Effectiveness of different vaccine platforms in reducing mortality and length of ICU stay in severe and critical cases of COVID-19 in the Omicron variant era: A national cohort study in Iran.

Various severe acute respiratory syndrome coronavirus 2 vaccines with different platforms have been administered worldwide; however, their effectiveness in critical cases of COVID-19 has remained a concern. In this national cohort study, 24 016 intensive care unit (ICU) coronavirus disease-2019 (COVID-19) admissions were included from January to April 2022. The mortality and length of ICU stay were compared between the vaccinated and unvaccinated patients. A total of 9428 (39.25%) patients were unvaccinated, and 14 588 (60.75%) patients had received at least one dose of the vaccine. Compared with the unvaccinated, the first, second, and third doses of vaccine resulted in 8%, 20%, and 33% lower risk of ICU mortality in the adjusted model, with risk ratio (RR): 0.92, 95% confidence interval (CI): 0.84-1.001, RR: 0.80, 95% CI: 0.77-0.83, and RR: 0.67, 95% CI: 0.64-0.71, respectively. The mean survival time was significantly shorter in the unvaccinated versus the fully vaccinated patients (hazard ratio [HR]: 0.84, 95% CI: 0.80-0.88); p < 0.001). All vaccine platforms successfully decreased the hazard of ICU death compared with the unvaccinated group. The duration of ICU stay was significantly shorter in the fully vaccinated than in unvaccinated group (MD, -0.62, 95% CI: -0.82 to -0.42; p < 0.001). Since COVID-19 vaccination in all doses and platforms has been able to reduce the risk of mortality and length of ICU-stay, universal vaccination is recommended based on vaccine availability.

National and sub-national prevalence, trend, and burden of mental disorders and substance abuse in Iran: 1990 - 2013, study protocol.

BACKGROUND: The measurement of population-based dimensions of mental disorders and their effects on the population health is one of the major public health concerns.  There is some evidence on the trend and point estimations of mental disease and substance abuse for many specific groups of Iranian population but there is a progressive requirement to documents on their exposure distribution at sub-national level, information about their trends, and their effects on the population health.  METHODS: The present protocol is aimed to provide the standards of data collection and methodology processes for estimating the trends of selected mental disorders and their attributed burden at national and sub-national levels. For nine categories of mental disorders, we will estimate 1990 to 2013 trends of prevalence, Years of Life Lost due to premature mortality (YLLs), and Years Lived with Disability (YLDs) and Disability-Adjusted Life Years DALYs by sex, age group, and province. We will also quantify the uncertainty intervals for the estimates of interest. CONCLUSION: The study of National and sub-national prevalence, trend, and burden of mental disorders and substance abuse in Iran provides valuable convincing evidences for policy makers and other stakeholders for more evidence-based priority setting, resource allocation, interventions, service providing, and evaluation at both national and sub-national levels. The results also could be used for future complementary global, regional, national, and sub national studies.