A multicenter retrospective study of clinical features, laboratory characteristics, and outcomes of 166 hospitalized children with coronavirus disease 2019 (COVID-19): A preliminary report from Iranian Network for Research in Viral Diseases (INRVD).

BACKGROUND: The objectives of this study were to analyze the clinical features and laboratory profiles and risk factors associated with critical illness of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: One hundred and sixty-six coronavirus disease 2019 (COVID-19) Iranian pediatric patients were recruited through a collaborative research network between March and May 2020. Demographics, clinical, laboratory, and radiological results were obtained from patient files. RESULTS: Of 166 patients, 102 (61%) and 64 (39%) were males and females, respectively. Ninety-six (57.8%) and 70 (42.2%), had moderate and severe conditions, respectively. Thirty (18%) of patients died. The common symptoms were fever (73%), cough (54%), and shortness of breath, headache decrease in neutrophil and platelet counts; increase values in lactate dehydrogenase, decrease in the blood pH and HCO3 were significantly associated with the disease severity. 54% and 56% of patients showed abnormal radiographic appearance in Chest X-ray and in chest computed tomography scan, respectively. Sixty-one (36.7%) of patients were referred to intensive care unit (ICU). The coexistence of comorbidity was the main factor associated with ICU admission, shock, arrhythmia, acute kidney injury, acute respiratory distress syndrome, acute cardiac injury, and death. CONCLUSIONS: We describe a higher than previously recognized rate of COVID-19 mortality in Iranian pediatric patients. Epidemiological factors, such as the relatively high case fatality rate in the country and the presence of underlying diseases were the main factors for the high death rate.

Crimean-Congo hemorrhagic fever and its relationship with climate factors in southeast Iran: a 13-year experience.

INTRODUCTION: Crimean-Congo hemorrhagic fever (CCHF) is endemic in southeast Iran. In this study we present the epidemiological features of CCHF and its relationship with climate factors in over a 13-year span. METHODOLOGY: Surveillance system data of CCHF from 2000 to 2012 were obtained from the Province Health Centre of Zahedan University of Medical Sciences in southeast Iran. The climate data were obtained from the climate organization. The seasonal auto-regression integrated moving average (SARIMA) model was used for time series analysis to produce a model as applicable as possible in predicting the variations in the occurrence of the disease. RESULTS: Between 2000 and 2012, 647 confirmed CCHF cases were reported from Sistan-va-Baluchistan province. The total case fatality rate was about 10.0%. Climate variables including mean temperature (°C), accumulated rainfall (mm), and maximum relative humidity (%) were significantly correlated with monthly incidence of CCHF (p <0.05). There was no clear pattern of decline in the reported number of cases within the study's time span. The first spike in the number of CCHF cases in Iran occurred after the first surge of the disease in Pakistan. CONCLUSIONS: This study shows the potential of climate indicators as predictive factors in modeling the occurrence of CCHF, even though it has to be appreciated whether there is any need for a practically applicable model. There are also other factors, such as entomological indicators and virological finding that must be considered.