Elevated interleukin (IL)-6 as a predictor of disease severity among Covid-19 patients: a prospective cohort study.

BACKGROUND: accompanied to the spreading of coronavirus disease 2019 (Covid-19) in the world, identifying factors related to the severity of the disease is one of the interests of physician and medical researchers. We hypothesized that interleukin 6 serum level is associated with severe outcome. METHODS: In this longitudinal prospective cohort study we enrolled 208 confirmed COVID-19 patients who were admitted to the Tohid Hospital (Sanandaj, Iran). Patients were classified into two groups based on IL-6 value in the first day of admission, elevated (n = 107) or not elevated/normal (n = 101), and followed until the occurrence of final outcome (death or discharge from the hospital). Data were analyzed using univariate methods, Chi-squared and independent two sample T test. The relationship between the independent variables and our interesting outcomes were investigated by multiple linear and penalized logistic regression modeling. RESULTS: A total of 208 patients, 51% female and mean age 53.6 ± 16.3 years, including 107 elevated and 101 non-elevated IL-6 patients, were followed. No significant difference was observed between the two groups in demographic and clinical characteristics. Although not significant, logistic regression results showed that the chance of death occurrence among patients with elevated IL-6 are 3.91 times higher. According to the multiple linear regression modeling, elevated IL-6 significantly increased the duration of hospital stay (P = 0.02). Frequency of ICU admission (P = 0.04) and mean of ICU stay (P = 0.8) are also higher in elevated IL-6 group. CONCLUSION: This study revealed that elevated IL-6 is significantly related to prolongation of hospital stay in Covid-19 patients. Although not significant, the occurrence of death among patients who had increased IL-6 in the time of admission was higher than patients with normal or lower serum levels of IL-6.

Epidemiologic Parameters for COVID-19: A Systematic Review and Meta-Analysis.

Background: The World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak to be a public health emergency and international concern and recognized it as a pandemic. This study aimed to estimate the epidemiologic parameters of the COVID-19 pandemic for clinical and epidemiological help. Methods: In this systematic review and meta-analysis study, 4 electronic databases, including Web of Science, PubMed, Scopus, and Google Scholar were searched for the literature published from early December 2019 up to 23 March 2020. After screening, we selected 76 articles based on epidemiological parameters, including basic reproduction number, serial interval, incubation period, doubling time, growth rate, case-fatality rate, and the onset of symptom to hospitalization as eligibility criteria. For the estimation of overall pooled epidemiologic parameters, fixed and random effect models with 95% CI were used based on the value of between-study heterogeneity (I2). Results: A total of 76 observational studies were included in the analysis. The pooled estimate for R0 was 2.99 (95% CI, 2.71-3.27) for COVID-19. The overall R0 was 3.23, 1.19, 3.6, and 2.35 for China, Singapore, Iran, and Japan, respectively. The overall serial interval, doubling time, and incubation period were 4.45 (95% CI, 4.03-4.87), 4.14 (95% CI, 2.67-5.62), and 4.24 (95% CI, 3.03-5.44) days for COVID-19. In addition, the overall estimation for the growth rate and the case fatality rate for COVID-19 was 0.38% and 3.29%, respectively. Conclusion: The epidemiological characteristics of COVID-19 as an emerging disease may be revealed by computing the pooled estimate of the epidemiological parameters, opening the door for health policymakers to consider additional control measures.

A screening strategy for identifying the dominant variant of SARS-COV-2 in the fifth peak of Kurdistan- Iran population using HRM and Probe-based RT-PCR assay.

By the emergence of SARS CoV-2 variants, many studies were developed to deal with it. The high transmissibility and mortality rate of some variants, in particular developing countries have caused the operation of simple diagnostic tests for genomic surveillance. In this study, we developed two assays of High Resolution Melting (HRM) and Probe-based RT-PCR as simple and inexpensive methods to identify the variants. We screened the mutations of del69-70, E484K, E484Q, D614G, L452R, and T478K in 100 cases from SARS-COV-2 positive patients in Kurdistan- Iran population. In general, the result of the two methods overlapped each other, nevertheless, we suggested HRM results be confirmed with a standard assay (Whole-Genome Sequencing). This work indicated that HRM as the rapid and inexpensive method could identify and categorize the variants of SARS CoV-2 and reduce the costs for carrying out sequencing.

The prevalence of depression, anxiety, stress, and related factors among COVID-19 patients in Kurdistan Province, Iran (2020).

The emergence of mental health problems during a pandemic is a major concern of healthcare systems. This cross-sectional, analytical study was performed on 1072 patients with COVID-19 disease without pre-existing mental disorders in Kurdistan Province in 2020 to obtain the frequency of depression, anxiety, and stress using a valid, standard electronic depression, anxiety, and stress scale-21 questionnaire. Data analyses were conducted in SPSS Version 23 using logistic regression modeling. The mean age of the participants was 31.91 ± 10.28 years and 543 subjects (50.7%) were female. The prevalence of stress, anxiety, and depression was 51.7% (95% confidence interval [CI]: 48.7-54.7), 64.3% (95% CI: 61.3-67.1), 61.4% (95% CI: 58.4-64.2), respectively. The prevalence of depression, anxiety, and stress was higher in the employees and retirees compared to the unemployed and homemakers (P < 0.05). Furthermore, the frequency of stress (odds ratio [OR]: 1.36, P = 0.01) and depression (OR: 1.3, P = 0.04) in patients who undertook severe protection measures was significantly higher than those who used lower. The patients with COVID-19 experienced high levels of depression, anxiety, and stress. Therefore, it is essential to provide psychological and psychiatric services to these patients electronically or face to face at health centers.