جستجوی مقالات مرتبط با کلیدواژه « COVID-19 infection » در نشریات گروه « پزشکی »

Hospital outcomes for myocardial infarction are among the clinical conditions influenced by the spread of COVID-19. Patients with COVID-19 frequently experience cardiovascular complications, with challenges encountered in acute management. We assessed clinical presentation, incidence, clinical outcomes and angiographic findings of myocardial infarction in COVID-19 patients.

This  study is a observational retrospective multicenter, medical diagram study was conducted on successive patients hospitalized with diagnosis of Covid-19 and myocardial infarction ,in two large referral hospitals with catheterization equipment and laboratories.COVID-19 infection was confirmed with reverse transcription–polymerase chain reaction assays of a nasopharyngeal sample or pattern of pulmonary parenchymal involvement in lung HRCT (approved by an expert respiratory or infection disease specialist). Data collected included patient demographics, comorbidities, electrocardiogram(ECG) and echocardiography results ,inpatient medication, treatment (fibrinolytic therapy, percutaneous coronary intervention  (PCI) ,coronary artery bypass graft (CABG), vasopressor use, invasive mechanical ventilation),laboratory test results (leucocyte count, C-reactive protein , D dimer, BUN, Cr, and ferritin)and outcome(duration of hospitalization, revascularization success, in-hospital reinfarction and mortality).

The most common comorbidities were hypertension (29, 58%), diabetes mellitus (21, 42%), dyslipidemia (14, 28%) and smoking (5, 10%). Fourteen patients (44.4%) were treated with PCI and 8 (19.5%) patients with fibrinolytic therapy as the initial reperfusion strategy. Revascularization was successful in 62% of patients.  The median CRP level of patients died was 96, which was significantly more than the level (46) in discharged cases (p<0.001). Creatinine levels were also significantly higher in patients who died compared to those who were discharged (p=0.008).

The results of this study demonstrate upper mortality rate in patients with diabetes, kidney injury and high-level CRP, denoting the baseline clinical and laboratory data could be defined as prognostic markers in COVID-19 patients, especially while managing myocardial infarction with concurrent COVID-19 infection.

 Because of waxing and waning nature of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it has turned the entire globe upside down since its conception in December 2019. Vaccination against COVID-19 has emerged as the only ray of light in this dark tunnel of the pandemic, and has proven to curtail the morbidity and mortality associated with the viral infection. Thus, aspiration behind doing this study was to present the actual conformity of Indian cancer center patient population to COVID-19 vaccination.

The current prospective research was conducted on 396 cancer patients from North Indian Tertiary Cancer Center (TCC) between October 2021-February 2022 to analyze vaccine acceptance among its cancer patients. Face-to-face interviews were done to ask about the demographics and status of vaccination. Data was analyzed using SPSS v.25. Quantitative data presented as mean and standard deviation (SD). Qualitative data presented as ratios and percentages. Qualitative data were compared using Chi-square test. p<0.05 was considered significant.

Among 396 patients, 221 (55.80%) were male and 175 (44.19%) were female, and mean age of study population was 55.96 years. 292 (73.74%) were from rural background while 104 (26.26%) belonged to urban background. Most common site of malignancy was head and neck cancer with 40.66% patients. 245 (61.36%) out of 396 patients were vaccinated either with single or both doses of COVID-19 vaccine, but 153 (38.64%) were not vaccinated. Out of vaccinated patients, 70.37% patients were fully vaccinated with 2 doses and 29.63% were vaccinated with single dose of COVID-19 vaccination.

Hesitancy of cancer patients in receiving COVID-19 vaccination is still a big hurdle to return to pre-pandemic oncological care, and this can be mitigated by amalgamated active efforts of government, treating oncologist and family of cancer patients.

Diabetes is a non-communicable disease with fatal complications. Diabetic patients are highly susceptible to COVID-19 side effects and persistent post-discharge symptoms that impact health-related quality of life (HRQoL).

This study aimed to assess HRQoL and examine factors affecting diabetic and non-diabetic COVID-19 patients after hospitalization.

In a cross-sectional study, 220 diabetic and non-diabetic COVID-19 patients were randomly selected after hospitalization in Sirjan, Iran, from January 2020 to October 2021. The European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire was used to measure HRQoL as a dependent variable and its dimensions (including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) as independent variables. In addition, a checklist was used to identify determinants of HRQoL, including age, gender, education, family income, household ownership, occupation, number of family members, and access to health services, that might affect the HRQoL participants.

The mean HRQoL score in COVID-19 diabetics (0.766±0.110) was significantly lower than that in their non-diabetic counterparts (0.859±0.077). The EQ-5D-5L scores in the diabetic group were significantly higher in younger participants, men, employed subjects, patients with higher educational levels, higher income, higher health status, supplemental insurance, access to health services, and fewer family members. According to the results of the Betamix model, education and diabetes were significant independent predictors of HRQoL scores.

Diabetic COVID-19 cases experienced a significant decrease in HRQoL after hospitalization. This drop might have been due to more side effects of COVID-19 in diabetic patients and lower utilization of health services during this period. It is suggested that the health sector changes the management of diabetics during the COVID-19 epidemic by taking measures such as using telemedicine, providing home services, or prescribing medications for a longer period.

COVID-19 infection increases the risk of pathological thrombotic events in venous and arterial circulation. COVID-19 patients are reported, a wide range of neurovascular symptoms is highlighted, such as cerebral vascular accidence. This study aimed to report a massive stroke in a pregnant woman with COVID-19 infection.

Case Report: 

We report a 41-year-old pregnant woman, gravid 5 para 2 living 2 abortion 2 at gestational age 22 weeks and 4 days with Covid-19 infection, which developed into a massive stroke in the Basilar artery despite receiving a therapeutic dosage of Enoxaparin Sodium.

The possibility of thrombosis should be considered in COVID-19 patients with symptoms indicating an increase in intracranial pressure (ICP) such as decreased consciousness, strabismus, and agitation. Considering the higher risk of thrombotic events in COVID-19 patients, cerebral venous sinus thrombosis (CVST) could be a possible consequence. Thus, the precise observation of neurologic manifestations in covid-19 patients, especially in pregnant women, is recommended. 

There is little data on the mortality rate and severity of COVID-19 infection among pediatrics. This knowledge is particularly significant because pneumonia is the main underlying cause of death in children worldwide. This systematic review and meta-analysis aims to evaluate the mortality rate of COVID-19 in the pediatric population in Iran.

A systematic review and meta-analysis of the publications was conducted based on the PRISMA guidelines to search for COVID-19 child mortality. PubMed, Google Scholar, Embase, Medline databases, and Persian database were searched for publications on pediatric COVID-19 infections published in Iran with a focus on mortality in children with COVID -19 infection in Iran between January 1st to April 30th, 2021. Articles representing at least one Pediatric with and without comorbidities, COVID-19 infection, and informed outcomes were examined.

Eight studies including three case series, and five retrospective cross-sectional studies altogether representing a total of 238 pediatric patients with COVID-19 were included in this meta-analysis. Of this population, 14 patients had died. In this study, the mean age of the study sample was 6.7 years. The mortality rate among children hospitalized with COVID-19 was 9% (95% CI 0.055-0.146). Also, children with comorbidities had a higher risk of COVID-19 related mortality.

Unlike adults, most infected children are asymptomatic and are not usually hospitalized. Children with underlying conditions are at increased risk of severe COVID-19 related mortality than children without underlying illness. More attention should be paid to children with comorbidities and children of young age.

The novel coronavirus disease 2019 (COVID-19) has placed heavy direct and indirect economic burden on the people and the health system.

The present study aimed to estimate the economic burden of COVID-19 in Qom Province, using the step-down cost accounting (SDCA) method.

This descriptive, cross-sectional study included all COVID-19 patients in Qom Province from February 19, 2020, to June 19, 2020. The patients’ data were collected in the form of major cost groups with integrated health system (IHS), health information system (HIS), and a financial software called Roozamad. The governmental, out-of-pocket, and opportunity costs paid by patients and hospitals were calculated and evaluated using SDCA in Microsoft Excel software.

The incidence of COVID-19 infection was 518 per 100,000 populations in Qom Province in the aforementioned period. The total government costs for the treatment of the patients were calculated to be 2,229,216,930,370 Rials (8,916,867 $). Among the major governmental cost groups, personnel costs accounted for the highest total expenditures. In addition, out-of-pocket costs of patients and their families equaled 30,038,013,060 Rials (120,152 $). The costs of final service departments accounted for more than half of the total costs. The opportunity costs were calculated as 420 billion Rials (15.68% of total costs).

According to the findings, the direct and indirect costs associated with the treatment of COVID-19 patients can impose a heavy economic burden on the households and health care system. Therefore, disease prevention strategies such as observing health protocols are recommended to reduce the burden of the disease.

This study aimed to investigate the satisfaction rate of patients referred to Bahrami Hospital, Tehran City, Iran, by telerehabilitation and hands-on provision during the COVID-19 pandemic.

Six pediatric patients with torticollis’ disorders, Erb’s palsy, and muscle weakness were referred to Bahrami Hospital. All those subjects were assessed and advised with different exercises and interventions, and then the rest session followed with the online managing with videos or WhatsApp consultation. Then satisfaction rate of the patients was evaluated based on a Likert-type scale.

The patients revealed low satisfaction for alone telerehabilitation. However, all patients preferred to combine teleconsultation and hands-on rehabilitation. Of course, they were all satisfied with telerehabilitation.

It seems that most patients are afraid of the inability to perform accurate exercises and prefer to come on face-to-face rehabilitation, sometimes used in addition to telerehabilitation and teleconsultation.

World Health Organization (WHO) declared COVID -19 infection a global pandemic. Children have milder disease than adults but different aspects of disease in children are not fully understood.

We describe 5 pediatric patients with COVID-19 that referred to Amirkola Children’s Hospital, Babol, Iran. The youngest patient was 4 years old and the oldest was 12 years old. Three patients were males. None of the patients had a history of contacts with symptomatic patients with COVID -19. The most common symptoms included fever, cough, anorexia, weakness and diarrhea. One patient had gastrointestinal symptoms without respiratory symptoms. All patients had elevated ESR and CRP. Three of them had lymphopenia. RT-PCR was positive in all patients. Management included supportive care, antibiotics, antiviral treatment and hydroxychloroquine. All patients were discharged with good condition.

Children may have a variety of symptoms including respiratory or gastrointestinal symptoms. Mortality is rare in children and prognosis is better than the adults

There is no data on the outcome of COVID-19 infection in patients with breast cancer from India. This study was done to assess the outcome of patients with breast cancer who had COVID-19 infection.

We analyzed patients with breast cancer who were diagnosed with COVID-19 infection from May to September 2020 in the medical oncology department of a tertiary cancer center in India. Symptomatic patients (fever and influenza-like illness symptoms) or asymptomatic patients planned for systemic therapy were tested for COVID-19 by RT-PCR.

A total of 441 breast cancer patients received 1174 systemic therapies from May to September 2020. Among them, 36 patients who had COVID-19 infection were analyzed in detail. The majority (86%) were asymptomatic at presentation. The most common symptoms were fever followed by cough. Patients were either admitted to the hospital (53%) or kept in home quarantine (47%). Patients who received oxygen, non-invasive assisted ventilation (NIV), and mechanical ventilation (MV) were 8%, 3%, and 3% respectively. The median duration of hospitalization and home quarantine was 11 days and 19 days respectively. The recovery of patients with COVID-19 infection was 94%. The median duration to clearing SARS-COV-2 by RT-PCR was 19 days. The total/all-cause mortality was 6% (n=2). The mortality due to COVID-19 infection was 3% (n=1). Subsequently, 89% were restarted on systemic therapy. The median delay in restarting systemic therapy was 23 days.

Systemic therapy can be safely administered during the ongoing COVID19 pandemic. Further, follow-up of patients is warranted to assess the long-term impact of COVID-19 infection.

The present study aimed to assess COVID-19 disease complications and its related 30-day mortality in pediatric patients with perioperative SARS-CoV-2 infection who had surgery.

A multi-center, prospective, brief report of pediatric patients who had surgery at 6 hospitals in 4 cities of Khuzestan Province, South-western Iran, one of the provinces with the highest prevalence and death rates due to COVID-19 disease. COVID-19 status and its effect on the course and outcome of the patients was investigated.

246 pediatric patients who had surgery between Jan 20 and Jun 01, 2020 with a 30-day follow-up period enrolled in the study. Four (1.62%) of the 246 patients who underwent surgery had perioperative COVID-19 infection. The most common symptoms included dyspnea, fever, and cough. Surgical procedures included total gastrectomy and esophagojejunostomy, bilateral pleural effusions tap, catheter placement for dialysis, and CV-line placement. Three patients had comorbidities including congestive heart failure (CHF), end-stage renal disease (ESRD), and diabetes.

Based on our results, it can be said that the prevalence of this disease in children is lower than the average of the society; and the outcome in younger patients seems to be better. Though it seems that COVID-19 disease is a low risk and somehow benign condition in children undergoing surgery, but due to the unpredictable nature of the disease, public health recommendations at both general and special levels have been made by the World Health Organization (WHO) to prevent the disease. Further studies with larger samples are necessary to confirm our findings and to clarify which age groups are at increased risk for developing severe COVID-19 infection and its related morbidities and death.

There is controversy about the efficacy of 5-alpha-reductase inhibitors in COVID-19 patients. Some assumed that finasteride might be a risk factor for deterioration and others proposed it as a possible adjunct treatment for moderate to severe COVID-19 infection in the elderly.

We performed a randomized controlled clinical trial (registration ID IRCT20200505047318N1) on 80 hospitalized male patients aged ≥50 years diagnosed with COVID-19 pneumonia in a tertiary hospital in Qazvin (Iran) from April to July 2020.   The patients were randomized into one of the 2 treatment groups using simple randomization.  Treatment group patients underwent routine drug therapy and 5 mg finasteride once daily for 7 days. The primary endpoint was mortality rate and length of hospital stay (LOS), and secondary endpoints were peripheral capillary oxygen saturation, respiratory rate, and inflammatory markers changes. The study protocol was approved by the medical ethics committee of Qazvin University of Medical Sciences (registration ID IR.QUMS.REC.1399.080). Data were analyzed by statistical tests and SPSS version 25. Also, p<0.05 was considered to be statistically significant.

We found a significant difference on O2 saturation among the 2 study groups on fifth day compared with the admission time (p= 0.018). The results did not show significant differences in mortality rate (2.5% vs 10%; p= 0.166) and LOS (p= 0.866) between patients in the finasteride and the control group.

A short course of finasteride administration partially improves O2 saturation but does not influence other outcomes in hospitalized male patients aged ≥50 years with COVID-19 pneumonia. Further research in a large scale with longer follow-up is required to help clarify the role of finasteride in this setting.

The clinical and socioeconomic effects of COVID-19 are still being felt throughout the world. The disease affects people of all age groups, but it is known to have a milder clinical course in children including neonates. There is paucity of data from Sub-Saharan Africa on neonatal COVID-19 infection, and no such case has been reported in the literature in Ghana.

This study presented a case report of a neonate who was found to be positive for COVID-19 infection after presenting symptoms such as respiratory distress, rhinorrhoea, and cough. This neonate was managed with in-hospital standard protocol for sepsis with a focus on pneumonia.

The national guidelines on COVID-19 management were used for the neonate who was recovered and discharged.

Facial ulcers may be the manifestation of a wide variety of disorders with infective, inflammatory, granulomatous, or malignant etiopathogenesis, leading to challenges in differential diagnosis and management. Mucormycosis is an angio-invasive, rapidly spreading, and potentially fatal fungal infection beginning from the nose and paranasal sinuses after the inhalation of fungal spores, manifesting with cutaneous necrotic eschar. The rhinomaxillary region is the commonest site involved, particularly in immunocompromised individuals. Mucormycosis incidence in people with coronavirus disease 2019 (COVID-19) is on the rise, especially in India during the second wave. Diabetes mellitus is an independent risk factor for severe COVID-19 infection, as well as for mucormycosis. We report an elderly gentleman with uncontrolled diabetes, treated for the COVID-19 infection, who presented with an ulcer over the left nasal ala. This case report highlights the importance of high-index suspicion and prompt and aggressive multidisciplinary management of mucormycosis, as a life-saving measure.
 

Spontaneous pneumomediastinum or mediastinal emphysema is relatively a rare disease that occurs in viral and bacterial infections with the benign entity.

The patient was a 57-year-old man who, after a week of self-isolation at home, coming to the CO-VID-19 triage center of the hospital with severe shortness of breath. He was admitted to the Intensive Care Unit (ICU) due to acute respiratory failure. The patient was treated as the protocol designed and respiratory support with high flow nasal oxygen and Non-Invasive Positive Pressure Ventilation (NIPPV). Spontaneous pneumomediastinum was developed during viral pneumonia infection. The known risk factors included age, male sex, and abnormal laboratory finding. All the biochemical and hematological findings such as lymphopenia, thrombocytopenia, raised CRP, LDH, and ferritin were detected in our cases. They indicate a possible prognosis for the development of acute respiratory failure and adverse clinical outcomes.

Spontaneous pneumomediastinum has usually a benign outcome in COVID-19 Pneumonia and its prognosis is related to background conditions in patients.

Severe Acute Respiratory Syndrome (SARS) associated with SARS-CoV-2, causes a severe form of the respiratory illness known as Coronavirus Disease-19 (COVID-19). COVID-19 has emerged as a worldwide pandemic with a high number of fatalities. Approximately 112,654,202 people have been infected so far with this disease which has led to the death of more than one point seven million (2,496,749) till 24th Feb, 2021. Measures to counter this disease have led to a global economic slowdown. Multiple drug trials are ongoing and several putative candidates for vaccination against the virus have been approved and are in the pipeline. Many studies have also characterized the immunological profile of patients infected with COVID-19. Some studies suggest that the severity of the COVID-19 infection is directly associated with the cytokine storm. In this review, we aim to compile the available knowledge and describe the nature of immune responses in patients infected with COVID-19 in different age groups, comorbidity, and immune-compromised state and their association with disease severity.

 Coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection has been widespread.

 We aim to investigate the demographic and clinical characteristics associated with COVID-19 infection between January 24 to June 10, 2020.

 All data related to tested patients (positive and negative cases) were extracted from the integrated health information system (IHIS) between January 24 to June 10, 2020. Statistical analyses were performed using data related to the anamnesis of all patients, odds ratios (OR) of COVID-19 infection in defined subgroups including contact history, partial pressure of oxygen (PO2) higher than 93 mmHg, the muscle-pain symptom, the cough symptom, and the fever symptom.

 The COVID-19 infection was significantly associated with contact history (OR 5.25, [95% CI 4.35 to 6.34], P-value < 0.0001); PO2 higher than 93 mmHg (OR 1.74 [95% CI 1.44 to 2.22], P-value < 0.0001); muscle-pain symptom (OR 1.89 [95% CI 1.58 to 2.26], P-value < 0.0001); cough symptom (OR 1.32 [95% CI 1.14 to 1.53], P-value < 0.0001); and fever symptom (OR 1.29 [95% CI 1.11 to 1.49], P-value = 0.0004).

 The results of our study indicated that contact with patients or suspicious individuals can be considered as the most important symptoms of COVID-19 disease. Furthermore, the high pressure of oxygen, muscle-pain, cough, and fever symptoms were identified as considerable symptoms of COVID-19 disease.