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Background and Objectives: The COVID-19 epidemic and its subsequent effects have become a significant global challenge. In addition to being affected by this crisis, Iran is also facing many other problems, including sanctions and economic problems. So, there is a concern that it will suffer more severe consequences. Methods: Scenario planning is one of the ways to recognize future changes and environmental uncertainties. This study used the so-called global business network (GBN) method, also known as the scenario matrix method. This method is based on two key uncertainties and six steps have been taken to examine variables related to health and socio-economic factors and use the opinions of relevant experts. Results: To be expected, Iran's health system will be able to manage the epidemic in the face of various conditions with severity and weakness, and only in the pessimistic scenario or in Worst-case scenario with the default assumption of the continuation of sanctions and the spread of the epidemic. It leads to global restrictions, loss of foreign exchange reserves, loss of performance or collapse of the health system, increasing the number of deaths and diminishing the quality of life. Conclusion: Regarding the COVID-19 epidemic and the existing background factors, scenarios of Iran's health and economic conditions were narrated. Given the ability of the scenarios to understand the complexity and help in decision-making, it is considered a useful tool for policy makers to have a broader, comprehensive and reasonable look to achieve a correct consensus. This situation leads to the preservation and continuation of society health and conventional economic decisions.
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Background and Objectives: The COVID-19 epidemic and its subsequent effects have become a significant global challenge. In addition to being affected by this crisis, Iran is also facing many other problems, including sanctions and economic problems. So, there is a concern that it will suffer more severe consequences. Methods: Scenario planning is one of the ways to recognize future changes and environmental uncertainties. This study used the so-called global business network (GBN) method, also known as the scenario matrix method. This method is based on two key uncertainties and six steps have been taken to examine variables related to health and socio-economic factors and use the opinions of relevant experts. Results: To be expected, Iran's health system will be able to manage the epidemic in the face of various conditions with severity and weakness, and only in the pessimistic scenario or in Worst-case scenario with the default assumption of the continuation of sanctions and the spread of the epidemic. It leads to global restrictions, loss of foreign exchange reserves, loss of performance or collapse of the health system, increasing the number of deaths and diminishing the quality of life. Conclusion: Regarding the COVID-19 epidemic and the existing background factors, scenarios of Iran's health and economic conditions were narrated. Given the ability of the scenarios to understand the complexity and help in decision-making, it is considered a useful tool for policy makers to have a broader, comprehensive and reasonable look to achieve a correct consensus. This situation leads to the preservation and continuation of society health and conventional economic decisions. © 2022 The Authors. Published by Tehran University of Medical Sciences.
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Background and Objectives: The COVID-19 epidemic and its subsequent effects have become a significant global challenge. In addition to being affected by this crisis, Iran is also facing many other problems, including sanctions and economic problems. So, there is a concern that it will suffer more severe consequences. Method(s): Scenario planning is one of the ways to recognize future changes and environmental uncertainties. This study used the so-called global business network (GBN) method, also known as the scenario matrix method. This method is based on two key uncertainties and six steps have been taken to examine variables related to health and socio-economic factors and use the opinions of relevant experts. Result(s): To be expected, Iran's health system will be able to manage the epidemic in the face of various conditions with severity and weakness, and only in the pessimistic scenario or in Worst-case scenario with the default assumption of the continuation of sanctions and the spread of the epidemic. It leads to global restrictions, loss of foreign exchange reserves, loss of performance or collapse of the health system, increasing the number of deaths and diminishing the quality of life. Conclusion(s): Regarding the COVID-19 epidemic and the existing background factors, scenarios of Iran's health and economic conditions were narrated. Given the ability of the scenarios to understand the complexity and help in decision-making, it is considered a useful tool for policy makers to have a broader, comprehensive and reasonable look to achieve a correct consensus. This situation leads to the preservation and continuation of society health and conventional economic decisions.Copyright © 2022 The Authors. Published by Tehran University of Medical Sciences.
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Background and purpose: The COVID-19 pandemic resulted in an uncontrolled disease burden on healthcare workers (HCWs) worldwide. We aimed to investigate the prevalence and severity of COVID-19 in HCWs of selected hospitals in Mazandaran province and examine the association between COVID-19 and missed opportunities of HCWs. Materials and methods: In this retrospective descriptive-analytical study, 1105 HCWs in Qaemshahr Razi Hospital and Sari Fatemeh-Zahra Hospital were studied between February 2020 and June 2020. In order to evaluate the frequency and severity of the disease, clinical and paraclinical manifestations were recorded by a trained HCW. Data were analyzed in SPSS V18. Results: The frequency of COVID-19 was 16.19% among HCWs. The patients included 113 (63.13%) nurses, 47(26.26%) service providers and administrative personnel, and 19(10.61%) physicians. Duration of sick leave was found to be significantly associated with severity of COVID-19 (P=0.006). This length was also significantly associated with the job and was longer in nurses (P=0.013). Our findings revealed a significant relationship between the level of adherence to personal protective equipment (PPE) and the severity of COVID-19 (P=0.001). Conclusion: COVID-19 could exert remarkable impact on the quality of work in HCWs, especially among nurses. Effective training of HCWs regarding PPE instructions results in suitable protection against severe forms of the disease.
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Background and purpose: There are limited studies on co-infection of COVID-19 and tuberculosis (TB). This study aimed to describe the clinical, radiological, laboratory characteristics, treatment and outcome of patients admitted with tuberculosis and COVID 19 co-infection. Materials and methods: In this retrospective study, we investigated all patients with either active TB or old TB and COVID-19 admitted to Qaemshahr Razi Teaching Hospital between 2020 and 2022. Results: A total of 9251 patients with COVID-19 were admitted to our hospital between February 2020 and May 2022. There were eight patients with pulmonary tuberculosis and COVID-19 co-infection, including five (62.5%) male patients. The mean age of these patients was 61.13..22.63 years old. The mean time of symptom onset to hospital admission was 15.13..30.56 days and 50% were diagnosed with active TB and other half had old TB. Four patients were admitted to the ICU, three of whom required ventilation. Finally, four (50%) patients deceased. In this study, among factors that influence patients' outcomes, only underlying diseases were significantly associated with death. Conclusion: Tuberculosis is assumed to cause a higher mortality risk in COVID-19 patients, especially in those with chronic underlying diseases.
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Background and purpose: There are limited studies on co-infection of COVID-19 and tuberculosis (TB). This study aimed to describe the clinical, radiological, laboratory characteristics, treatment and outcome of patients admitted with tuberculosis and COVID 19 co-infection. Material(s) and Method(s): In this retrospective study, we investigated all patients with either active TB or old TB and COVID-19 admitted to Qaemshahr Razi Teaching Hospital between 2020 and 2022. Result(s): A total of 9251 patients with COVID-19 were admitted to our hospital between February 2020 and May 2022. There were eight patients with pulmonary tuberculosis and COVID-19 co-infection, including five (62.5%) male patients. The mean age of these patients was 61.13+/-22.63 years old. The mean time of symptom onset to hospital admission was 15.13+/-30.56 days and 50% were diagnosed with active TB and other half had old TB. Four patients were admitted to the ICU, three of whom required ventilation. Finally, four (50%) patients deceased. In this study, among factors that influence patients' outcomes, only underlying diseases were significantly associated with death. Conclusion(s): Tuberculosis is assumed to cause a higher mortality risk in COVID-19 patients, especially in those with chronic underlying diseases.Copyright © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: The COVID-19 pandemic resulted in an uncontrolled disease burden on healthcare workers (HCWs) worldwide. We aimed to investigate the prevalence and severity of COVID-19 in HCWs of selected hospitals in Mazandaran province and examine the association between COVID-19 and missed opportunities of HCWs. Material(s) and Method(s): In this retrospective descriptive-analytical study, 1105 HCWs in Qaemshahr Razi Hospital and Sari Fatemeh-Zahra Hospital were studied between February 2020 and June 2020. In order to evaluate the frequency and severity of the disease, clinical and paraclinical manifestations were recorded by a trained HCW. Data were analyzed in SPSS V18. Result(s): The frequency of COVID-19 was 16.19% among HCWs. The patients included 113 (63.13%) nurses, 47(26.26%) service providers and administrative personnel, and 19(10.61%) physicians. Duration of sick leave was found to be significantly associated with severity of COVID-19 (P=0.006). This length was also significantly associated with the job and was longer in nurses (P=0.013). Our findings revealed a significant relationship between the level of adherence to personal protective equipment (PPE) and the severity of COVID-19 (P=0.001). Conclusion(s): COVID-19 could exert remarkable impact on the quality of work in HCWs, especially among nurses. Effective training of HCWs regarding PPE instructions results in suitable protection against severe forms of the disease.Copyright © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: There are limited studies on co-infection of COVID-19 and tuberculosis (TB). This study aimed to describe the clinical, radiological, laboratory characteristics, treatment and outcome of patients admitted with tuberculosis and COVID 19 co-infection. Materials and methods: In this retrospective study, we investigated all patients with either active TB or old TB and COVID-19 admitted to Qaemshahr Razi Teaching Hospital between 2020 and 2022. Results: A total of 9251 patients with COVID-19 were admitted to our hospital between February 2020 and May 2022. There were eight patients with pulmonary tuberculosis and COVID-19 co-infection, including five (62.5%) male patients. The mean age of these patients was 61.13±22.63 years old. The mean time of symptom onset to hospital admission was 15.13±30.56 days and 50% were diagnosed with active TB and other half had old TB. Four patients were admitted to the ICU, three of whom required ventilation. Finally, four (50%) patients deceased. In this study, among factors that influence patients' outcomes, only underlying diseases were significantly associated with death. Conclusion: Tuberculosis is assumed to cause a higher mortality risk in COVID-19 patients, especially in those with chronic underlying diseases.
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Background and purpose: The COVID-19 pandemic resulted in an uncontrolled disease burden on healthcare workers (HCWs) worldwide. We aimed to investigate the prevalence and severity of COVID-19 in HCWs of selected hospitals in Mazandaran province and examine the association between COVID-19 and missed opportunities of HCWs. Materials and methods: In this retrospective descriptive-analytical study, 1105 HCWs in Qaemshahr Razi Hospital and Sari Fatemeh-Zahra Hospital were studied between February 2020 and June 2020. In order to evaluate the frequency and severity of the disease, clinical and paraclinical manifestations were recorded by a trained HCW. Data were analyzed in SPSS V18. Results: The frequency of COVID-19 was 16.19% among HCWs. The patients included 113 (63.13%) nurses, 47(26.26%) service providers and administrative personnel, and 19(10.61%) physicians. Duration of sick leave was found to be significantly associated with severity of COVID-19 (P=0.006). This length was also significantly associated with the job and was longer in nurses (P=0.013). Our findings revealed a significant relationship between the level of adherence to personal protective equipment (PPE) and the severity of COVID-19 (P=0.001). Conclusion: COVID-19 could exert remarkable impact on the quality of work in HCWs, especially among nurses. Effective training of HCWs regarding PPE instructions results in suitable protection against severe forms of the disease.
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Background and purpose: There are limited studies on co-infection of COVID-19 and tuberculosis (TB). This study aimed to describe the clinical, radiological, laboratory characteristics, treatment and outcome of patients admitted with tuberculosis and COVID 19 co-infection. Materials and methods: In this retrospective study, we investigated all patients with either active TB or old TB and COVID-19 admitted to Qaemshahr Razi Teaching Hospital between 2020 and 2022. Results: A total of 9251 patients with COVID-19 were admitted to our hospital between February 2020 and May 2022. There were eight patients with pulmonary tuberculosis and COVID-19 co-infection, including five (62.5%) male patients. The mean age of these patients was 61.13±22.63 years old. The mean time of symptom onset to hospital admission was 15.13±30.56 days and 50% were diagnosed with active TB and other half had old TB. Four patients were admitted to the ICU, three of whom required ventilation. Finally, four (50%) patients deceased. In this study, among factors that influence patients' outcomes, only underlying diseases were significantly associated with death. Conclusion: Tuberculosis is assumed to cause a higher mortality risk in COVID-19 patients, especially in those with chronic underlying diseases. © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: The COVID-19 pandemic resulted in an uncontrolled disease burden on healthcare workers (HCWs) worldwide. We aimed to investigate the prevalence and severity of COVID-19 in HCWs of selected hospitals in Mazandaran province and examine the association between COVID-19 and missed opportunities of HCWs. Materials and methods: In this retrospective descriptive-analytical study, 1105 HCWs in Qaemshahr Razi Hospital and Sari Fatemeh-Zahra Hospital were studied between February 2020 and June 2020. In order to evaluate the frequency and severity of the disease, clinical and paraclinical manifestations were recorded by a trained HCW. Data were analyzed in SPSS V18. Results: The frequency of COVID-19 was 16.19% among HCWs. The patients included 113 (63.13%) nurses, 47(26.26%) service providers and administrative personnel, and 19(10.61%) physicians. Duration of sick leave was found to be significantly associated with severity of COVID-19 (P=0.006). This length was also significantly associated with the job and was longer in nurses (P=0.013). Our findings revealed a significant relationship between the level of adherence to personal protective equipment (PPE) and the severity of COVID-19 (P=0.001). Conclusion: COVID-19 could exert remarkable impact on the quality of work in HCWs, especially among nurses. Effective training of HCWs regarding PPE instructions results in suitable protection against severe forms of the disease. © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: There are limited studies on co-infection of COVID-19 and tuberculosis (TB). This study aimed to describe the clinical, radiological, laboratory characteristics, treatment and outcome of patients admitted with tuberculosis and COVID 19 co-infection. Material(s) and Method(s): In this retrospective study, we investigated all patients with either active TB or old TB and COVID-19 admitted to Qaemshahr Razi Teaching Hospital between 2020 and 2022. Result(s): A total of 9251 patients with COVID-19 were admitted to our hospital between February 2020 and May 2022. There were eight patients with pulmonary tuberculosis and COVID-19 co-infection, including five (62.5%) male patients. The mean age of these patients was 61.13+/-22.63 years old. The mean time of symptom onset to hospital admission was 15.13+/-30.56 days and 50% were diagnosed with active TB and other half had old TB. Four patients were admitted to the ICU, three of whom required ventilation. Finally, four (50%) patients deceased. In this study, among factors that influence patients' outcomes, only underlying diseases were significantly associated with death. Conclusion(s): Tuberculosis is assumed to cause a higher mortality risk in COVID-19 patients, especially in those with chronic underlying diseases. Copyright © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: The COVID-19 pandemic resulted in an uncontrolled disease burden on healthcare workers (HCWs) worldwide. We aimed to investigate the prevalence and severity of COVID-19 in HCWs of selected hospitals in Mazandaran province and examine the association between COVID-19 and missed opportunities of HCWs. Material(s) and Method(s): In this retrospective descriptive-analytical study, 1105 HCWs in Qaemshahr Razi Hospital and Sari Fatemeh-Zahra Hospital were studied between February 2020 and June 2020. In order to evaluate the frequency and severity of the disease, clinical and paraclinical manifestations were recorded by a trained HCW. Data were analyzed in SPSS V18. Result(s): The frequency of COVID-19 was 16.19% among HCWs. The patients included 113 (63.13%) nurses, 47(26.26%) service providers and administrative personnel, and 19(10.61%) physicians. Duration of sick leave was found to be significantly associated with severity of COVID-19 (P=0.006). This length was also significantly associated with the job and was longer in nurses (P=0.013). Our findings revealed a significant relationship between the level of adherence to personal protective equipment (PPE) and the severity of COVID-19 (P=0.001). Conclusion(s): COVID-19 could exert remarkable impact on the quality of work in HCWs, especially among nurses. Effective training of HCWs regarding PPE instructions results in suitable protection against severe forms of the disease. Copyright © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: Tocilizumab (TCZ), a monoclonal antibody against interleukin-6 (IL-6) receptor, is emerged as an alternative treatment for COVID-19 patients with a risk of cytokine storms. This study aimed at investigating the efficacy of TCZ in patients with COVID-19. Material(s) and Method(s): In a retrospective observational study, we examined the demographic and clinical characteristics of patients with COVID-19 and also the outcomes of TCZ therapy (Actemra and Temziva) in Qaemshahr Razi Hospital. Result(s): Out of 56 cases, 32 (57.1%) were women and the median age of the patients was 57.5 years. Among the patients, 19 (33.9%) were admitted to ICU where seven (12.7%) were intubated and eight (14.3%) patients deceased. Before TCZ therapy, mean oxygen saturation level was 90.1% which elevated to 93.8% after receiving TCZ (P=0.001). In this study, Temziva was associated with lower mortality rate compared with Actemra (P=0.004). Conclusion(s): TCZ therapy in patients with COVID-19 could improve oxygen saturation level and Temziva results in lower mortality rate. However, further studies with larger sample size are required to confirm these results. Copyright © 2022, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: COVID-19 is a viral respiratory disease that results in high mortality. Evidence suggests that micronutrients affect viral and bacterial infections. This study was performed to evaluate the effectiveness of micronutrients (vitamin D, vitamin C, and selenium) on the disease severity in patients hospitalized with COVID-19. Materials and methods: This retrospective cross-sectional study was carried out in patients with diagnosis of COVID-19 in Qaemshahr Razi Hospital, 2020. Medical records were reviewed and 42 were selected. Data of patients that received micronutrients including vitamin D, vitamin C, and selenium and those that did not receive these supplements were compared. Duration of hospitalization, respiratory support, oxygen therapy, requiring invasive/non-invasive mechanical ventilation, and incident of death were investigated. Statistical analysis was done in SPSS V25.
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Background and purpose: COVID-19 could potentially disrupt routine care management in health systems. One of such problems is associated with HIV surveillance. The aim of this research was to study the effects of COVID-19 pandemic on HIV care indicators. Materials and methods: This retrospective cohort study was performed using data at individual and aggregate levels obtained from center for disease control and prevention in Mazandaran province affiliated with Mazandaran University of Medical Sciences. We modulated upon Poisson regression for analyzing the impact of COVID-19 pandemic on HIV incidence, mortality, treatment failure, hospitalization, refer to counselling center, HIV viral load (VL), and CD4 cell count monitoring.
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Background and purpose: COVID-19 could potentially disrupt routine care management in health systems. One of such problems is associated with HIV surveillance. The aim of this research was to study the effects of COVID-19 pandemic on HIV care indicators. Material(s) and Method(s): This retrospective cohort study was performed using data at individual and aggregate levels obtained from center for disease control and prevention in Mazandaran province affiliated with Mazandaran University of Medical Sciences. We modulated upon Poisson regression for analyzing the impact of COVID-19 pandemic on HIV incidence, mortality, treatment failure, hospitalization, refer to counselling center, HIV viral load (VL), and CD4 cell count monitoring. Result(s): One year after COVID-19 pandemic, the incidence of HIV was 0.44 per 100,000 people less compared with one year earlier (P= 0.051). CD4 counting and patients follow up at this time were 0.32 less (P< 0.001) and 1.11 more (P= 0.045) per 100,000 people, respectively compared with those before the COVID-19 pandemic. Conclusion(s): Current study showed that COVID-19 pandemic disrupted HIV care. It seems that despite regular follow up services provided by health center staff, coronaphobia was a huge barrier to care programs in HIV patients. Copyright © 2022, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: COVID-19 is a viral respiratory disease that results in high mortality. Evidence suggests that micronutrients affect viral and bacterial infections. This study was performed to evaluate the effectiveness of micronutrients (vitamin D, vitamin C, and selenium) on the disease severity in patients hospitalized with COVID-19. Material(s) and Method(s): This retrospective cross-sectional study was carried out in patients with diagnosis of COVID-19 in Qaemshahr Razi Hospital, 2020. Medical records were reviewed and 42 were selected. Data of patients that received micronutrients including vitamin D, vitamin C, and selenium and those that did not receive these supplements were compared. Duration of hospitalization, respiratory support, oxygen therapy, requiring invasive/non-invasive mechanical ventilation, and incident of death were investigated. Statistical analysis was done in SPSS V25. Result(s): Survival rates in the groups receiving vitamin C, D, and selenium were not significantly different from the groups that did not receive these supplements (P= 0.42, 0.63, 0.084, respectively). The study showed no significant relationship between vitamin D, C, and selenium intake and the need for ventilation due to respiratory distress (P= 0.139, 0.2, and 0.8, respectively). Conclusion(s): No remarkable difference was seen between the recipients of vitamin C, D, and selenium and those who did not receive supplements in terms of survival and the need for mechanical ventilation. So, these supplements did not affect the clinical outcomes of patients with COVID-19. Copyright © 2022, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in December 2019 in China and spread rapidly around the world. The aim of this study was to compare clinical and laboratory findings and disease outcome between survived and deceased COVID-19 patients admitted to Qaemshahr Razi Hospital, Iran. Materials and methods: In this retrospective study, demographic, clinical, paraclinical, and treatment information of hospitalized COVID-19 patients were analyzed. Logistic regression analysis was performed using SPSS V25.
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Background and purpose: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in December 2019 in China and spread rapidly around the world. The aim of this study was to compare clinical and laboratory findings and disease outcome between survived and deceased COVID-19 patients admitted to Qaemshahr Razi Hospital, Iran. Materials and methods: In this retrospective study, demographic, clinical, paraclinical, and treatment information of hospitalized COVID-19 patients were analyzed. Logistic regression analysis was performed using SPSS V25. Results: Among 1013 COVID-19 patients, 145 (14.3%) died. Mortality rate was significantly higher in patients older than 65 years of age (54.5%) (P= 0.0001). Comorbidities was seen in 631 patients (62.4%). Mortality rate was significantly higher in patients with hypertension (P= 0.005), diabetes (P<0.05), congestive heart failure (P< 0.0001), and chronic kidney disease and chronic lung disease (P<0.0001). Most deceased patients had low oxygen saturation (<90%) (25.5%) that required assisted mechanical ventilation (61.4%) and were admitted to Intensive Care Units (66.9%). There were significant differences between survived and deceased COVID-19 patients in leukocytosis (P= 0.001) lymphopenia, (P= 0.003), creatinine level (P< 0.0001), and lactate dehydrogenase > 250 (U/L) (P<0.0001). Conclusion: COVID-19 pandemic indicates high infectivity of the virus. Currently, there is no definitive treatment against the virus, so, findings associated with COVID-19 mortality could be of great help in early diagnosis of high-risk individuals and applying appropriate therapeutic interventions.