Zahra Sedaghat; Mohammad Fararouei; Seyed Saeed Hashemi Nazari
Abstract
Background: In 2020, shortly after recognizing the COVID-19 virus in China on March 11, the World Health Organization (WHO) declared the Covid-19 outbreak a pandemic. It is estimated that COVID-19 is responsible for millions of morbidities and deaths globally, causing devastating health, social and economic ...
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Background: In 2020, shortly after recognizing the COVID-19 virus in China on March 11, the World Health Organization (WHO) declared the Covid-19 outbreak a pandemic. It is estimated that COVID-19 is responsible for millions of morbidities and deaths globally, causing devastating health, social and economic crises. This ecologic study aimed to define the correlation between a few key elements of a national health system (i.e., quality of health care services, rate of provided COVID-19 diagnostic tests, and coverage of flu vaccine in the preceding years of the COVID-19 pandemic) and the fatality rate of COVID-19 in countries that were affected by the Covid-19 epidemic in the early phase of the pandemic.Methods: In this ecological study, data regarding the total population, number of active cases, total cases, mortality, and time to peak of the COVID-19 epidemic for the countries with defined criteria and the required data available were collected from the Worldmeter database. Thehealth system quality of the selected countries was obtained using a report by WHO (Measuring Overall Health System Performance for 191 Countries). The Flu vaccine coverage of the selected populations was ordered and ranked using graphs provided by a joint VENICE–ECDC–WHO survey. The analysis was done by fitting meta-regression using rates and confidence intervals. A forest graph was used to show the summary of the results. R version 6.3 (package meta) was used to do the analysis.Results: The average Case fatality rate (CFR) of the 26 selected countries was 115 per 1000 for COVID-19. Testing for heterogeneity suggested that CFR was highly heterogeneous among the countries. The regression analysis results suggested that CFR for COVID-19 was inversely related to the rate of COVID-19 diagnostic tests and was directly related to the rate of flu vaccine coverage).Conclusion: The direct correlation between flu vaccine coverage and CFR of COVID-19 may suggest a positive effect of the natural circulation of flu infection on the effectiveness of the individuals’ immune response. Also, the natural flu infection may protect those who could not tolerate the respiratory complications of COVID-19 infection. The results may help NHSs to cope better with future pandemics. In addition, to provide a faster and more effective response to any future infectious pandemic, better access to diagnosis tests seems to be an effective approach in reducing morbidity and mortality.
Javad Javan-Noughabi; Sayed Ali Mousavi; Seyed Yaser Hashemi; Ahmad Faramarzi; Farshad Bahrami Asl; Hamidreza Shabanikiya
Abstract
Background: Coronavirus disease 2019 (COVID-19) has posed an unusual threat to global health. Up to May 26, 2021, according to a report by the World Health Organization (WHO), 167.01 million cases, and 3.47 million deaths were reported. This study aimed to estimate and compare epidemiological indices ...
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Background: Coronavirus disease 2019 (COVID-19) has posed an unusual threat to global health. Up to May 26, 2021, according to a report by the World Health Organization (WHO), 167.01 million cases, and 3.47 million deaths were reported. This study aimed to estimate and compare epidemiological indices of COVID-19 in high-incidence countries.Methods: We conducted a descriptive and comparative analysis intending to examine the epidemiological indices of COVID- 19 in high-incidence countries, using the data published by the WHO until May 17, 2021. We calculated the incidence and mortality rate per 1,000,000 inhabitant-day at risk daily, weekly, and overall, using person-day as the denominator.Results: The fatality rate in 14 countries was about 1.94%. The highest fatality rate was acquired in Italy (2.99%), followed by the United Kingdom (2.86%) and Iran (2.79%). The lowest value on the fatality rate was in Turkey and India, at 0.88% and 1.1%. The highest incidence rate was reported in the USA (207 cases per 1,000,000 person-day), followed by France (190), Poland (171), and Argentina (167). The highest mortality rate for the whole period was extracted in Brazil (4.60 death per 1,000,000 population-day), and the lowest rate happened in India (0.42).Conclusion: Until May 17, 2021, COVID-19 has affected about 117.6 million patients and caused 2.3 million deaths in 14 highincidence countries. This study shows that a specific pattern of COVID-19 has been observed in every country.
Elham Keshtzar; Marzieh Rashedinia
Abstract
Background: Novel 2019 Coronavirus (covid-19) or SARSCoV-2 disease is spreading quickly throughout the globe and threatening public health. Severe acute respiratory syndrome SARS-CoV-2 may precipitate “cytokine” storm, immune system dysregulation, and hyper-coagulation that are responsible ...
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Background: Novel 2019 Coronavirus (covid-19) or SARSCoV-2 disease is spreading quickly throughout the globe and threatening public health. Severe acute respiratory syndrome SARS-CoV-2 may precipitate “cytokine” storm, immune system dysregulation, and hyper-coagulation that are responsible for several organ failure, morbidity, and mortality. The severity of infection symptoms is extremely variable from mild symptoms to acute respiratory distress syndrome. Overproduction of inflammatory cytokines and interplay between the immune system response and dysregulation of coagulation system are hypothesized to play a critical role in the pathological mechanism of seriously ill patients with covid-19 infection via the IL-1/IL-6 central pathway.Methods: The role of SARS-CoV-2 virus in covid-19 disease through cytokine storm and coagulopathy has been discussed in the present brief review. The electronic databases Pubmed, Google Scholar, and SCOPUS were searched to retrieve related English-language articles published between the years 2019 and 2021.Results: The interplay between immune system responses and coagulation pathway was observed in pathological condition of coronavirus patients, leading to abnormal condition of clot formation and increasing incidence of strokes. Indeed, in nonsurvivor patients, the levels of IL-6, IL-1, and D-dimer were higher than survivor coronavirus patients.Conclusion: Severe SARS-CoV-2 patients with higher level of IL-1/IL-6 and coagulation abnormality confirm this hypothesis that anticytokine drugs are effective for managing cytokine storm, preventing the risk of strokes, and reducing hospitalization and mortality in covid-19 patients.
Jalal Saem; Hajar Haghshenas; Fateme Zare Qashlaghi; Fatemeh Mohseni; Rouhollah Rouhandeh; Mohammad-Rafi Bazrafshan; Amirhossein Saem
Abstract
Background: There are still conflicting results on thepostoperative consequences of patients with hip and femoralfractures based on the type of anesthesia. The aim of this studywas to compare mortality and morbidity of general and spinalanesthesia in patients undergoing hip and femoral fractures.Methods: ...
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Background: There are still conflicting results on thepostoperative consequences of patients with hip and femoralfractures based on the type of anesthesia. The aim of this studywas to compare mortality and morbidity of general and spinalanesthesia in patients undergoing hip and femoral fractures.Methods: In this analytical cross-sectional study, the informationof 93 patients who had undergone hip and femoral surgery withgeneral and spinal anesthesia was studied during 2011-2019 inthe medical records by census method. Data were analyzed usingSPSS 23 software and descriptive and analytical statistics.Results: The general anesthesia group consisted of 29 patientsand the spinal anesthesia group included 64 patients. The twogroups were the same in terms of demographic information,preoperative hemodynamic variables, and previous medicalhistory. The results of the independent t-test with a significancelevel of 5% did not show a significant difference between thetwo groups in the following variables: mean duration of surgeryand duration of anesthesia, mean arterial pressure and heartrate after surgery, changes in blood pressure, and heart rateduring surgery, bleeding, intravenous fluids and blood productsintake, postoperative hemoglobin, number of days hospitalizedin the Intensive Care Unit and surgical ward. The mean postoperative mean arterial pressure score in the general anesthesiagroup was significantly higher than the spinal group (P=0.004).Complications and mortality after surgery did not differ betweenthe two types of anesthesia.Conclusion: In general, these two methods of anesthesia do notdiffer from each other in terms of postoperative complications andmortality, and physicians can choose the appropriate anesthesiamethod according to the specific conditions of the patients
Mohammad-Rafi Bazrafshan; Ahmadreza Eidi; Zahra Keshtkaran; Nasrin Shokrpour; Parisa Zand; Hamed Delam
Abstract
Background: In December 2019, a series of pneumonia cases of unknown cause appeared in Wuhan, China, which was very similar to viral pneumonia. In late January 2020, the World Health Organization named this disease the sixth public health emergency of international concern due to an increase in ...
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Background: In December 2019, a series of pneumonia cases of unknown cause appeared in Wuhan, China, which was very similar to viral pneumonia. In late January 2020, the World Health Organization named this disease the sixth public health emergency of international concern due to an increase in the number of COVD-19 cases. This study was designed to determine different epidemiological and clinical aspects of COVID-19 worldwide. Methods: This is a review study. We searched for articles related to COVID-19 from December 20, 2019 to June 05, 2020. Two researchers performed the search separately, and finally articles containing information on coronavirus, its mortality and epidemiology and clinical characteristics of the patients were selected for review and extraction. Results: The results of various studies show that the most common symptoms of the disease include fever, cough and fatigue, and the most common respiratory symptom is Rhinorrhoea. Transmission occurs primarily when an infected person sneezes or coughs through respiratory droplets, such as the spread of influenza and other respiratory pathogens. Some studies have reported that the COVID-19 incubation period is an average of 4.6 days, ranging from 1.2 to 11.1 days and can potentially be asymptomatic. Conclusion: The significant increases in the morbidity and mortality necessitate prevention and control activities by educating people on important health issues such as staying at home, using clean masks and gloves, as well as performing proper and timely medical interventions.
Hamed Delam; Kosar Zarebi; Esmaeil Kavi; Nasrin Shokrpour; Mohammad-Rafi Bazrafshan
Abstract
Background: Suicide is a multi-factorial phenomenon whose patterns can vary even from one place to another in one country; the purpose of this study was to determine the causes of suicide attempt in a 6-year period in Larestan County in the period between 2012 and 2017. Methods: The present study was ...
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Background: Suicide is a multi-factorial phenomenon whose patterns can vary even from one place to another in one country; the purpose of this study was to determine the causes of suicide attempt in a 6-year period in Larestan County in the period between 2012 and 2017. Methods: The present study was a descriptive-analytic cross-sectional study. In order to investigate the epidemiological condition of suicide attempters in Larestan, all files of suicide cases registered in the period between 2012 and 2017 in this city were investigated, and finally 723 cases were included in the study. For statistical analysis, independent t-test, chi-square and logistic regression models were used. A significance level of 5% was considered. Results: Of the total 723 suicide attempts recorded in the health network of Larestan, the mean age at suicide attempt was 26.08 ± 7.88 years and 3.73% of them had died as a result of suicide attempt. Drug abuse and poisoning were the most common methods of suicidal attempt. Based on the regression model, Increase in age, male sex, and physical problems were the most important factors in predicting suicide death (P<0.05). Conclusion: Various factors including age, male gender and physical problems contribute to suicide and deaths associated with it; therefore, the implementation of educational and counseling programs for these individuals, especially in adolescence and youth, and people with physical and psychological problems is essential.
Zahra Maleki; Mohammad Ghorbani; Haleh Ghaem; Farid Zand
Abstract
Objectives: Many risk factors are associated with death in and discharge from the Intensive Care Unit (ICU). This study aimed to evaluate the risk factors associated with death and discharge among ICU patients. Methods: This historical cohort study was conducted on 712 patients admitted to the ICU of ...
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Objectives: Many risk factors are associated with death in and discharge from the Intensive Care Unit (ICU). This study aimed to evaluate the risk factors associated with death and discharge among ICU patients. Methods: This historical cohort study was conducted on 712 patients admitted to the ICU of Namazi hospital in Shiraz between 2013 and 2015. The competing risks regression model was suitable for assessing the risk factors associated with death and discharge in ICU. Data analysis was performed using STATA 13.0 and R software. Results: The mean age of the participants was 53.3±20.7 years. Out of 712 patients, 436 (61.2%) were male and 121 (17.8%) died. In the competing risks model, death was considered as the event of interest, and age and total days of Central Venous Catheter (CVC) and mechanical ventilation use increased the risk of death (all Sub-distribution Hazard Ratios (SHRs) > 1). Conclusion: The findings indicated that increase in age, use of CVC and mechanical ventilation, and female sex caused an increase in death in ICU. However, the risk of death decreased or the chance of discharge increased when the patients were admitted due to surgical reasons.
