جستجوی مقالات مرتبط با کلیدواژه "COVID-19" در نشریات گروه "پزشکی"

The COVID-19 pandemic significantly threatens immunocompromised patients. We aimed to investigate the clinical and paraclinical findings and consequences of COVID-19 in kidney transplantation recipients.

In this retrospective study, kidney transplant recipients admitted to Ayatollah Rouhani, Shahid Beheshti, and Shahid Yahyanejad referral hospitals of Babol, North of Iran, with a diagnosis of COVID-19, were examined. Information such as demographic and laboratory findings, clinical symptoms, and treatments received was entered into pre-prepared questionnaires.

Out of the 35 patients included in the study, 19 (54.3%) were males, and 16 (45.7%) were females. The mean age of patients was 47.46±11.28. Among the clinical symptoms, cough and decreased level of consciousness were associated with a higher mortality rate (P= 0.02). Furthermore, the mortality rate was found to be 17.1%. C-reactive protein (CRP) level, oxygen saturation percentage, and diffuse lung involvement were significantly associated with COVID-19 mortality (p <0.05). In this study, no correlation was found between the amount of Cr and the outcome of COVID-19 disease (P = 0.66), and also, no significant relationship was found between the amount of BUN and the outcome of COVID-19 (P = 0.46). Even the patient who was admitted with a Cr of 6.4 did not die and was discharged with a Cr of 3.4.

Due to the higher mortality rate in transplant patients with COVID-19, the need for more clinically severe treatment and intensification of care in this group of patients is essential.

COVID-19 developed a sudden onset of smelling disorders. Researchers used self-reported or special tests to study this issue. We aimed to investigate whether quantitative-test smell disorders have a considerable difference from self-reported or not.

We searched 554 studies published between December 2019 to September 2020 by the PICO model. Our search strategies were based on MeSH terms in the electronic databases Web of Science (136 articles), Scopus (84 articles), and PubMed (334 articles). The duplicated articles were excluded, then the preferred reporting items for systematic reviews and meta-analysis guidance were utilized. Finally, we divided the studies into two (self-report (33 articles) and specific-test (9 articles)) groups.

33 (80%) articles expressed olfactory dysfunction by self-report of patients and 9(20%) studies were conducted by a specific test. Only three studies, one in self-report; ((internal reliability, Cronbach α = 0.84) and validity (r = –0.60, p < 0.001)) and two in specific-test groups; ((test-retest r=0.94) and another study (test-retest r >0.7)) conducted validity and reliability. Self-reported studies published a various range of prevalence (20% _97%) in patients with COVID-19. COVID-19 patients with a specific-test group were found to have a primary incidence of anosmia of over 65%, even reaching 98% depending on the types of tests.

Self-reporting of COVID-19 detection can be affected by sociodemographic factors. Although self-reported questionnaires are economical and easy to use, standardized tests provide more reliable comparisons and professional assessments. Therefore, standardized tests are recommended for more accurate screening over self-reporting.

COVID-19 has rapidly brought many changes to people’s lives. The current research aimed to explore how these changes affected the social resilience of the residents in a local neighborhood. 

  The present case study was conducted in the spring of 2021, using in-depth interviews and field observations in the Tawheed neighborhood of Gonabad City, Iran. Purposive sampling was used to select the interviewees with maximum variation. Interviews continued until data saturation was reached, which occurred after the 17th participant was interviewed. To analyze the data, a directed qualitative content analysis and the complexity approach proposed by David Byrne and Gil Callahan were utilized. 

The local residents’ social resilience during the pandemic was explained in light of the complexity theory. A total number of four categories and 13 sub-categories were extracted: uncertainty of the disease (uncertainty of information about the disease, no common understanding of the disease, no common norms of health behaviors, and unknown aspects of the disease), features of connectivity and network of social relationships (perceived common benefits, family cohesion, access to online social networks), initial states and availability of sources (unstable living conditions, poor health facilities, and structure of the neighborhood), interaction of micro- and macro-factors (trust in healthcare systems and leaders, and financial rules and policies). 

  The social resilience of the residents in the local neighborhood during the pandemic was influenced by many factors, primarily related to their initial conditions. To improve social resilience, it seems necessary to carry out effective interventions based on local and indigenous capacities.

The COVID-19 pandemic, caused by SARS-CoV-2, has presented a global health challenge. Older people and patients with underlying conditions such as hypertension, diabetes, and obesity are more susceptible to severe disease outcomes. Obesity or high body mass (BMI) index is a significant risk factor for creating diabetes and plays a crucial role in the pathogenesis of COVID-19 infection. Obesity has been shown to increase vulnerability to infections, making it a significant risk factor for COVID-19. This study aims to investigate the relationship between BMI and COVID-19 severity and outcomes in patients with and without diabetes.

This case-control study was conducted on 400 patients with confirmed COVID-19 infection, referred to teaching hospitals in Sari City, Iran, during April and May 2019. The study population consisted of 192 diabetic patients (case group) and 208 non-diabetic individuals (control group), matched for age and sex. Participants’ data, including demographics, medical history, laboratory findings, and disease progression details, were collected using a comprehensive questionnaire. According to CDC criteria, COVID-19 disease severity was defined as mild, moderate, and severe. The relationship between BMI and COVID-19 severity was compared between the diabetic and non-diabetic groups.

This study was conducted on 192 diabetic and 208 non-diabetic COVID-19 patients with an average age of 62.85±0.88 and 53.21±1.18 years, respectively. The average BMI in the diabetic group was 28.68±0.4, whereas it was 26.94±0.31 (P=0.001) in the non-diabetic group. There was a statistically significant difference in the severity of COVID-19 infection between diabetic and non-diabetic patients (P=0.008). The results showed a statistically significant difference in disease severity based on BMI in the diabetic group (P=0.02). Significant differences were observed in the need for mechanical ventilation (P=0.000) and mortality in people with diabetes compared to nondiabetics. A significant association was observed between BMI and ICU admission in both diabetic (P=0.001) and non-diabetic (P=0.000) groups.

The study concluded that BMI may be a significant risk factor for severe COVID-19 outcomes, particularly among people with diabetes. This finding emphasizes the importance of BMI in disease prevention and control strategies, especially for populations with underlying conditions like diabetes.

The pharmaceutical supply chain (PSC) faced numerous challenges, particularly during the COVID-19 crisis. Due to the supply chain (SC) 's vulnerabilities, it requires enhanced capabilities to address these challenges. In Iran, specific economic and political issues have intensified the vulnerabilities of the PSC.

This study investigates the issues caused by the COVID-19 crisis in the PSC, identifies and characterizes these issues, and recommends appropriate courses of action to address future SC disruptions.

This study is a qualitative-quantitative analysis conducted in Iran during the COVID-19 crisis. Qualitative thematic analysis was performed from July 2022 until May 2023. Semi-structured, in-depth, face-to-face interviews with 23 Iranian PSC specialists were conducted until saturation was reached. The qualitative phase was analyzed using MAXQDA 2021. The quantitative phase included a survey of 547 individuals working in pharmaceutical manufacturing in Iran, with the questionnaires analyzed using SPSS 26.

In the qualitative phase, the research identified two main themes: (1) vulnerabilities and (2) capabilities, along with 15 subthemes providing solutions to enhance the resilience of the PSC. In the quantitative phase, findings from 64 questionnaires highlighted major vulnerabilities and capabilities necessary to create a resilient SC. The median score for vulnerabilities was 5.12, while the median score for capabilities was 5.39.

According to the questionnaire results, the quantitative findings indicate that capabilities received a higher score, suggesting that this sector of the PSC demonstrated better resilience against the pandemic. This study, with its contextual focus, mixed-method approach, comprehensive analysis of vulnerabilities and capabilities, and sector-specific insights, offers a novel contribution to the understanding of SC resilience within Iranian pharmaceutical manufacturing. It also has the potential to promote further research in other sectors of the PSC.

Trace elements play crucial roles in metabolic processes and serve as cofactors for various enzymes, although their specific involvement in fungal pathogenesis remains unclear. This study aimed to explore the impact of essential trace elements, iron (Fe), manganese (Mn), zinc (Zn), and copper (Cu), in conjunction with D-dextrose, on conidial germination and growth of Aspergillus fumigatus and A. flavus.

The research involved determining the minimum inhibitory concentrations (MIC) of Fe, Mn, Zn, and Cu for Aspergillus ATCC strains. The study commenced by determining the MIC of the four trace elements, followed by evaluating the impact of selected trace elements on the kinetic growth and germination rates of Aspergillus species by the micro-broth method. Following MIC assessment, optimized concentrations of the trace elements (~140 and 550 pM) and various concentrations of D-dextrose (1-3% w/v) were introduced to assess their effects on fungal growth in RPMI 1640 broth. Growth was measured in optical density, while conidial germination rates were also observed.

The MICs for Fe, Mn, and Zn exceeded 35 µM, while Cu exhibited lower MICs of 2 and 7.6 µM against A. fumigatus and A. flavus, respectively. Fe, Mn, Zn, and Cu significantly enhanced fungal growth in both Aspergillus species at optimized concentrations. Additionally, growth rates increased proportionally with higher D-dextrose concentrations. Notably, combining enriched trace elements and D-dextrose resulted in up to 98% conidial germination.

The findings demonstrate that optimized concentrations of essential trace elements and D-dextrose significantly promote conidial germination and growth of Aspergillus species in vitro. These results suggest that trace element supplementation might have important implications for immunocompromised and hyperglycemic patients. Further studies are warranted to explore the interactions between these micronutrients in fungal physiology and pathogenesis.

During the COVID-19 pandemic, disease coding significantly influenced national and international strategies for prevention, treatment, and control. This study aimed to assess the factors influencing COVID-19 records' coding errors in teaching hospitals in South Khorasan province.
In 2022, researchers conducted a cross-sectional study in South Khorasan Province, Iran. Data was gathered using a self-developed questionnaire distributed among medical coders in all hospitals. Descriptive statistics were employed in the data analysis using SPSS version 19.
The study's results showed that non-observance of diagnostic principles by physicians (66 out of 92), a lack of specialized medical coding specialists (52 out of 92), and the use of ambiguous and non-standard abbreviations (51 out of 92) were the most significant factors affecting COVID-19 coding errors. Among the three main factors affecting COVID-19 records' coding errors, factors related to the medical coder (47.66 out of 92), factors related to healthcare providers (29.8 out of 92), and organizational and environmental factors (21.4 out of 92) were the most significant.
This study revealed that multiple factors contribute to coding errors in COVID-19 records, with the most critical being physicians' non-adherence to diagnostic principles, the shortage of medical coding specialists, the use of unclear and non-standard abbreviations, and the absence of COVID-19 coding continuing education. Therefore, we recommend conducting workshops on diagnosis and coding for medical coders, particularly emphasizing the precise coding of COVID-19 records.

This study aimed to summarize the baseline and radiological characteristics of patients with COVID-19 and investigate the correlation between clinical outcomes and radiological findings in the first week after admission.

A single-center retrospective study was carried out on confirmed cases of COVID-19 based on RT-PCR and chest CT scan findings according to Iran’s National Guidelines for defining COVID-19 in patients admitted to Imam Hossein Hospital, Tehran, Iran. Baseline and chest CT scan characteristics of patients were investigated, and their correlation with the change in clinical outcome was reported.

72 patients (50%) with a mean age of 54.65±16.2 years were in two periods of time including the first day of diagnosis and 6.0±3.4 days later. Based on CT scan Severity Score (CTSS) changes (decrease/no change or increase) during the study, patients were divided into two groups of CTSS progression (n=47) and CTSS no-progression (n=25). Diabetes mellitus (20%) and hypertension (19.1%) were the most frequent comorbidities among the patients in the non-progression and progression groups, respectively. There was no significant difference in demographic features including age and gender, and comorbidities (P>0.05). On the first day of diagnosis, there was no significant difference in blood tests and radiological findings and the number of patients who managed out-patients or in-patients in both groups. However, on the second evaluation day, patients in the progression group had significantly higher CTSS in comparison with the non-progression group (13.11±4.7 vs. 9.48±4.2, P=0.003), and the clinical situation in 15 patients in progression changed from out-patient to in-patient (p=0.033).  Only chest CT imaging score was a potential parameter associated with the change in clinical progression (P=0.030, RR=10.18, 95, CI=1.25-89.72).

Increasing CTSS is a strong predictor of worsening clinical outcomes during hospitalization in COVID-19 patients.

Medication errors can lead to damage to patients with various disabilities or death. This study aims to identify factors affecting the incidence of medication error and its association with patient safety culture from the nurse’s perspective during the COVID-19 pandemic.

This cross-sectional study was conducted among 340 employed in the hospitals affiliated with Shiraz University of Medical Sciences in 2021. Data were collected by applying a questionnaire for medication error and the standard questionnaire of the Hospital Survey on Patient Safety Culture. Descriptive statistics, the independent t-test, ANOVA, and Pearson correlation were applied using SPSS software version 23.

The main reasons for medication errors were fatigue due to the workload (3.13±1.16 out of 5), method of supervision in the hospital units (3.06±0.98 out of 5), and massive pile-up of duties (3.00±1.19 out of 5). Other results indicated a significant negative association between factors affecting medication error and patient safety culture (r=-0.574, p=0.002). A significant correlation was observed among factors affecting medication error and patient safety culture with demographic determinants of age and years of working experience (p<0.05). Significant differences were also observed among the two main studied variables, the number of monthly work shifts, and the number of patients (p<0.05).

Applying strategies for the reduction of physical fatigue and mental exhaustion along with balancing work shifts and managing the accumulative duties and massive tasks can help decrease the rates of medication errors.

There have been safety concerns regarding the COVID-19 vaccines because of their unprecedented speed of development. Therefore, systematic reviews are necessary to address these concerns and reduce public hesitancy regarding COVID-19 vaccines. This study aims to systematically review the reported adverse events related to viral vector COVID-19 vaccines.

We performed a systematic search in the databases of PubMed, Scopus, Web of Science, and Cochrane on September 15th, 2021. This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The records underwent two-step title/abstract and full-text screenings, and the eligible records were included in the data extraction process. We used the Newcastle-Ottawa Scale (NOS) for the Bias Assessment of included articles.

The adenovirus vector-based COVID-19 vaccines, including the Janssen COVID-19 vaccine, the AstraZeneca COVID-19 vaccine, and the Sputnik V vaccine were included in this review. Among these vaccines, the AstraZeneca has presented enormous side effects with most being systemic and a few sporadic cases of life-threatening events such as thrombosis and capillary leak syndrome and even death in a few cases. Prominent systemic side effects of the adenovirus vaccines include fever, fatigue, malaise, arthralgia, myalgia, sweating, and dizziness. Erythema, swelling, tenderness, itching, and numbness at the injection site are the most common local reactions.

It appeared that the frequency of serious adverse events is negligible, and vaccination to prevent severe COVID-19 and mortality has greater benefits than adverse events in the general population.

Forecasting the longevity of patients' immune stability could be the most effective approach to preventing illnesses. This study investigates immunoglobulin M (IgM) serum longevity, immunoglobulin G (IgG), and corresponding risk factors in the first phase seropositive patients in Mazandaran, Iran.
This descriptive cross-sectional study aimed to assess IgM and IgG serum levels in a cohort of 184 seropositive patients during six months. The data analysis involved various statistical methods including descriptive statistics, the chi-square test, independent and paired t-tests, and single and multivariate logistic regression.
A total of 103 (56%) patients lacked the necessary antibodies, whereas 81 (44%) remained seropositive. According to the results of multivariable logistic regression, patients with a travel history, hospital admissions, and end-stage renal disease (ESRD) had 3.24 (P=0.04), 12.63 (P=0.018), and 9.79 (P=0.001) times higher chances of stable seropositivity, respectively. The average IgG and IgM serum levels fell by 4.5 and 3 units, respectively (P<0.001). In addition, serum levels of IgM and IgG increased by 12% and 12.5%, respectively, and dropped by 75.5% in both serums. There was no increase in either serum level for any of the patients.
The duration of immune serum stability in patients can significantly reduce disease mortality. The concurrent detection of IgM and IgG antibodies also assists in identifying the infectious stage.

The recent outbreak of Coronavirus 2019 (COVID-19) is a respiratory disorder caused by the Acute Respiratory Syndrome Coronavirus 2. At the start of the epidemic, early intubation was the optimal strategy for managing ARDS caused by COVID-19. Several non-invasive methods for respiratory support in patients with moderate to severe COVID-19 may reduce intubation, disease severity, ventilator use, and hospitalization in the intensive care unit (ICU). In this study, the characteristics of COVID-19 patients who failed NIV therapy were compared with those who had successful NIV. 
The present descriptive-analytical study was conducted at the COVID-19 center of KHORSHID University Hospital. Patients were aged > 18 years with confirmed COVID-19 and hospitalized in the ICU from the beginning of January to the end of March 2021. They had an oxygen level of < 88% despite receiving 15 L of oxygen with reserve masks and were undergoing non-invasive ventilation (NIV) treatment. Data collection included patients' demographic information, vital signs, and test results upon hospital admission, and assessed disease severity using APACHE, SAPS, and SOFA scores. Patients were categorized into responders (R) and non-responders (NR) to determine predictors of non-invasive ventilation (NIV) success, with follow-up based on device tolerance and changes in vital signs.
71 Individuals were candidates for NIV. Twenty patients were excluded from the study, and 51 patients were included in the study. Of these, 35 patients underwent NIV treatment failure (NR). On the other hand, 16 (31.4%) patients completely recovered after receiving NIV (R) and they were discharged from the ICU.
Serum Albumin and BMI levels of COVID-19 patients undergoing NIV therapy seem to affect their responses to treatment. Hence, it is recommended to evaluate the nutritional status of patients before the start of NIV.

The COVID-19 pandemic significantly impacted educational systems, leading to the rapid adoption of distance education. This shift affected midwifery departments in Turkey, raising items about its appropriateness for such a practical discipline.

This study aimed to evaluate the attitudes of educators in Turkish university midwifery departments toward distance education during the pandemic.

This cross-sectional study was conducted on 87 academic midwives in midwifery departments of universities in Turkey from June to December 2020. Data was collected online using a structured survey by a researcher. A survey was developed by trainers based on literature to understand the attitudes and opinions of the trainers towards distance education during the COVID-19 pandemic.

The mean (SD) age of participants was 36.13 (12.92) years and 12.64 (8.83) years of university teaching experience. A majority strongly disagreed that distance education suits midwifery curricula (36.8%), and 77% strongly disagreed with using distance education for practical courses. However, 27.6% were undecided on its suitability for theoretical classes.

Most midwifery educators believe that distance education is not entirely suitable for teaching the midwifery curriculum. To increase the effectiveness of distance education, a hybrid education model should be adopted; theoretical courses should be conducted remotely, and practical courses should be conducted face-to-face. Digital simulations and virtual laboratories should be expanded to support practical training. Academicians should be trained on interactive methods to increase student participation, the infrastructure of universities' distance education systems should be strengthened, and access problems should be resolved.

Studies suggest a potential global increase in the incidence rate of type 1 diabetes (T1D) following the SARS-CoV-2 pandemic. This study aimed to assess the incidence of T1D in Isfahan Province before and during the pandemic to better understand the situation in this population. In this cross-sectional study, we determined the incidence rate of new-onset T1D for the two years preceding the COVID-19 pandemic (2018-2019) and during the two years of the pandemic (2020-2021). We also calculated incidence rates each year by sex and age groups (0–4 years, 5–9 years, 10–14 years, and 15–18 years). The age-adjusted incidence rates (95% CI) of T1D in Isfahan were as follows: 16.38 (16.27-16.49) in 2018, 13.94 (13.51-14.35) in 2019, 13.17 (12.44-13.90) in 2020, and 18.09 (17.17-19.00) in 2021 per 100,000 children. The average annual percent change (APC) was 9.7%, with the highest APC of 37.34% in 2021. There was no statistically significant trend in T1D incidence during the study period (P > 0.05). The frequency of diabetic ketoacidosis (DKA) was higher during the COVID-19 period in 2020 and 2021 compared to 2018, with rates of 54.89% in 2021, 52.82% in 2020, 52.68% in 2019, and 32.49% in 2018 (P < 0.005). This research observed an increasing incidence rate of T1D, particularly in the second year of the COVID-19 outbreak. While other studies have also reported an increase in T1D cases, the complex nature of T1D development makes it challenging to draw definitive conclusions about the impact of SARS-CoV-2 infection on T1D onset.

The effect of COVID-19 vaccination coverage on the role of social capital as an essential dimension in disease prevention is undeniable. This study investigated the correlation between Covid-19 vaccination coverage and social capital. This ecological study used aggregate data from 130 countries. A fully vaccinated index was used to cover the COVID-19 vaccination. The main variable was the cumulative fully COVID-19 vaccinated population share data, which was retrieved from Our World in Data repository. The data related to social capital was retrieved from the global sustainable competitiveness databases. Cumulative fully vaccinated population shares related to COVID-19 were 46.83%. The higher rate of cumulative fully vaccinated population shares related to Covid-19 was reported in the United Arab Emirates (90.28%), Portugal (88.98%), and Singapore (87.00%), and also the lower rate of cumulative fully vaccinated population shares related to Covid-19 were reported from Burundi (0.02), Chad (0.48), and Haiti (0.61). There was a positive significant association between cumulative fully vaccinated population shares and social capital (r=0.74, p<0.001). A positive significant association between cumulative fully vaccinated population shares and social capital was found in 39 high-income countries (r=0.33, p=0.03), 36 upper-middle-income countries (r=035, p=0.04), and 36 lower-middle-income countries (r=0.51, p=0.002). A strong positive association between cumulative fully vaccinated population shares and social capital in the countries was observed. Appropriate interventions are needed to increase the level of social capital and its components in countries to increase access to vaccination and health status in countries in the conditions of a pandemic.

One of the most important indicators of people's health in the pandemic of coronavirus (COVID-19) is their health-promoting behaviors. This study was conducted to investigate the status of health-promoting behaviors of nurses in teaching hospitals in southern Iran during the COVID-19 pandemic. This cross-sectional descriptive-analytical study was conducted on 340 nurses of teaching hospitals of Shiraz University of Medical Sciences in 2022. Data were collected through a standard health-promoting lifestyle questionnaire that was designed in 10 dimensions (physical health, exercise and wellbeing, weight and nutrition control, disease prevention, psychological health, spiritual health, social health, avoiding medicines and drugs, preventing incidents and environmental health) with totally 70 questions. Data were analyzed using descriptive statistics, T-test, ANOVA, Pearson correlation coefficient by SPSS23 at a significance level of α= 0.05. The mean score of total health-promoting behaviors was evaluated to be 3.48±1.12, which is in a moderate range. Spiritual health (4.62±1.29) had the highest and that of exercise and wellbeing (2.38 ± 1.38) had the lowest mean score. There was a positive and significant correlation between all components of health-promoting behaviors (P<0.05). There was a significant difference between health-promoting behaviors with demographic variables like gender (P= 0.01), marital status (P= 0.03), and educational level (P= 0.03). Nurses' health-promoting behaviors were at a "moderate" level, by continuing the condition of the pandemic, it is recommended to the health policymakers to prepare a more supportive work environment considering educational interventions with an emphasis on exercise and wellbeing.

Morbidity and mortality from coronavirus are more likely in vulnerable groups, such as cancer patients. Implementing self-care education for prevention in these patients is a priority. This study aimed to investigate the effect of telenursing education on self-care behaviors that prevent COVID-19 in cancer patients.

This interventional study was conducted at Vasei Sabzevar Hospital on patients with various types of cancer undergoing chemotherapy and radiation therapy in 2020 coinciding with the second peak of COVID-19, for one month (30 minutes daily). Two-stage sampling was conducted in the intervention group (31 participants) and the control group (26 participants). Self-care and patient follow-up training on the prevention of COVID-19 were conducted through WhatsApp. Data were collected using a researcher-made self-care questionnaire, a demographic questionnaire, and a medical information form. 

The mean age of the participants was 58.24±13.27 years, with the majority being female (n=35; 61%). Breast cancer was the most common cancer among the studied subjects (n=24; 42.1%). In the intervention group, the mean score of self-care before the intervention was 21.65±8.72 and after the intervention, it was 36.76±3.14. The results of the independent t-test showed a significant difference between the two groups (P<0.001). Fisher’s exact test did not indicate a significant difference between the two groups in terms of COVID-19 morbidity (P=0.118). 

The results of the present study showed that telenursing education improves self-care behaviors in the prevention of coronavirus in cancer patients.

Chest computed tomography (CT)-derived findings pose clinical value in detecting high-risk COVID-19 patients.

This retrospective cohort study aimed to assess poor hospital prognosis in COVID-19 patients using on-admission chest CT findings.

This study included 166 hospitalized COVID-19 patients with a confirmed diagnosis of COVID-19 from October to December 2020 in Southern Iran. Demographic variables, on-admission clinical and laboratory data, and on-admission high-resolution chest CT (HRCT) such as visual lung involvement score, distribution, area, main pattern, and related features, as well as short-term follow-up during the hospital stay, were extracted. Poor prognosis was defined as ICU admission, need for invasive mechanical ventilation, development of acute respiratory distress syndrome, or death.

The COVID-19 patients with poor prognosis had a significantly higher visual lung involvement score compared to those without poor prognosis (20 [IQR: 14, 23] vs. 13 [IQR: 10, 17]; P < 0.0001). The two groups were not statistically different for other HRCT findings. In a multivariable model, lung involvement score was the only statistically significant independent variable for in-patient COVID-19 poor prognosis (odds ratio: 1.197 [95% confidence interval: 1.064, 1.348]; P = 0.003).

On-admission chest CT findings can potentially be utilized to evaluate prognosis and guide the treatment strategy of hospitalized COVID-19 patients as early as during the emergency ward stay.

The COVID-19 pandemic, which occurred between 2019 and 2023, posed a significant threat to global health. Its high transmissibility, the emergence of new variants, and the novel nature of the disease made treatment and control highly challenging.

This study aimed to develop an algorithm for predicting the mortality of hospitalized COVID-19 patients using machine learning methods.

This cross-sectional study was conducted on 581 hospitalized COVID-19 patients. The approach integrated multi-model features derived from computed tomography (CT) scans and electronic health record (EHR) data. High-resolution computed tomography (HRCT) images were initially processed using the Pulmonary Toolkit package in MATLAB software. Subsequently, the extracted variables were entered into the model as predictive factors, alongside demographic characteristics, underlying conditions, and laboratory results of the patients. The machine learning model was developed using the AdaBoost method by incorporating demographic and laboratory data with HRCT features.

In this study, 581 hospitalized COVID-19 patients were included. Among them, 199 (34.25%) patients died, while 382 (65.75%) recovered. According to the machine learning algorithm, the most effective variables for predicting COVID-19 mortality were lymphocyte variables, CRP, age, mean lung density, lung tissue percentage, RBC count, D-dimer levels, and emphysema. The MCC Index in this study was 0.73, and the area under the ROC curve was 0.96.

According to our results, the three variables with the greatest impact on predicting mortality in COVID-19 patients were related to HRCT findings, laboratory results, and patient age. Therefore, it is recommended that, given the high cost of HRCT, this diagnostic test should only be performed if other risk factors are identified in laboratory results. If necessary, HRCT should be conducted promptly.

There are ongoing controversies regarding pregnancy outcomes during the COVID-19 era.

This observational study with a retrospective design was conducted to investigate the maternal and neonatal impacts of COVID-19 on pregnancy outcomes.

An observational study with a retrospective design was carried out using census sampling from February 2020 to July 2021. The study population included pregnant women who were referred to Asalian Hospital in Khorramabad city, western Iran. A total of 769 mothers (107 with COVID-19 and 662 without COVID-19) were included in the study.

The most common symptoms reported by infected mothers were body pain/myalgia (68, 72.3%), fatigue (57, 60.6%), headache (47, 50%), and shivering (46, 48.9%). After adjusting for covariates, the risk of caesarean section (CS) in pregnant women with COVID-19 was found to be 3.2 times higher (95% confidence interval: 1.90 - 5.50). In contrast, the risks of newborn hospitalization, prematurity, low APGAR scores, respiratory distress, and smaller head circumference were higher among newborns of non-COVID-19-infected mothers than those of COVID-19-infected mothers (P < 0.05).

While it is generally expected that COVID-19-infected mothers would experience adverse maternal and neonatal outcomes, this retrospective study demonstrated that COVID-19 infection does not result in adverse outcomes for mothers or newborns, apart from a higher rate of CS.