra Moradi; Fatemeh Ershadi
Volume 23, Issue 10 , 2021
Abstract
Background: At the end of 2019, the world faced a phenomenon that plunged all human beings into extreme fear and anxiety. A new type of coronavirus began to spread among people around the world, and this was the beginning of one of the greatest pandemics and its problems in the world.
Objectives: The ...
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Background: At the end of 2019, the world faced a phenomenon that plunged all human beings into extreme fear and anxiety. A new type of coronavirus began to spread among people around the world, and this was the beginning of one of the greatest pandemics and its problems in the world.
Objectives: The present study aimed to study the effect of Emotion-Focused Therapy (EFT) on reducing post-traumatic stress and depression among Covid-19 patients. The statistical population was all English language students at the University of Tehran who had recovered from Covid-19. A total of three students (with a mean age of 22±2 years old) were selected from those who had recovered from Covid-19 using convenience sampling.
Results: The data were analyzed using visual inspection, Reliable Change Index (RCI), and percentage change formula. The results of the study indicated that the mean improvement of post-traumatic stress variable for the three patients in the post-treatment and follow-up was 42.39% and 41.54%, respectively. Additionally, this value for the depression variable was 60.78 and 60.22% in the post-treatment and the follow-up.
Conclusion: Based on the results of the study, EFT was effective on post-traumatic stress and depression in students infected with Covid-19. Therefore, it is recommended to use this treatment to reduce post-traumatic stress and depression in patients with Covid-19.
Yusuf Ata; Ahmet Kagan As; Mesut Engin; Nurcan Kacmaz Kat; Tirdad Setayeshi; Sad?k Ahmet Sunbul; Cuneyt Eris; Ufuk Ayd?n; Filiz Ata; Tamer Turk
Volume 23, Issue 10 , 2021
Abstract
Background: The struggle of humanity with Coronavirus disease 2019 (COVID-19) infection, which affected the whole world and caused severe social and health crises, continues without deceleration.
Objectives: This study aimed to determine the relationship between the abnormal laboratory parameters upon ...
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Background: The struggle of humanity with Coronavirus disease 2019 (COVID-19) infection, which affected the whole world and caused severe social and health crises, continues without deceleration.
Objectives: This study aimed to determine the relationship between the abnormal laboratory parameters upon admission and the intensity of lung involvement using chest computerized tomography severity score (CT-SS).
Methods: This single-center study evaluated a total of 242 patients who were admitted to our hospital due to COVID-19 with positive polymerase chain reaction (PCR) test results. The patients were divided into three groups of no involvement on thorax CT images, mild involvement, and moderate-severe involvement.
Results: The mean ages of groups 1 (n=42), 2 (n=123), and 3 (n=77) were 38±10.6, 56.3±16, and 61±15.6 years, respectively (P<0.001). The three groups showed significant differences in terms of hypertension, diabetes mellitus, heart rate, oxygen saturation, lymphocyte count, platelet-lymphocyte ratio (PLR), systemic immune inflammation index (SII), ferritin, troponin-I, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP) values (P<0.001). The CRP (R=0.545, P<0.001), ferritin (R=0.481, P<0.001), and SII (R=0.473, P<0.001) were moderately and positively correlated with CT-SS, while neutrophil-lymphocyte ratio (R=0.404, P<0.001), PLR (R=0.371, P<0.001), and ESR (R=0.327, P<0.001) were mildly and positively correlated with CT-SS.
Conclusion: The results of the present study showed that elevation in CRP, as well as ferritin and SII values upon admission to the hospital was significantly correlated with CT-SS. The results also revealed that the presence of lung parenchyma involvement might be predicted in PCR positive COVID-19 patients without the need for thorax CT. Furthermore, it is believed that this information will provide great convenience to the clinicians who first welcome the patient in terms of predicting COVID-19 lung involvement.
Reza Safdari; Marsa Gholamzadeh; Sorayya Rezayi; Mozhgan Tanhapour; Soheila Saeedi
Volume 23, Issue 9 , 2021
Abstract
Background: Due to the outbreak of coronavirus disease 2019 (COVID-19), applying telehealth and telemedicine to prevent the spread of the disease is inevitable.
Objectives: Therefore, this study aimed to investigate the application of telehealth and telemedicine in the human coronavirus epidemic.
Methods: ...
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Background: Due to the outbreak of coronavirus disease 2019 (COVID-19), applying telehealth and telemedicine to prevent the spread of the disease is inevitable.
Objectives: Therefore, this study aimed to investigate the application of telehealth and telemedicine in the human coronavirus epidemic.
Methods: The systematic search was conducted using Medline (through PubMed), Scopus, and ISI Web of Science to identify relevant studies published until June 10, 2020. The inclusion criteria were the usage of telemedicine and telehealth as healthcare services during COVID-19, severe acute respiratory syndrome (SARS), or Middle East respiratory syndrome epidemics. This review was performed according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Results: In total, 598 articles were identified after the removal of the duplicates. After the systematic screening, 18 studies met the inclusion criteria. The analysis showed that only one study was related to SARS, and the rest were on COVID-19 disease. Teleconsultation and televisit were more prevalent (55.6%) than the other types of telemedicine services. The most mentioned obstacles were access to suitable technologies and lack of assessment or follow-up to achieve outcomes.
Conclusion: The results indicated that telehealth and telemedicine could have advantages, such as prevention of the spread of COVID-19, reduction of the healthcare burden, and maintenance of appropriate patient care. In addition to these benefits, several limitations and obstacles, including organizational, technological, and patient-related barriers, may be encountered. Hence, it is better to consider the necessary arrangements before implementing telemedicine.
Hassan Abolghasemi; Abdol Majid Cheraghali; AbbasAli ImaniFooladi; Peyman Eshghi; Mokhtar Tazik; Nariman Sadri; Farzaneh BoloukiMoghaddam; Mohammad Rezapour; sina Imanizadeh; Matin Maeini Maleki; Mohammad Hosein Ranjkesh; Hoshyar Maghsoudi; Mahtab Maghsoodlu; NasimSadat HosseiniDivkolaye; Ramezan Jafari; Behzad Einollahi; Mohamad Nikpouraghdam; Zahra Soleimani; Ali Bahramifar; Hassan Goodarzi; Nematollah JoneidiJafari; Mojtaba Sepandi; Ali Ghazvini; Seyed Mohammad Javad Hoseini; Mohammad Hadi Radfar
Volume 23, Issue 9 , 2021
Abstract
Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients.
Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 ...
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Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients.
Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 patients.
Methods: This study was performed on 50 consecutive COVID-19 patients with severe/critically ill disease. Severe disease was defined as having at least one of the following symptoms: shortness of breath, respiratory frequency ? 20/min, blood oxygen saturation ? 93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio < 300, lung infiltrates > 50% within the last 24-48 h. Critically ill disease was identified by intensive care unit admission, respiratory failure, septic shock, or multiple organ dysfunction or failure. Primary outcomes included the safety of CP transfusion, 14-day and 30-day survival rate, and change in lung computed tomography (CT) scan score. Several other clinical and laboratory features were evaluated as the secondary outcomes.
Results: Based on the results, 21 out of 50 consecutive patients were on mechanical ventilation at the time of CP transfusion. In total, 32 patients (64%) survived 30 days after CP transfusion. The survival rates were 74% and 44% in patients who received CP < 7 and ? 7 days after admission, respectively. While 92% of patients without mechanical ventilation survived, the survival rate of patients on mechanical ventilation was 29%. Moreover, the CT scan score and some other clinical features were improved in the group that received CP transfusion, and no adverse effects were observed.
Conclusion: The CP transfusion is a safe and effective treatment in severe/critically ill COVID-19 patients. The best outcome can be achieved in patients who are not on mechanical ventilation, especially early in the disease course.
Alireza Ahmadi; Soroush Ardeshiri; Vahid Rajab Nezhadi; Aida Pajoohesh; Touba Narimani Moghadam; Mohamad Sabaghan; Jaffar Fatahi Asl; Javad Zarei; Kambiz Ahmadi Angali
Volume 23, Issue 9 , 2021
Abstract
Background: Coronavirus disease 2019 (COVID-19) has become a global health challenge with high transmission and mortality rates.
Objectives: This study aimed to identify the risk factors for mortality in hospitalized patients with COVID-19 in Behbahan, Southwestern of Iran.
Methods: In this cross-sectional ...
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Background: Coronavirus disease 2019 (COVID-19) has become a global health challenge with high transmission and mortality rates.
Objectives: This study aimed to identify the risk factors for mortality in hospitalized patients with COVID-19 in Behbahan, Southwestern of Iran.
Methods: In this cross-sectional study, information of 800 patients with COVID-19 admitted to Shahidzadeh Hospital in Behbahan, Southwest of Iran, were investigated from March 20, 2020, to January 20, 2021. Subsequently, the demographic characteristics, clinical symptoms, vital signs, pharmacotherapy, laboratory findings, and the patients' underlying diseases were extracted from their medical records. Multivariable Cox regression with proportional hazard assumption was used to investigate the risk factors of death.
Results: The present study included 800 patients with COVID-19 with a mean age of 57.51±16.83 years at the time of diagnosis. Overall, 447 (55.8%) male and 353 (44.1%) female patients were included in this study, respectively. Among the total patients, 116 (14.5%) and 684 (85.5%) cases died and recovered, respectively. Based on the multivariable Cox regression analysis, age (HR=1.04; 95% CI: 1.03-1.05; P<0.001), cardiovascular diseases (HR=2.46; 95% CI: 1.63- 3.70; P<0.001), and renal failure (HR=2.77; 95% CI: 1.43- 534; P<0.001) were found to be associated with the death hazard in patients with COVID-19.
Conclusion: According to the findings of this study, the patient's age at the time of diagnosis, cardiovascular diseases, and renal failure were indicated to be the risk factors of high mortality rate in patients with COVID-19. Identification of these risk factors can be helpful in the timely intervention of patients at high risk of death for health care providers.
Seyed Hamid Falaki; Maryam Safaeikoshkak; Jaber Abedi; Milad Ahmadi Marzaleh
Volume 23, Issue 8 , 2021
Abstract
The first report of Coronavirus Disease 2019 (COVID-19) was presented in Wuhan, Hubei province, China, in December 2019 (1). COVID-19 is an infectious virus with a high level of spread. According to its fast pandemic condition in the world, it has been announced as an emergency of public health by the ...
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The first report of Coronavirus Disease 2019 (COVID-19) was presented in Wuhan, Hubei province, China, in December 2019 (1). COVID-19 is an infectious virus with a high level of spread. According to its fast pandemic condition in the world, it has been announced as an emergency of public health by the World Health Organization (WHO) related to its fast pandemic condition (1-3). Movements of population, communication among humans, and environmental factors cause the transfer of this virus. The most prevalent clinical symptoms include fever, cough, headache, muscle cramps, and fatigue (4). Different industries in different countries have faced many problems and even there were many days off in the world after the COVID-19 pandemic. The pharmaceutical industry, among all industries, has a unique and exclusive sensitivity according to the necessity in the production of pharmaceutical products. The pharmaceutical industry has been important since the past years as a complementary part of the primary process in the treatment of the patients that shows the significance of development in this industry.
In the COVID-19 pandemic situation, pharmaceutical companies try to respond to the challenges in the supply chain, change the business process, and protect the health of the staff. If the epidemic of COVID-19 continues for a medium/long time, this will affect active supplies, necessary materials, and medication export/import. Moreover, it causes adverse effects on research and development (R&D) activities, production, and developmental projects related to improving the industry. Although the effect of global expansion has not been apparent yet, pharmaceutical companies should respond, improve, and develop. Therefore, during the COVID-19 pandemic situation, pharmaceutical companies should continue their activities and even develop it while facing many challenges. Moreover, it will help them detect the challenges and approaches of development in safety and health in pharmaceutical companies during the COVID-19 pandemic situation.
Challenges of pharmaceutical companies in the COVID-19 pandemic situation include: 1) Hiding or lack of reports in COVID-19 affection; 2) Lack of appropriate monitoring of distribution vehicles in the prevention of infection; 3) Continual contacts with documents and internal permissions of products leading to the lack of supervision of health principles; 4) Production in closed and limited space; 5) Continual production line and necessity of team working; 6) Commotion of the personnel with public transportation and lack of knowledge in family health; 7) The physical presence of staff in administrative positions (R&D, marketing, IT, and planning); 8) Serving food in the restaurant of the company (breakfast, lunch, dinner, and snack); 9) Closing of air conditioning system in departments; 10) Lack of correct extrusion of produced wastes; 11) Lack of the attention of personnel on their health; and 12) The entrance of infected products and raw materials to the COVID-19.
Solutions in safety and health improvement of pharmaceutical company in facing COVID-19 pandemic include: 1) Disinfection of the external surface of the vehicles which contain materials and raw materials barrels at the entrance; 2) Use of electronic forms for documentation, product permissions, other production processes, quality control, and Health and Safety Executive ; 3) Use of distancing between the personnel with separator and fresh air injection into the rooms with building management system equipment; 4) Supply of mask and shield for all staff in sufficient number, and control of the use, extirpation, and protection of documents; 5) Use of masks with cartridge and N95 pad in administrative departments in exposure to chemical materials and changing them according to standard; 6) Assignment of the dedicated vehicles to the staff communication and their disinfection; 7) The necessity of using masks by the staff during transportation; 8) Provision of the opportunity for administrative staff to work from long distance; 9) Installation of the bags and buckets for sanitary wastes (mask, gloves, and tissue); 10) Disinfection of air conditioning system based on WHO rules; 11) Disinfection of all spaces and surfaces per hour or after use; 12) Installation of automatic disinfection equipment at the entrance of all buildings and busy places; 13) Introduction of COVID-19 as a job sickness to fast identification and self-declaration of the staff and elimination of transferring chain; 14) Assignment of subvention to treatment and leave of absence with salary for COVID-19 patients; 15) Psychological consultation and call contact with COVID-19 patients; 16) Online monitoring of the personnel and their families with an online questionnaire; 17) Transfer and management of waste by mechanizing systems and trained executive team with personal protection equipment; 18) Arrangement of all internal and external meetings online; 19) Presentation of all training courses in online classes (sky-room webinar); 20) Risk assessment in facing COVID-19 patients based on age, background illness, facing jobs, and a team of colleagues; 21) Non-public quarantine of the staff according to the importance of medicine production; 22) Specialization in COVID-19 tests for a suspicious person; 23) Distribution of self-protect equipment and disinfectants among the staffs families; 24) Quarantine of suffering, suspicious people or those who were in contact with suffering patients; 25) Quarantine of the products in the warehouse to eliminate the transporting chain of the infected products.
Conclusion
The pharmaceutical stability of industry and permanent presence is an inseparable part of treatment teams in the world. Therefore, the necessity of continual observation of environmental health in pharmaceutical companies and the staff health could develop the efficiency, health protection of the personnel, and consumers in the COVID-19 pandemic situation. Controlling the challenges, as the next step, helps the presence of pharmaceutical companies in the current condition. Therefore, international, national, and local organizations should emphasize the revision of health and safety standards in the workplace. In addition, the self-declaration of industries and physical observation is necessary to conduct the suggested solutions for the personnel health as a staff in the health area.
Ercument Ozturk; Zeynel Abidin Ozturk
Volume 23, Issue 8 , 2021
Abstract
Background: During the Coronavirus Disease-2019 (COVID-19) pandemic, palliative care units and nursing homes became risky in terms of infection transmission. The measures that are taken in the general population have also been strictly applied for caregivers. However, to achieve success, the personal ...
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Background: During the Coronavirus Disease-2019 (COVID-19) pandemic, palliative care units and nursing homes became risky in terms of infection transmission. The measures that are taken in the general population have also been strictly applied for caregivers. However, to achieve success, the personal compliance of the caregivers is as important as setting the rules.
Objectives: This study aimed to evaluate the demographic characteristics, knowledge levels, and attitudes towards the measures taken for pandemics of the caregivers who were caring for their patients in the palliative care unit. It was also attempted to evaluate the relationship between these parameters and their quality of life (QOL).
Methods: The level of knowledge and the level of agreement with the measures with questions prepared by three physicians working in the palliative care unit were assessed in this study. The QOL was also evaluated using the 3-level version of EQ-5D (EQ-5D-3L).
Results: Education, employment, smoking, as well as parental and marital status, were found to be related to a high level of knowledge. It has been shown that the level of knowledge is higher in female caregivers and those who were caregiving for less than three years. The caregivers of Alzheimer's disease patients were also revealed to know more about the COVID-19 pandemic. Single, male, employed, smoking, and experienced less than three years caregivers were seemed to have a higher level of agreement with the measures. In addition, it was concluded that the QOL was positively correlated with the level of knowledge and negatively correlated with the compliance of the measures.
Conclusion: It is essential to know the characteristics and beliefs of the caregivers in pandemic management in palliative care; accordingly, more studies should be conducted on this issue.
Alireza Nikbakht Nasrabadi; Fatemeh Karami; Saeideh Varasteh; Alireza Arman
Volume 23, Issue 7 , 2021
Abstract
Aim: The present study aimed to explore lived experiences of critically ill patients with COVID-19 after discharge from intensive care units of hospitals in Iran.
Materials and Methods: The present study was qualitative research with a hermeneutic phenomenological approach. Participants were purposefully ...
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Aim: The present study aimed to explore lived experiences of critically ill patients with COVID-19 after discharge from intensive care units of hospitals in Iran.
Materials and Methods: The present study was qualitative research with a hermeneutic phenomenological approach. Participants were purposefully selected from critically ill patients with COVID-19 who were discharged from the intensive care unit (ICU) and transferred to the general ward. Data were mostly collected through in-depth, semi-structured, face-to-face interviews and, in some cases, telephone calls. Data were analyzed using the method of Dickelman et al. (1985). Guba and Lincoln's (1989) criteria were used to achieve data authenticity.
Results: Data were obtained from 16 COVID-19 recovered patients with a history of ICU admission. Twelve participants were female and four were male with a mean age of 35 years. The four main themes were identified along with their subthemes: perception of death before dying (worry, helplessness, and expecting a different death), social stigma (social isolation and stigma), a nurse as a symbol of rebirth (a compassionate and supportive nurse and the supportive role of others), and meaningful life (a change in outlook on life and the manifestation of spirituality).
Conclusion: The results of the present study indicated that personal thoughts such as thinking about death and social treatments such as stigma can lead to threatening physical and psychological problems in COVID-19 patients. Nurses and family members can prevent many of these problems by providing holistic care and psychological support. Apart from the challenges posed by the disease, post-recovery changes in patients' attitudes toward life can be considered as a positive point.
Ibrahim halil Sever; Bahattin Ozkul; Bedriye Koyuncu Sokmen; Nagihan Inan Gurcan
Volume 23, Issue 7 , 2021
Abstract
Purpose: This study aimed to evaluate the diagnostic performance of the coronavirus disease 2019 (COVID-19) imaging reporting and data system (CO-RADS) scoring system in admitted patients with suspected COVID-19 infection.
Methods: This retrospective study included all patients admitted to our hospital ...
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Purpose: This study aimed to evaluate the diagnostic performance of the coronavirus disease 2019 (COVID-19) imaging reporting and data system (CO-RADS) scoring system in admitted patients with suspected COVID-19 infection.
Methods: This retrospective study included all patients admitted to our hospital with COVID-19 pneumonia suspicion within March 20-May 15, 2020, who were examined by both computed tomography (CT) and real-time reverse transcription polymerase chain reaction (rRT-PCR) at initial presentation. Four radiologists, who were blinded to the rRT-PCR results and medical history, assessed all images independently and classified the CT findings according to the CO-RADS scoring system previously defined. Diagnostic value of the scoring system and interobserver agreement in rRT-PCR positive-negative groups and for CO-RADS 1-5 were evaluated.
Results: In this study, 274 (153 men and 121 women; median age=49; interquartile range [IQR] 25-62 years) rRT-PCR positive and 437 (208 men and 229 women; median age=46; IQR 32-64 years) rRT-PCR negative individuals were included. It was found that CO-RADS had a good diagnostic performance with area under the receiver operating characteristic roc curve of 0.857. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were obtained at 81.9%, 89.4%, 75.7%, 92.5%, and 84.8%, respectively. The interobserver agreement of four radiologists in CO-RADS 1 and 5 was substantial to almost perfect according to the kappa values. Other CO-RADS scores showed a fair to moderate agreement. The interrater agreement was slightly higher in the PCR (-) patient group than in the positive one.
Conclusion: In conclusion, CO-RADS was a successful scoring system for distinguishing highly suspicious cases in terms of COVID-19 infection lung involvement, showing high interobserver agreement.
Zahra Javidarabshahi; Sara Najafi; Sara Raji
Volume 23, Issue 6 , 2021
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) emerged in December 2019 in China and caused a catastrophic pandemic in 2020. Significant manifestations of COVID-19 are related to the respiratory system; however, other organs, such as the brain and heart, can also be involved.
Case presentation: A ...
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Introduction: Coronavirus disease 2019 (COVID-19) emerged in December 2019 in China and caused a catastrophic pandemic in 2020. Significant manifestations of COVID-19 are related to the respiratory system; however, other organs, such as the brain and heart, can also be involved.
Case presentation: A 44-year-old-male was hospitalized in our referral emergency center due to being febrile and confused. He experienced five episodes of convulsion in the hospital. Within a day, the respiratory symptoms developed. The polymerase chain reaction of cerebrospinal fluid (CSF) was positive for COVID-19. The analysis of CSF and findings of chest computed tomography scan revealed that the case was infected with meningitis induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and pneumonia.
Conclusions: It has been reported that neurological symptoms of COVID-19 can appear earlier than other symptoms. To the best of our knowledge, few articles have represented COVID-induced meningitis. This case study reported the first case of meningitis induced by SARS-CoV-2 in Iran
Batoul Khoundabi; Ahmad Soltani; Milad Ahmadi Marzaleh
Volume 23, Issue 6 , 2021
Abstract
Background: Given the fact that nurses are at the frontier of taking care of COVID-19 patients, they are directly or indirectly faced with many psychological problems.
Objectives: The present research used a systematic review approach to explore the psychological problems of nurses during the COVID-19 ...
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Background: Given the fact that nurses are at the frontier of taking care of COVID-19 patients, they are directly or indirectly faced with many psychological problems.
Objectives: The present research used a systematic review approach to explore the psychological problems of nurses during the COVID-19 pandemic in 2020.
Methods: This systematic review was conducted using PubMed, Cochran Library, Scopus, EMBASE, Science Direct, ProQuest, and Web of Science databases until May 21, 2020. These databases were searched using some keywords and the papers with a focus on the psychological problems of nurses during the COVID-19 pandemic were selected.
Results: Primarily, the academic papers were searched using their titles, abstracts, and full texts. In total, 10 articles were selected for the final analysis; nine of them were cross-sectional in type and one of them was qualitative and phenomenological. Moreover, seven studies were carried out in the Chinese context and were followed by other similar studies performed in Italy, Pakistan, India, and Singapore. Based on the findings, the most prevalent psychological problems were panic, anxiety, stress, sleep disorders, discomfort, depression, lack of self-control, overstimulation, and post-traumatic stress disorder.
Conclusion: During the epidemic and pandemic of infectious diseases, such as COVID-19, a wide range of psychological problems arise among the healthcare staff, especially nurses. As nurses are at the frontier of taking care of and treating COVID-19 patients, they need to be fully supported. Healthcare policymakers should devise educational and psychological supporting protocols to improve the mental health of nurses.
Amir Hosein Ghazale; Ali Ghazvini; Mostafa Ghanei; Ensieh Vahedi; Abolfazl Mozafari; Shideh Omidian; Mohammad Rezapour; Nafiseh Rastgoo; Fatemeh Movaseghi; Fateme Mansouri; Mohammad Ali Zohal; Maryam Gheraati; Seyed Hassan Saadat; Hassan Goodarzi; Mohammad Gholami Fesharaki; Amir Mohammad Dehghan Banadkooki; Shahrzad Saloo; Hesamodin Salou
Volume 23, Issue 6 , 2021
Abstract
Background:
COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Therefore, the present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease.
Materials ...
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Background:
COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Therefore, the present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease.
Materials and Methods:
This two-center cohort study included 175 confirmed COVID-19 inpatients at two medical centers designated for the treatment of COVID-19 patients in Qom and Qazvin, Iran. In this study, four different groups of drug regimens were studied which included G1 (azithromycin, prednisolone, and naproxen), G2 (lopinavir/ritonavir, azithromycin, naproxen, and prednisolone), G3 (hydroxychloroquine, azithromycin, naproxen, and prednisolone), and G4 (levofloxacin, vancomycin, hydroxychloroquine, and oseltamivir). It should be noted that G1, G2, G3, and G4 treatment regimens were used on 48, 39,30, and 77 patients, respectively.
Results:
The study participants included 175 confirmed COVID-19 patients with mean±SD age of 58.9 ±15.1 years, out of whom 80 (46%) patients were male and the rest were females. The results indicated that the hospital stay period was significantly shorter in the G1 compared to other groups (G1:5.9±2.4, G2:8.1±4.2, G3: 6.3±1.7, and G4: 6.4±2.9; [P-value=0.008]). It should be noted that pulse rate, oxygen saturation, hemoglobin, and platelet count (PLT) changed significantly during the study in four treatment groups; however, a significant change in temperature, creatinine, and white blood cell (WBC) was observed only in G3, G4, and G1 groups, respectively. The number of ICU admissions and deaths were not statistically significant among the patients who received the four treatment regimens (P=0.785). Based on the results, the history of ischemic heart disease, baseline oxygen saturation, WBC, neutrophil, lymphocyte count, and C-reactive protein (CRP) are the risk factors for the prolonged hospital stay in COVID-19 patients.
Conclusion:
The obtained results in this study indicated that the combination of azithromycin, prednisolone, and naproxen is the most effective regimen for the treatment of COVID-19, compared to three other combination treatment regimens.
Taghi Riahi; Sima Shokri; Seyed Hamid Reza Faiz; Karim Hemati; Seyed Hamzeh Mousavie; Amir Baghestani; Ali Khazaeian; Babak Hassanlouei
Volume 23, Issue 5 , 2021
Abstract
Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a variety of symptoms and laboratory and radiologic features whose identification can help diagnose and manage patients with COVID-19 more effectively.
Objectives: This ...
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Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a variety of symptoms and laboratory and radiologic features whose identification can help diagnose and manage patients with COVID-19 more effectively.
Objectives: This study aimed to describe the epidemiological, clinical, and laboratory features of patients with COVID-19, compare clinical features of patients in the intensive care unit (ICU) with those of non-ICU admitted patients, and define mortality risk factors for this disease.
Methods: This cross-sectional study was carried out on 781 COVID-19 patients hospitalized in Rasool Akram Medical Complex, Tehran, Iran, from February to May 2020. Patients epidemiological, demographic, clinical, laboratory findings were collected. Routine blood tests included complete blood count, coagulation profile, and serum biochemical tests. Confirmed infection was defined as positive reverse transcription-polymerase chain reaction (RT-PCR) to SARS-CoV-2 in their nasopharyngeal specimens or typical clinical, laboratory, and imaging findings of COVID-19 infection altogether. All data were analyzed using SPSS software (version 21).
Results: In this study, the majority of patients were male (n=470, 60.2%) and the remainder were female. The median age of the patients was 64 years. Hypertension (31.8%) and tuberculosis (1.4%) were the most common and the least common underlying condition among the patients, respectively. Moreover, cough and seizure were the most common (75.7%) and the least common (2.4%) symptoms in patients. The history of diabetes mellitus, the presence of dyspnea, loss of taste, and the occurrence of seizure were associated with a higher risk of ICU admission. On the other hand, advanced age, positive PCR, presence of dyspnea, myalgia, loss of taste, and elevated liver enzymes, and lactate dehydrogenase (LDH) were associated with a higher risk of mortality. Based on the results, smoking had a preventive effect on mortality (OR=0.292, P=0.048); however, it had no significant effect on ICU admission.
Conclusion: According to the obtained results, positive PCR and initial symptoms of dyspnea and myalgia were associated with increased odds of mortality by two times. In addition, elevated alanine aminotransferase and lactate dehydrogenase were associated with a higher rate of mortality. ICU admission was the main variable to increase the odds of mortality. Eventually, smoking might play a protective role against COVID-19 mortality.
Simintaj Sharififar; Maryam Moradi; Milad Ahmadi Marzaleh
Volume 23, Issue 5 , 2021
Abstract
Background: The illness caused by the novel coronavirus is an emerging disease, and for this reason, the international community is encountered with its unknown nature, such as clinical features, treatments, and long-term complications. Experience suggests that humans are affected by the psychological ...
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Background: The illness caused by the novel coronavirus is an emerging disease, and for this reason, the international community is encountered with its unknown nature, such as clinical features, treatments, and long-term complications. Experience suggests that humans are affected by the psychological and social effects of epidemics and pandemics of infectious diseases. Accordingly, it is a new experience to care for patients with this disease that has to be more explored. The present study aimed to detect the challenges with which nurses are faced in the process of caring for patients with coronavirus disease 2019 (COVID-19) in Iran using a qualitative method.
Methods: This qualitative study utilized in-depth semi-structured interviews with 19 key informants selected via targeted sampling. The obtained data were analyzed by thematic analysis to identify the challenges to which the nurses have encountered in the process of caring for patients with COVID-19 in Iran.
Results: Challenges of the nurses in the caring process for patients with COVID-19 are listed in five categories of stress and psychological issues, equipment-related challenges, increased events of errors, medication and treatment problems, and hospital management. It should be mentioned that at the same time, 35 other subcategories were also identified in this study.
Conclusion: Since nurses are at the forefront in fighting the COVID-19, there must be plans to increase their preparedness. Deficiencies in health systems, including equipment, medicine, and personal protective gear should also be addressed so that nurses can better respond to these incidents. Psychological and mental support is a key component of the nurses appropriate response; therefore, along with nurses' responses, individuals, groups, and family psychological supports should be facilitated to increase performance and effectiveness in response to COVID-19.
Atefeh Mousavi; Soheila Rezaei; Jamshid Salamzadeh; Ali Mirzazadeh; Farzad Peiravian; Nazila yousefi
Volume 23, Issue 5 , 2021
Abstract
Background: Reports, mostly from high-income countries, have shown a wide range of symptoms, clinical profiles, and outcomes for patients diagnosed with COVID-19. However, little is known about these issues in developing countries.
Objectives: This research used medical records in 15 hospitals in Tehran, ...
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Background: Reports, mostly from high-income countries, have shown a wide range of symptoms, clinical profiles, and outcomes for patients diagnosed with COVID-19. However, little is known about these issues in developing countries.
Objectives: This research used medical records in 15 hospitals in Tehran, the capital city of Iran, to assess predictors of in-hospital mortality in patients diagnosed with COVID-19.
Methods: The required information was extracted from patients' medical records, including age, gender, laboratory data (complete blood count, serum electrolytes, and liver, renal, and muscle injury tests) at admission, and the outcome of in-hospital mortality (yes/no) of 4,542 adult patients with confirmed COVID-19. This research used logistic regression to assess the predictors for mortality (measured as adjusted odds ratio [aOR]) and Chi-square automatic interaction detector to classify high-risk patients in different age groups as a decision tree model. Two models were developed through a machine learning approach.
Results: Overall, 822 (18.09%) cases passed away in the hospital. Mortality risk was increased from 4.33% in patients aged 18-40 years old to 40.96% in those aged 80+ years old. After adjusting for covariates, age (aOR 1.62 to 7.05 vs. those aged 18-40 years old), high aspartate transaminase (aOR 1.64 to 3.21), high alkaline phosphatase (aOR=2.17), low sodium (aOR=1.31), high sodium level (aOR=5.05), high potassium (aOR=2.41), low calcium (aOR=2.31), high creatine phosphokinase (aOR=2.21 to 2.24), and high creatinine (aOR=3.43) were significantly associated with in-hospital mortality.
Conclusion: Based on the results of our study, the mortality rate was high among in-hospital patients, particularly among older age and those who had liver and renal dysfunctions, muscle injury, and electrolyte imbalance at admission. Triage and special care for these high-risk patients can improve in-hospital outcomes.
Somayeh Fazaeli; Mehdi Yousefi; Jamshid Jamali; Zahra Ebrahimi; maliheh hemati esmaeili
Volume 23, Issue 5 , 2021
Abstract
Background: Nursing care activities in the context of infectious epidemics, such as COVID-19, can lead to high levels of stress in nurses.
Objectives: This study aimed to investigate the relationship between the occupational stress and adequacy of hospital support measures among nurses with the experience ...
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Background: Nursing care activities in the context of infectious epidemics, such as COVID-19, can lead to high levels of stress in nurses.
Objectives: This study aimed to investigate the relationship between the occupational stress and adequacy of hospital support measures among nurses with the experience of caring for patients with infectious and non-infectious diseases during the COVID-19 outbreak.
Methods: This descriptive-analytical and cross-sectional study was conducted on nurses caring for patients with COVID-19 in Imam Reza Hospital Complex in Mashhad, Iran. The sample size was determined at 194 nurses who were selected through random sampling. The data were collected using a standard questionnaire and analyzed through a structural equation modeling approach using Smart PLS software (version 2.0). Moreover, descriptive and inferential statistics were employed for data analysis.
Results: The results of the correlation analysis showed a negative and significant relationship between occupational stress and adequacy of hospital support measures (P<0.001). Furthermore, the mean occupational stress scores of the nurses with the experience of working in infectious and non-infectious diseases wards were 63.96 and 65.34, respectively. Additionally, there was no difference between the mean values of occupational stress of nurses with the experience of working in non-infectious and infectious diseases wards. Moreover, the effects of the control variables of the work shift (morning, evening, or night) and work experience (years) were not significant in this study.
Conclusion: The COVID-19 epidemic caused many nurses to work in new and sometimes stressful environments and conditions. Proper work shifts, improvement of interpersonal communication, and provision of ongoing supportive measures can be effective in reducing occupational stress.
Shahriyar Shahbazi Khamas; Atefeh Jafari; Elham Ramezanzadeh
Volume 23, Issue 3 , 2021
Abstract
On February 19, 2020, the first confirmed case of Coronavirus disease 2019, known as COVID-19, was identified in Iran. Afterward, the disease spread rapidly throughout the country. Some of the cases were asymptomatic, some had mild to severe symptoms, and some of them died. Transplant patients are highly ...
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On February 19, 2020, the first confirmed case of Coronavirus disease 2019, known as COVID-19, was identified in Iran. Afterward, the disease spread rapidly throughout the country. Some of the cases were asymptomatic, some had mild to severe symptoms, and some of them died. Transplant patients are highly at risk due to long-term immunosuppressive therapy, and precise treatment approaches are needed to not only cure the disease but also protect graft function.
This study reports two kidney transplant patients with COVID-19 pneumonia, both of whom showed respiratory and gastrointestinal symptoms. High cyclosporine and tacrolimus trough levels were observed despite initial dose reduction. After a treatment program containing reduced immunosuppressant dose and the addition of pulsatile hydrocortisone, these patients recovered effectively. We also discuss the importance of drug-drug interactions related to COVID-19 treatment protocol medications, especially with immunosuppressants, in these patients.
In conclusion, frequent monitoring of the trough levels of calcineurin and mammalian target of rapamycin inhibitors during hospitalization is recommended since it helps to determine the ideal treatment and prevent serious clinical toxicity.
Damla Aksit Bicak
Volume 23, Issue 3 , 2021
Abstract
Background: The implemented COVID-19 prevention measures exert negative effects on childrens nutrition and education, with approximately 1.5 billion children kept away from schools during this time.
Objectives: The present study aimed to assess the changes in toothbrushing and cariogenic dietary practices ...
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Background: The implemented COVID-19 prevention measures exert negative effects on childrens nutrition and education, with approximately 1.5 billion children kept away from schools during this time.
Objectives: The present study aimed to assess the changes in toothbrushing and cariogenic dietary practices of children who spent most of their time at home during the COVID-19 pandemic.
Methods: The study was conducted on parents with children aged 1-15 years in Turkey from 1-26 May 2020 which was a period of confinement and self-isolation. A web-based questionnaire was prepared and distributed via email and social media upon the request of parents. The questionnaire consisted of 10 items divided into three parts. The first part of the questionnaire included items regarding the demographic data of the parents and children, the second part contained some items about the cariogenic dietary practices of children, and the last part encompassed items on children's toothbrushing frequency before and during the outbreak. Statistical analyses were performed using the Number Cruncher Statistical Systems (NCSS) software.
Results: A total of 1013 questionnaires were incorporated into the final analysis. Based on the results, childrens intake of jam, honey, and molasses increased; nonetheless, their intake of sugar-sweetened, fruit-flavored juices, flavored milk, candy, and chocolate reduced during the COVID-19 outbreak (P<0.05). Moreover, no difference was found in the consumption frequencies of other foods and the frequency of toothbrushing of the children before and after the COVID-19 outbreak (P> 0.05).
Conclusion: As evidenced by the obtained results, the cariogenic food consumption of children was not high and even decreased during the pandemic. Although not perfect, it is evident that parents did not experience much trouble managing their childrens consumption of cariogenic foods and beverages during the time spent at home.
Latif Panahi; Tofigh Yaghubi; Marzieh Amiri; Heydar ali Balou; Abolfazl Etebarian Khorasgani; somaye pouy
Volume 23, Issue 3 , 2021
Abstract
Background: Coronavirus disease 2019 (COVID-19) was introduced by the World Health Organization as a pandemic and emergency for human health. This study aimed to investigate the clinical characteristics of patients infected with COVID-19 in Guilan Province, Iran.
Methods: This retrospective study was ...
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Background: Coronavirus disease 2019 (COVID-19) was introduced by the World Health Organization as a pandemic and emergency for human health. This study aimed to investigate the clinical characteristics of patients infected with COVID-19 in Guilan Province, Iran.
Methods: This retrospective study was conducted on 1,000 patients with a definitive diagnosis of COVID-19 pneumonia admitted to six hospitals in Guilan Province, Iran, from April 13 to June 14, 2020. This study evaluated the patients' clinical information, demographic characteristics, laboratory results, and chest computed tomography scans.
Findings: The mean age of the patients was obtained at 55±1.3 years, and the majority (n=800; 80%) of the cases were male. Furthermore, most patients had underlying diseases, including respiratory system disease (n=173; 17.3%), cardiovascular disease (n=711; 71.1%), and malignancy (n=146; 14.6%). The most common causes of the infection with COVID-19 included the presence in crowded places (n=733; 73.3%), close contact with the infected person (n=370; 82.2%), possession of pets (n=107; 23.2%), and family gathering (n=822; 82.2%). In addition, the most common clinical symptoms in patients included fever (n=911; 91.1%), cough (n=900; 90%), and dyspnea or shortness of breath (n=889; 88.9%). Other less common symptoms were diarrhea (n=160; 16%), vomiting (n=168; 16.8%), and headache (n=217; 21.7%). Dyspnea developed in 889 (88.9%) patients, and 660 (66%) cases had increased leucocytes.
Conclusion: COVID-19 causes mild to fatal pneumonia in patients. Therefore, early detection and treatment of these patients are of utmost importance. Timely treatment of the disease can reduce the severity of symptoms and prevent the further spread of the disease.
suleyman sayar; zeynep pelin polat; kamil ozdil
Volume 23, Issue 2 , 2021
Abstract
Background: Coronavirus disease 2019 (COVID-19) can have a wide clinical spectrum.
Objectives: The current study aimed to analyze the clinical and laboratory risk factors of the severe course of disease in patients with COVID-19.
Methods: Consecutive patients with a diagnosis of COVID-19 pneumonia ...
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Background: Coronavirus disease 2019 (COVID-19) can have a wide clinical spectrum.
Objectives: The current study aimed to analyze the clinical and laboratory risk factors of the severe course of disease in patients with COVID-19.
Methods: Consecutive patients with a diagnosis of COVID-19 pneumonia were included in the present study. The demographic characteristics, comorbid diseases, symptoms, chest computed tomography (CT) findings, laboratory data, oxygen saturation (SpO2), and body temperature of the patients were recorded. The coexistence of pulmonary infiltration in CT and SpO2 of ? %93 on fingertip pulse oximeter was defined as the severe course of the disease.
Results: A total of 475 patients were included in the current study. The mean age of the patients was 52.02±15.9 years, and 259 (54.5%) participants were male. The disease was mild and severe in 80% (n=380) and 20% (n=95) of the study subjects, respectively. The age of > 50 years, coexistence of hypertension (HT) and diabetes mellitus (DM), neutrophil-to-lymphocyte ratio (NLR) of > 4, lactate dehydrogenase (LDH) of > 240 U/L, C-reactive protein (CRP) of > 8 mg/dL, and D-dimer of ? 1000 ng/mL were determined to be the risk factors for the severe course of the disease.
Conclusion: Age, NLR, CRP, LDH, D-dimer, comorbidity, and coexistence of DM and HT were the independent risk factors for the severe course of the disease. The aforementioned factors should be taken into account during risk stratification and management of patients with COVID-19.
