Quality of life in children with asthma compared to healthy children: a case-control study.

OBJECTIVE: Asthma is a chronic condition characterized by episodic wheezing, cough, and shortness of breath resulting from airway hyperresponsiveness and inflammation. Over 300 million people are affected worldwide, and its prevalence is increasing by 50% every decade. Assessing the quality of life in children with asthma is fundamental, as consistently poor health-related quality of life is associated with poorly controlled asthma. This study is aimed to evaluate and compare factors associated with HRQOL between healthy controls and children with asthma. METHODS: In the current case-control study, 50 children aged 8-12 years with asthma (cases) enrolled at outpatient hospital clinics by a trained pediatric allergist/immunologist (A.P.) and matched with 50 healthy controls by age and sex. All enrolled subjects were interviewed utilizing the PedsQL questionnaire to assess health-related quality of life; also, patient demographics, including age, sex, and family income status, were obtained from a questionnaire. RESULTS: A total of 100 children comprising 62 males and 38 females with a mean age of 9.63 ± 1.38 years, participated in this study. The average score of children with asthma was 81.63 ± 9.38, and the average score for healthy participants was 89.58 ± 7.91. We found that asthma was associated with a significant drop in health-related quality of life in this sample. CONCLUSIONS: The results indicated that the PedsQL score and its subscales, except social functioning, were significantly higher in children with asthma compared to healthy ones. Also, SABA use, nocturnal symptoms, and asthma severity are negatively related to the health-related quality of life.

Exploring the relationship between asthma, its severity and anxiety symptoms in pediatric patients: a case-control study.

BACKGROUND: Asthma is a global health concern, especially among children, and is associated with various underlying mechanisms. Childhood exposure to early life stress and anxiety can potentially exacerbate asthma symptoms and complicate its management. While some studies have suggested the benefits of psychological therapies as adjuncts to medication in asthma management, evidence remains inconsistent, emphasizing the need for rigorous evaluation. METHOD: This case-control study involved 120 children aged 5-15, with 60 children having asthma and 60 healthy controls. Asthma severity was assessed based on EPR3 guidelines, while anxiety symptoms were measured using the Spence Children's Anxiety Scale (SCAS). Demographic data and asthma-related information were collected via questionnaires. Statistical analyses were conducted to explore the relationship between asthma and anxiety. RESULTS: Children with asthma exhibited significantly higher anxiety symptoms compared to those without asthma (p < 0.001). Subdomain analysis revealed elevated scores in separation anxiety (SA; p = 0.025), social phobia (SP; p < 0.001), agoraphobia (p = 0.004), and fears of physical injury (p < 0.001) in children with asthma. Furthermore, increased need for SABA, frequency of nocturnal symptoms, and asthma severity were associated with higher anxiety levels in pediatric asthma patients. CONCLUSIONS: This study highlights a significant association between asthma and heightened anxiety symptoms in children, particularly in domains, such as SA, SP, agoraphobia, and fears related to physical injury. However, limitations include reliance on self-evaluation questionnaires and the observational nature of the study, emphasizing the need for cautious interpretation.

Post-chemo-radiotherapy response and pseudo-progression evaluation on glioma cell types by multi-parametric magnetic resonance imaging: a prospective study.

BACKGROUND: We focused on Differentiated pseudoprogression (PPN) of progression (PN) and the response to radiotherapy (RT) or chemoradiotherapy (CRT) using diffusion and metabolic imaging. METHODS: Seventy-five patients with glioma were included in this prospective study (approved by the Iranian Registry of Clinical Trials (IRCT) (IRCT20230904059352N1) in September 2023). Contrast-enhanced lesion volume (CELV), non-enhanced lesion volume (NELV), necrotic tumor volume (NTV), and quantitative values ​​of apparent diffusion coefficient (ADC) and magnetic resonance spectroscopy (Cho/Cr, Cho/NAA and NAA/Cr) were calculated by a neuroradiologist using a semi-automatic method. All patients were followed at one and six months after CRT. RESULTS: The results of the study showed statistically significant changes before and six months after RT-CRT for M-CELV in all glioma types (𝑝 < 0.05). In glioma cell types, the changes in M-ADC, M-Cho/Cr, and Cho/NAA indices for PN were incremental and greater for PPN patients. M-NAA/Cr ratio decreased after six months which was significant only on PN for GBM, and Epn (𝑝 < 0.05). A significant difference was observed between diffusion indices, metabolic ratios, and CELV changes after six months in all types (𝑝 < 0.05). None of the patients were suspected PPN one month after treatment. The DWI/ADC indices had higher sensitivity and specificity (98.25% and 96.57%, respectively). CONCLUSION: The results of the present study showed that ADC values and Cho/Cr and Cho/NAA ratios can be used to differentiate between patients with PPN and PN, although ADC is more sensitive and specific.

Brain diffusion MRI biomarkers after oncology treatments.

In addition to providing a measurement of the tumor's size and dimensions, magnetic resonance imaging (MRI) provides excellent noninvasive radiographic detection of tumor location. The MRI technique is an important modality that has been shown to be useful in the prognosis, diagnosis, treatment planning, and evaluation of response and recurrence in solid cancers. Diffusion-weighted imaging (DWI) is an imaging technique that quantifies water mobility. This imaging approach is good for identifying sub-voxel microstructure of tissues, correlates with tumor cellularity, and has been proven to be valuable in the early assessment of cytotoxic treatment for a variety of malignancies. Diffusion tensor imaging (DTI) is an MRI method that assesses the preferred amount of water transport inside tissues. This enables precise measurements of water diffusion, which changes according to the direction of white matter fibers, their density, and myelination. This measurement corresponds to some related variables: fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD), and others. DTI biomarkers can detect subtle changes in white matter microstructure and integrity following radiation therapy (RT) or chemoradiotherapy, which may have implications for cognitive function and quality of life. In our study, these indices were evaluated after brain chemoradiotherapy.

Family clustering of SARS-CoV-2 in Qazvin, Northwest of Iran.

Background: Human infection affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been recognized as a global health concern. We report the epidemiological and clinical characteristics of patients with a familial cluster of SARS-CoV-2 from Qazvin province (located in the northwest of Iran). Methods: In this cross-sectional study, we enrolled 332 hospitalized patients that were confirmed SARS-CoV-2 diseases with laboratory-based (PT-PCR) test in Qazvin province, Iran. Having family infection transmission and subsequently, family clustering of SARS-COV-2 disease was assessed with the Generalized Estimating Equation model in patients. Results: Crude odds ratio estimates of creating family clustering of SARS-CoV-2 infection was 0.47 times [95% CI: 0.23, 0.98, p=0.045] less for female compared to the males; 2.26 [95% CI: 1.11, 4.58, p=0.024] and 2.69 [95% CI: 1.47, 4.93, p=0.001] for SARS-CoV-2 patients that had digestive and muscle pain in comparison with those did not this mentioned symptoms, respectively. 1.52 [95% CI: 1.05, 2.23, p=0.024] for patients with a longer hospitalization compared with patients that had shorter duration of hospitalization and adjusted odds ratio estimates were 2.13 [95% CI: 1.12, 4.03, p=0.020] for patients who receive public health services in comparison those did not receive public health services. Conclusion: Our findings confirm the person-to-person transmission of this novel coronavirus in family settings and hospitals, and the reports of infected travelers in other geographical regions. Major gaps in our knowledge about the potential factors in creating family clustering of SARS-CoV-2 infection, epidemiology, duration of human transmission and etc. need fulfillment by future studies.

Estimating the Size of Hidden Groups.

NSU studies have been applied in different countries. For example, this technique has been used in the United States to estimate the number of women who had been raped in the last year.

The Effect of Solution-Oriented Counseling on Coping Strategies in Mental Health Issues in Women with Gestational Diabetes.

This study aimed to investigate the effectiveness of solution-oriented intervention in patients with gestational diabetes, stress and anxiety on using coping strategies. This study was a randomized clinical trial with a control group. The population consisted of 56 diabetic women under treatment with insulin, who obtained higher score in one of the psychological disorders using DASS-21 (Depression, anxiety, stress scale). The participants were randomly assigned in two interventional (n = 28) and control (n = 28) groups after signing the written informed consent forms. The solution-oriented interventional program was conducted in six 60-min sessions for 6 weeks. Immediately after the final session and 6-8 weeks after the first session of the intervention, both groups completed coping inventory for stressful situations. The analytical statistic of t-test, chi-square, and variance analysis with repeated measurements using SPSS were used to analyze the data. solution-oriented counseling increased the problem-solving coping strategy in the intervention group (P = 0.001); the scores obtained by the subjects in the interventional group after adjusting the score before the intervention increased 2.68 units immediately after the intervention, which was not statistically significant (p-value = 0.44). However, it increased 11.5 scores six weeks after the intervention, which was statistically significant (P = 0.00). But, emotional and avoidance coping strategies were not significantly different between the two groups. This technique can be easily trained to all clients, and since it is focused on finding various solutions for psychological problems by clients, it can be used to reduce stress and anxiety in other chronic diseases as well.IRCT code: The code of this clinical trial study is IRCT20200202046339N1.

The real-time reproduction number, impact of interventions and prediction of the epidemic size of COVID-19 in the center of Iran.

BACKGROUND: The monitoring of reproduction number over time provides feedback on the effectiveness of interventions and on the need to intensify control efforts. Hence, we aimed to compute basic (R0) and real-time (Rt) reproduction number and predict the trend and the size of the coronavirus disease 2019 (COVID-19) outbreak in the center of Iran. MATERIALS AND METHODS: We used the 887 confirmed cases of COVID-19 from February 20, 2020, to April 17, 2020 in the center of Iran. We considered three scenarios for serial intervals (SIs) with gamma distribution. Rt was calculated by the sequential Bayesian and time-dependent methods. Based on a branching process using the Poisson distributed number of new cases per day, the daily incidence and cumulative incidence for the next 30 days were predicted. The analysis was applied in R packages 3.6.3 and STATA 12.0. RESULTS: The model shows that the Rt of COVID-19 has been decreasing since the onset of the epidemic. According to three scenarios based on different distributions of SIs in the past 58 days from the epidemic, Rt has been 1.03 (0.94, 1.14), 1.05 (0.96, 1.15), and 1.08 (0.98, 1.18) and the cumulative incidence cases will be 360 (180, 603), 388 (238, 573), and 444 (249, 707) for the next 30 days, respectively. CONCLUSION: Based on the real-time data extracted from the center of Iran, Rt has been decreasing substantially since the beginning of the epidemic, and it is expected to remain almost constant or continue to decline slightly in the next 30 days, which is consequence of the schools and universities shutting down, reduction of working hours, mass screening, and social distancing.

Increased incidence of the type 1 diabetes and diabetic ketoacidosis severity in children during COVID-19 pandemic.

AIM: The effect of COVID-19 on the occurrence of type 1 diabetes and ketoacidosis in children and adolescent. METHODS: In this descriptive-analytical cross-sectional study, the records of all children and adolescents hospitalized due to type1 diabetes for two years ago and during the COVID-19 pandemic and its peaks were investigated (January 2018-2022). Also, the desired variables including the frequency of hospitalized patients (known and new cases), the frequency of DKA, the severity of DKA, the duration of discharge from DKA, age, body mass index, duration of hospitalization, clinical symptoms including cerebral edema, laboratory data and the total daily dose insulin required at the time of discharge were compared and statistically analyzed. RESULTS: Out of the 334 hospitalized T1DM patients, the rate of new T1DM patients was significantly higher (P = 0.006) during the pandemic. Clearly, there were more cases of DKA during the pandemic (P = 0.007). The higher severity of DKA (0.026) and the need for higher doses of insulin (P = 0.005) were also observed. The hospitalization rate was higher during the corona peaks, particularly peaks 1 and 4, compared to the non-peak days of COVID-19. CONCLUSION: The increase in the incidence of diabetes (new cases) in the pandemic can suggest the role of the COVID-19 virus as an igniter. Also, as a trigger for the higher incidence of DKA with higher severities, which is probably caused by more damage to the pancreatic beta cells and requires higher doses of insulin.

HRCTCov19-a high-resolution chest CT scan image dataset for COVID-19 diagnosis and differentiation.

INTRODUCTION: Computed tomography (CT) was a widely used diagnostic technique for COVID-19 during the pandemic. High-Resolution Computed Tomography (HRCT), is a type of computed tomography that enhances image resolution through the utilization of advanced methods. Due to privacy concerns, publicly available COVID-19 CT image datasets are incredibly tough to come by, leading to it being challenging to research and create AI-powered COVID-19 diagnostic algorithms based on CT images. DATA DESCRIPTION: To address this issue, we created HRCTCov19, a new COVID-19 high-resolution chest CT scan image collection that includes not only COVID-19 cases of Ground Glass Opacity (GGO), Crazy Paving, and Air Space Consolidation but also CT images of cases with negative COVID-19. The HRCTCov19 dataset, which includes slice-level and patient-level labeling, has the potential to assist in COVID-19 research, in particular for diagnosis and a distinction using AI algorithms, machine learning, and deep learning methods. This dataset, which can be accessed through the web at http://databiox.com , includes 181,106 chest HRCT images from 395 patients labeled as GGO, Crazy Paving, Air Space Consolidation, and Negative.

The Clinical Role of CXCR4-Targeted PET on Lymphoproliferative Disorders: A Systematic Review.

Background/Objectives: We conducted a comprehensive investigation to explore the pathological expression of the CXCR4 receptor in lymphoproliferative disorders (LPDs) using [68Ga]Ga-Pentixafor PET/CT or PET/MRI technology. The PICO question was as follows: What is the diagnostic role (outcome) of [68Ga]Ga-Pentixafor PET (intervention) in patients with LPDs (problem/population)? Methods: The study was written based on the reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines, and it was registered on the prospective register of systematic reviews (PROSPERO) website (CRD42024506866). A comprehensive computer literature search of Scopus, MEDLINE, Scholar, and Embase databases was conducted, including articles indexed up to February 2024. To the methodological evaluation of the studies used the quality assessment of diagnosis accuracy studies-2 (QUADAS-2) tool. Results: Of the 8380 records discovered, 23 were suitable for systematic review. Fifteen studies (on 571 LPD patients) focused on diagnosis and staging, and eight trials (194 LPD patients) assessed treatment response. Conclusions: The main conclusions that can be inferred from the published studies are as follows: (a) [68Ga]Ga-Pentixafor PET may have excellent diagnostic performance in the study of several LPDs; (b) [68Ga]Ga-Pentixafor PET may be superior to [18F]FDG or complementary in some LPDs variants and settings; (c) multiple myeloma seems to have a high uptake of [68Ga]Ga-Pentixafor. Overall, this technique is probably suitable for imaging, staging, and follow-up on patients with LPD. Due to limited data, further studies are warranted to confirm the promising role of [68Ga]Ga-Pantixafor in this context.

Validity and Reliability of the Human Immunodeficiency Virus-Related Stigma Questionnaire in Persian.

Background: It was aimed to adapt a 12-item questionnaire into Persian among people living with human immunodeficiency virus (PLHIV) in Markazi province. Material and Methods: Content validity was evaluated based on the opinions of the relevant experts, and by calculating the scale-level content validity index (S-CVI) and the item-level content validity index (I-CVI). Reliability was assessed via test-retest, intraclass correlation coefficient (ICC), and Cronbach's alpha. Results: The obtained scores on clarity and relevancy (I-CVI) ranged from 0.9 to 1. The S-CVI also had an acceptable validity of 0.99. The Cronbach's alpha index of the whole questionnaire was 0.84 and ranged from 0.69 to 0.82 for subscales. The ICC in test-retest for all questionnaires was 0.88 and for subscales ranged from 0.77 to 0.88. Conclusion: The Persian version of the 12-item human immunodeficiency virus-related stigma questionnaire was found to be, in addition to being short and comprehensive, acceptable reliability and high validity to use in order to determine the stigma related to Persian-speaker PLHIV.

Diagnostic Accuracy of PET with Different Radiotracers versus Bone Scintigraphy for Detecting Bone Metastases of Breast Cancer: A Systematic Review and a Meta-Analysis.

Due to the importance of correct and timely diagnosis of bone metastases in advanced breast cancer (BrC), we performed a meta-analysis evaluating the diagnostic accuracy of [18F]FDG, or Na[18F]F PET, PET(/CT), and (/MRI) versus [99mTc]Tc-diphosphonates bone scintigraphy (BS). The PubMed, Embase, Scopus, and Scholar electronic databases were searched. The results of the selected studies were analyzed using pooled sensitivity and specificity, diagnostic odds ratio (DOR), positive-negative likelihood ratio (LR+-LR-), and summary receiver-operating characteristic (SROC) curves. Eleven studies including 753 BrC patients were included in the meta-analysis. The patient-based pooled values of sensitivity, specificity, and area under the SROC curve (AUC) for BS (with 95% confidence interval values) were 90% (86-93), 91% (87-94), and 0.93, respectively. These indices for [18F]FDG PET(/CT) were 92% (88-95), 99% (96-100), and 0.99, respectively, and for Na[18F]F PET(/CT) were 96% (90-99), 81% (72-88), and 0.99, respectively. BS has good diagnostic performance in detecting BrC bone metastases. However, due to the higher and balanced sensitivity and specificity of [18F]FDG PET(/CT) compared to BS and Na[18F]F PET(/CT), and its advantage in evaluating extra-skeletal lesions, [18F]FDG PET(/CT) should be the preferred multimodal imaging method for evaluating bone metastases of BrC, if available.

CHMMOTv1 - cardiac and hepatic multi-echo (T2*) MRI images and clinical dataset for Iron overload on thalassemia patients.

INTRODUCTION: Regarding deep learning networks in medical sciences for improving diagnosis and treatment purposes and the existence of minimal resources for them, we decided to provide a set of magnetic resonance images of the cardiac and hepatic organs. DATABASE DESCRIPTION: The dataset included 124 patients (67 women and 57 men) with thalassemia (THM), the age range of (5-52) years. Patients were divided into two groups: with follow-up (1-5 times) at time intervals of about (5-6) months and without follow-up. T2* and, R2* values, the results of the Cardiac and Hepatic overload report (normal, mild, moderate, severe), and laboratory tests including Ferritin, Bilirubin (D, and T), AST, ALT, and ALP levels were provided as an Excel file. Also, the details of the patients' Echocardiogram data have been made available. This dataset CHMMOTv1) has been published in Mendeley Dataverse and also is accessible through the web at: http://databiox.com .

Investigating the effect of mindfulness counselling on sexual functioning of women with premenstrual syndrome.

Mindfulness exercises can improve a wide range of the psychological and interpersonal consequences of premenstrual syndrome. Nevertheless, there is sparse information about the effect of mindfulness counselling on sexual dysfunction in women with this condition. This study aimed to determine the effect of mindfulness counselling on the sexual functioning of women with premenstrual syndrome. In this controlled randomized study, 112 women diagnosed with premenstrual syndrome referred to selected urban healthcare centers in Isfahan, Iran, were randomly allocated to two groups (intervention and control), each with 56 participants. The intervention group underwent mindfulness counselling in eight 60-minute sessions online via Google Meet. The control group did not receive any kind of intervention. The principal measure was score on the Rosen Female Sexual Functioning Index (FSFI) before, immediately, and one month after the intervention. The data were analyzed by SPSS 23, through descriptive and analytical statistical tests (chi-square, Mann-Whitney, independent t-test, ANOVA, and repeated measure) with a significance level of 0.05. There was no statistically significant difference in the mean FSFI score (or the subscores) between the intervention and control groups (p greater than 0.05) at baseline. In the intervention group, there were significant increases (relative to both baseline and in comparison with the control group) in the mean subscores for sexual desire (P < 0.0001), orgasm (P = 0.01), satisfaction (P = 0.0001), sexual pain (P = 0.003), and general sexual functioning (P < 0.0001) immediately after and one month after the intervention, but the score for sexual arousal was significantly greater only at the one-month evaluation (P < 0.0001) and there were no differences in the scores for vaginal lubrication. On the other hand. Mindfulness counselling was effective in improving the sexual functioning of women suffering from premenstrual syndrome, and should be used for this purpose in healthcare centers.

Renal Function in Patients with Thalassemia Major Receiving Exjade® Dispersible Tablets and a New Film-coated Tablet Formulation of Deferasirox (Nanojade®).

Background: In patients with ß-thalassemia major (TM), one of the long-term complications of regular blood transfusion is renal dysfunction. The purpose of the current study was to evaluate the renal function in TM patients receiving Exjade® dispersible tablets and a new film-coated tablet formulation of deferasirox (Nanojade®). Materials and Methods: In this descriptive cross-sectional study, a total of 80 TM patients aged 11-48-year-old entered the study. Patients received 20-30 mg/kg/d (single dose) Exjade® (Exjade group, n = 40) and Nanojade® (Nanojade group, n = 40) orally. To evaluated renal function, serum creatinine (SCr), estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), 24-h urine protein (UPro), UCa/UCr, spot UPro/UCr ratio, and serum ferritin were calculated at baseline and every 3 months to 9 months. Results: There was no significant difference in SCr, BUN, eGFR, 24-h UPro, UPro/UCr ratio, UCa/UCr ratio, and serum ferritin between groups at baseline and end of study (P baseline> 0.05, P end of study> 0.05). There was no significant difference in proteinuria between groups at baseline and end of study (P baseline> 0.05, P end of study> 0.05). Conclusions: The proportion of SCr, BUN, eGFR, 24-h UPro, UPro/UCr ratio, and UCa/UCr ratio was not significantly different in TM patients treated with Nanojade® compared to patients' received Exjade®. Nanojade® had similar effects to Exjade®, and therefore, the use of Nanojade® is safe in TM patients and does not seem to be associated with increased renal failure, proteinuria, and hypercalciuria.

HIV-Related Stigma Among People Living With HIV in Iran: A Cross-Sectional Study.

ABSTRACT: HIV is perceived as a taboo topic in Iranian culture. This study examined HIV-related stigma among Iranian people living with HIV (PLWH). This cross-sectional study was conducted among 123 PLWH in 2019. HIV-related stigma was assessed by a standardized questionnaire adapted into Persian for this study. The range of the stigma scores for each of the subscales (personalized stigma, negative self-image, disclosure concerns, and concerns about public attitudes) was 3-12, whereas the range for the total stigma score was 12-48. The highest and lowest mean scores were observed in concerns about public attitudes (10.07) and negative self-image (7.39). The total mean stigma score was 37.03, indicating a high level of stigma. The most important factors determining HIV-related stigma were socioeconomic status, transmission method, duration of disease, and education level. This study suggests the need for more effective interventions to reduce HIV-related stigma among Iranian PLWH.

Prevalence of sexual dysfunction in men with multiple sclerosis: a systematic review and meta-analysis.

BACKGROUND: Symptoms in multiple sclerosis (MS) can lead to different types and ranges of sexual dysfunction in MS patients. Studies in different parts of the world have reported a high range of sexual dysfunction in men with MS. This study aimed to estimate pooled prevalence of sexual dysfunction in men with MS. METHODS: The authors searched Web of Science, PubMed, Scopus, Embase, Magiran, SID, and Iran Medical Papers Database using the keywords "multiple sclerosis", "sexual dysfunctions", "men", "prevalence", and their synonyms systematically. Meta-analysis was performed using the random effects model with inverse variance-weighted method to estimate the overall prevalence of sexual dysfunction in men with MS. The protocol for this meta-analysis is available in PROSPERO (ID CRD42020199005). RESULTS: A total of 351 documents were identified, and 20 articles published from 1996 to 2019 were analyzed. The articles used sample sizes from 9 to 101 individuals. However, two studies conducted online used 388 and 1568 samples. Prevalence of sexual dysfunction in all studies was reported from 31 to 92%, and the pooled prevalence of sexual dysfunction in men with MS in all studies was 62.9% with a 95% confidence interval 53 to 72.7% (heterogeneity: I2 = 96.3%, Q-statistic = 12.48, P value < 0.001). According to the results of Egger's test, there was publication bias in the current study (ß = 4.55, Se = 1.38, P value = 0.004). CONCLUSION: Sexual dysfunction is highly prevalent in men with MS. Diagnosing sexual dysfunction in MS patients in clinics by specialists have to be considered a necessity.

Clinical Characteristics and Reproduction Number of Coronavirus Disease (COVID-19) Cases in Markazi Province in Iran.

BACKGROUND: The first case of Coronavirus Disease (COVID-19) was reported in Iran on February 19, 2020. This study aimed to assess the characteristics and reproduction number (R) of COVID-19 in Markazi province in Iran. METHODS: This is a cross-sectional study. Confirmed cases (N=2430) in the regions covered by Arak University of Medical Sciences from Feb 20 to Aug 26, 2020 were enrolled in the study. The included variables were clinical and demographic characteristics of COVID-19 patients. The case fatality rate (CFR), incidence rates, and R were estimated based on the daily reported data. For estimating R, generation time was assumed on multi scenarios. R was estimated by R0-package. Moreover, Chi square test was applied. All the analyses were performed in STATA, Excel, ArcMap and R. A p-value less than 0.05 was considered as statistically significant. CONCLUSION: As R is slightly high, the risk of epidemic has reduced gradually. However, observing social distance and related guidelines are still recommended.

Age-standardized mortality rate and predictors of mortality among COVID-19 patients in Iran.

BACKGROUND: To have a thorough understanding of epidemic surveillance, it is essential to broaden our knowledge of death tolls worldwide. This study aimed to determine the age-standardized mortality rate (ASMR) and predictors of mortality among coronavirus disease 2019 (COVID-19) patients. MATERIALS AND METHODS: In this cross-sectional design, all COVID-19 patients with a positive polymerase chain reaction test in the population covered by Arak University of Medical Sciences (AUMS) were entered to the study. Data collection was conducted by phone interview. The study variables comprised age, sex, coronary heart diseases, diabetes, and some symptoms at admission. The adjusted odds ratio (OR) and 95% confidence intervals (CIs) were obtained by logistic regression. The direct method was applied to calculate ASMR (per 100,000) of COVID-19. The analysis was applied by STATA software 12.0. RESULTS: A total of 208 cases of COVID-19 (out of 3050 total infected cases) were dead and 2500 cases were recovered. The mean age of dead patients was 70 years. The COVID-19 fatality rate in the population equaled 6.8%; in those patients who were 70 years old or more, however, the case fatality rate was 16.4%. The ASMR of COVID-19 was 12.9 (CI 95%: 11.2, 14.8). The odds of COVID-19-related death in the age over 60 were 10.87 (CI 95%: 6.30, 18.75) times than lower 45 years old. Moreover, it was observed that COVID-19 significantly increased the odds of COVID-19-related death in diabetes patients (OR = 1.45, CI 95%: 1.02, 2.06, P = 0.036). CONCLUSION: The ASMR of COVID-19 was relatively higher in males than females. In general, the COVID-19 fatality rate was relatively high. We found that older age and diabetes can have impact on the death of COVID-19, but the headache was found to have a negative association with the COVID-19-related death.