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Background and Aim: With the outbreak of the COVID-19 pandemic, the performance of hospitals were affected, and changes were made in the utilization of hospital services. Analyzing hospital performance data during the COVID-19 pandemic can provide insights into service utilization patterns and care outcomes for managers and policymakers. This study was conducted to investigate the impact of COVID-19 on selected outcome indicators in the hospitals of Shahid Beheshti University of Medical Sciences, Tehran. Materials and Methods: This research was descriptive-analytical and of the time series analysis type. Six outcome indicators were considered: hospitalization rate, bed occupancy rate, the average length of stay, emergency visits, laboratory tests, and imaging requests. Related data from 12 affiliated hospitals from 2017-2019 (pre-COVID) and 2020 (post-COVID) were obtained from the hospital's intelligent management system. The data were analyzed using R software's interrupted time series analysis method. Results: The hospitalization rate (P=0.015), bed occupancy rate (P=0.04), and the number of laboratory tests (P=0.003) significantly increased immediately after the outbreak of the pandemic. In contrast, emergency visits (P=0.034) have significantly decreased. The bed occupancy rate and the number of imaging requests showed no significant change. The decrease in emergency room visits within one year after the pandemic was significant, but the changes in other outcome indicators were non-significant (P>0.05). Conclusion: Understanding the changes and impact of a major event on hospital outcome indicators is necessary for decision-makers to effectively plan for resource allocation and effective pandemic response. The outbreak of COVID-19 has caused a change in performance and hospital outcomes by affecting the supply and demand of services. In a year after the pandemic's beginning, except for emergency visits, the other indicators have not experienced significant changes. Preservation of essential services such as emergency room visits is recommended in the strategy of rapid response to an epidemic outbreak and public campaigns to encourage people to seek medical care if needed in future waves of the pandemic. © 2022 the Authors.
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Introduction: Hemolytic-uremic syndrome (HUS) is the most common cause of acute renal failure in young children, characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and uremia.Whereas Serious gastrointestinal complications like gut necrosis, hemorrhagic colitis, pancreatitis, transient diabetes, hepatitis, cholestasis, peritonitis, and rectal prolaps have already been reported. We report a case of HUS complicated by duodenal intramural hematoma in a previously healthy 5 year old girl. Result(s): A 5-year-old, previously healthy girl presented with a history of fever, dysentery, and hematuria admitted in a remote local hospital with diagnosis of SARS-Covid19 and treated with prednisolon 50mg /day, metronidazole, dimeticone, metoclopramid. Subsequently she developed severe anemia (received packed cell) and tonic clonic generalized seizure. Ten days later, she referred to our center for HUS management. The course of hospitalization was complicated with intermitent fever ( urosepsis E. coli, Klebsiella, candida), encephalitis, pericarditits, and hyper reactive airway disease.SARS-covid19, immune deficiency investigations were negative(Figure1) .The patient developed protracted vomiting and persistent abdominal pain that was associated with pancreatitis, anicteric hepatitis. After ten days supportive therapy she presented with massive bilious vomiting, abdominal distention, and pain with no tenderness. Bile stained duodenal mucosa was seen on endoscopy. Abdominal scan and upper GI series revealed two hypoechoic heterogeneous collection with 15*14 and 40*30 mm in the wall of proximal part of 2nd and 3rd portion of duodenum suggesting intramural hematoma that was treated by fasting, parenteral hyperalimentation , and low dose octerotide. Ultimately, resolution occurred in 3 weeks. After four months of follow up, she was completely recovered. Conclusion(s): Conclusion(s): Although Intramural hematoma is rare, it can complicate the course of HUS.
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This study investigated the effect of Covid-19 on the lung in disease conditions. Covid-19 can cause pulmonary complications such as pneumonia and, in more severe cases, acute respiratory distress syndrome, or ARDS. Sepsis is another possible complication of Covid-19 that can permanently damage the lungs and other organs. Most coronary patients have severe respiratory problems. This is because their lungs are full of fluid, which can be seen on CT scans of the coronary lung as white spots called opaque glass opacity. Patients with pneumonia also have these characteristics. For this reason, CT scans alone cannot help diagnose coronary heart disease. Asthma is a common and long-term lung disease that makes it difficult to breathe and leads to shortness of breath. Asthma, along with diabetes and heart disease, is one of the diseases that make a person more vulnerable to the virus. The American Asthma and Allergy Foundation also lists asthma as an acute medical condition that increases a person's risk of developing the virus. The World Health Organization also supports this theory.
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Background: Ever since coronavirus disease 2019 (COVID-19) has emerged as a global public health problem, risk factors for severe disease have been reported in studies from Western countries. However, apart from studies of Chinese origin, few reports are available on COVID-19 severity among the Asian population. This study investigates potential risk factors for development of critical COVID-19 in an Iranian population. Methods: In this retrospective cohort study, we included all adults with COVID-19 from 2 tertiary centers in Iran who had been diagnosed between February 20 and April 1, 2020, in either inpatient or outpatient settings. “Critical COVID-19” was proposed when a hospitalized patient was scheduled for admission to intensive care unit, assisted by mechanical ventilation, or pronounced dead. We used univariable and multivariable logistic and linear regression models to explore the potential risk factors associated with critical COVID-19, admission to hospital, and length of hospital stay. Results: Of the 590 recruited patients, 427 (72.4%) were hospitalized, 186 (31.5%) had critical COVID-19, and 107 (18.2%) died. In the multivariable regression analysis, age >60 years and physical/mental disabilities were associated with critical COVID-19 (odds ratio (OR), 2.33 and 7.03;95% CI, 1.51-3.60 and 2.88-17.13, respectively);and history of renal, heart, or liver failure was associated with both COVID-19 hospitalization (OR, 4.13;95% CI 1.91-8.95;p<0.001) and length of hospital stay (Beta 1.90;95% CI, 0.763.04;p=0.001). Conclusion: Age >60 years and physical/mental disabilities can predict development of critical COVID-19 in the Iranian population. Also, the presence of renal, heart, or liver failure might predict both COVID-19 hospitalization and length of hospital stay. © 2021 Iran University of Medical Sciences. All Rights Reserved.
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The novel coronavirus disease (COVID-19) has rapidly spread across the world and caused a pandemic, and still continues to evolve. In Iran, the first cases of COVID-19 were officially announced between February 19 and 23, 2020 and it soon became clear that Iran is one of the countries that is worst-hit by COVID-19 outbreak (1, 2).
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BACKGROUND: The outbreak of the new coronavirus was first reported in China and then spread to other parts of the world. The number of people infected with the virus is significantly increasing, making the disease an international concern. AIM: The present study aimed to investigate the coronavirus and its effects on children. MATERIALS AND METHODS: In the present study, search engines, and scientific databases of Google Scholar, Science Direct, PubMed, Medline, and Cochrane were searched to examine the effect of coronavirus on children. To collect information, keywords were also searched in the databases. RESULTS: In spite of contradictory results, among the children, those under 5 years old are the high-risk group. CONCLUSION: Some researchers believe that the virus shows fewer symptoms in children. However, the immune system of infants under six months develops pneumonia in rare cases.
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Various manifestations may appear in chest computed tomography (CT) scan of patients with coronavirus disease 2019 (COVID-19). In this pictorial review, we present chest CT manifestations of 14 patients with laboratory-confirmed COVID-19 disease and various manifestations including ground-glass and consolidative opacities, reticular opacities, halo sign, and other findings.