Health Risk Assessment of Lead, Cadmium, and Arsenic in Leafy Vegetables in Tehran, Iran: the Concentration Data Study.

Absorption of heavy and toxic metals causes their accumulation in the edible parts of vegetables. Pollutants such as heavy metals have directly affected the health of society and contributed to emerging diseases in recent years. The current study aimed to detect heavy metals (Pb, Cd, As) in highly consumed leafy vegetables provided from the Tehran market. Four types of vegetables, including dill, parsley, cress, and coriander were selected and 64 samples were randomly collected from fruit and vegetable markets in different regions of Tehran in August and September 2022. Then, samples were analyzed by the ICP-OES system, and health risk assessment was conducted using non-carcinogenic and carcinogenic approach. The range of Pb concentration was 54-314, < LOQ-289, < LOQ-230, and < LOQ-183 µg/kg for dill, cress, parsley, and coriander, respectively. The high mean concentrations of Pb belong to the dill (161.43 ± 77.3 µg/kg) and cress (154.75 ± 72.9 µg/kg). In some samples of dill (37.5% of samples), cress (18.75% of samples), and parsley (12.5% of samples), the Pb content was above the national allowable limit (200 µg/kg). The range of Cd concentration was < LOQ-42, < LOQ-41, < LOQ-30, and < LOQ-38 µg/kg for dill, cress, parsley, and coriander, respectively. In none of the samples, the concentration of Cd was higher than the Iranian national limit (50 µg/kg). The As occurrence was observed in all cress samples with a mean of 165.19 ± 64.83 µg/kg. The range of As concentration was < LOQ-71, < LOQ-256, 58-273, and < LOQ-75 µg/kg for parsley, dill, cress, and coriander, respectively. The THQ and HI values were higher than 1, and either ILCR value was higher than 10-4 for all tested heavy metals, it can be concluded that higher levels of heavy metals than the standard limits in some samples may raise the warning alarm and should come to the attention of the authorities.

Relationship between diet quality and nonalcoholic fatty liver disease predictor indices in Iranian patients with metabolic syndrome: A cross-sectional study.

The present study aimed to assess the association between diet quality and nonalcoholic fatty liver disease (NAFLD) predictor indices in patients with metabolic syndrome (MetS). This cross-sectional study was carried out among 344 adult patients with MetS. The diet quality of patients was calculated by Healthy Eating Index-2015 (HEI-2015). NAFLD predictor indices (Hepatic Steatosis Index [HSI], Triglyceride-Glucose Index [TyG], and Fatty Liver Index [FLI]) were calculated and compared according to the HEI-2015 quartiles. The relationship between the HEI-2015 score and HSI, FLI, and TyG Index was estimated using multiple linear regression analysis. The findings of the present study revealed that patients with the highest HEI score had the lowest FLI score (p = .003) and HSI score (p = .05). There was an inverse relationship between the HEI-2015 score and FLI (ß = -0.49; p < .001), HSI (ß = -0.05; p = .25), and TyG Index (ß = -0.002; p = .34). According to our result, after adjusting for possible confounding factors, there was a statistically significant inverse association between HEI-2015 and FLI.

Potential roles of ellagic acid on metabolic variables in diabetes mellitus: A systematic review.

Diabetes mellitus is a widespread endocrine disorder globally. Due to its antioxidant and anti-inflammatory properties, ellagic acid has the potential to improve the metabolic effects of chronic non-communicable diseases. This systematic review summarizes current evidence about the potential effects of ellagic acid on metabolic variables in diabetes mellitus. A comprehensive systematic literature search was conducted in databases such as PubMed, Scopus, EMBASE, ProQuest and Google Scholar from inception until March 2022. All animal studies and clinical trials were eligible for inclusion. Studies using in vitro models or published in a non-English language were excluded. Of 1320 articles, 23 were selected for assessment, including 21 animal studies and two randomized controlled trial studies. Following ellagic acid administration, findings reported improvement in FBS, HbA1c, insulin (20, 8 and 12 studies, respectively), TG, TC, HDL-C (13, 10 and 5 studies, respectively), MDA, GSH, CAT, SOD (11, 6, 3 and 4 studies, respectively), and TNF-α and IL-6 (6 and 3 studies, respectively). In conclusion, ellagic acid may improve glycaemic indicators, dyslipidaemia, oxidative stress and inflammation in diabetes mellitus. However, further clinical trials are needed to explore the mechanisms more precisely and to observe the applied consequences.

Dietary Effects of Probiotic Lactobacillus casei on Some Immunity Indices of Common Carp (Cyprinus carpio) Exposed to Cadmium.

The present study investigated the effect of feeding common carp with Lactobacillus probiotic supplement on growth, blood indices, and immunity of serum and mucus exposed to cadmium. A total of 250 common carp with an average weight of 15 ± 0.62 were divided into three groups: fish without probiotics, and fish with two levels of probiotic. At the end of a 42-day feeding period, 50% of the lethal concentrations of cadmium were exposed for 14 days and blood and immune indices of serum and mucus were measured. The results showed that growth indices, blood indices, and serum and mucus immunity were significantly different from the control group (P < 0.05). Finally, this study showed probiotics could improve the decreasing effect of cadmium in BWI and PBWI indices and the additive effect of cadmium in FCR and ALT. Probiotic was also able to completely improve the decreasing effect of cadmium on lymphocyte indices and the additive effect of cadmium on ALP and AST and monocyte.

Dietary insulin indices and low-carbohydrate diet and the odds of colorectal cancer: a case-control study.

BACKGROUND: Regarding the role of insulin and insulin-inducing dietary factors in some cancers' etiology, we hypothesized that the risk of colorectal cancer may be lessened by following a lower carbohydrate and insulinogenic diet. Therefore, we performed this study to explore the association between a low-carbohydrate diet and insulin indices and the odds of colorectal cancer. METHOD: This hospital-based case-control study was conducted on 150 newly diagnosed colorectal cancer patients and 300 healthy age- and sex-matched hospitalized controls. A valid and reliable food frequency questionnaire was used to calculate the insulin indices and low-carbohydrate diet score. Multivariate logistic regression was used to estimate the association between insulin indices and low-carbohydrate diet and the odds of colorectal cancer. RESULT: After adjusting for potential confounders, individuals in the highest tertile of insulin indices had a higher risk of colorectal cancer (ORinsulin index = 3.46; 95% CI, 2.00-5.96; ORinsulin load = 2; 95% CI, 1.17-3.41). No association was found between a low-carbohydrate diet and colorectal cancer (OR = 1.55; 95% CI, 0.85-2.84). CONCLUSION: Current results demonstrated that a high insulinemic diet was associated with a higher risk of colorectal cancer.

Effects of curcumin and/or coenzyme Q10 supplementation on metabolic control in subjects with metabolic syndrome: a randomized clinical trial.

BACKGROUND: Metabolic syndrome (MetS) as a cluster of conditions including hyperlipidemia, hypertension, hyperglycemia, insulin resistance, and abdominal obesity is linked to cardiovascular diseases and type 2 diabetes. Evidence suggested that intake of curcumin and coenzyme Q10 may have therapeutic effects in the management of MetS. AIMS: We investigated the effects of curcumin and/or coenzyme Q10 supplementation on metabolic syndrome components including systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-c) and fasting plasma glucose (FPG) as primary outcomes, and total cholesterol (TC), low density lipoprotein-cholesterol (LDL-c) and body mass index (BMI) as secondary outcomes in subjects with MetS. METHODS: In this 2 × 2 factorial, randomized, double-blinded, placebo-controlled study, 88 subjects with MetS were randomly assigned into four groups including curcumin plus placebo (CP), or coenzyme Q10 plus placebo (QP), or curcumin plus coenzyme Q10 (CQ), or double placebo (DP) for 12 weeks. RESULTS: The CP group compared with the three other groups showed a significant reduction in HDL-c (P = 0.001), TG (P <  0.001), TC (P <  0.001), and LDL-c (P <  0.001). No significant differences were seen between the four groups in terms of SBP, DBP, FPG, WC, BMI and weight. CONCLUSION: Curcumin improved dyslipidemia, but had no effect on body composition, hypertension and glycemic control. Furthermore, coenzyme Q10 as well as the combination of curcumin and coenzyme Q10 showed no therapeutic effects in subjects with MetS. The trial was registered on 09/21/2018 at the Iranian clinical trials website (IRCT20180201038585N2), URL: https://www.irct.ir/trial/32518 .

Effect of whey protein supplementation on weight and body composition indicators: A meta-analysis of randomized clinical trials.

BACKGROUND & AIM: Whey protein (WP) is one of the well-known dairy driven products to help people to change their weight and body composition (BC). This study aimed to investigate the effect of WP on weight and BC on every published RCT on all populations. METHODS: A systematic review of the literature was undertaken to identify RCTs that examined the effect of WP on weight, body fat, lean body mass, fat-free mass, and waist circumference. To create weighted-group-mean differences for within- and between-group comparisons, random effects models were used. Subgroup analyses were also done to determine the effect of potential sources of heterogeneity. RESULTS: Thirty-five RCTs, with a total of 1902 adult participants were included in pooled analysis. The effect of WP supplementation on BMI (-0.156, 95% CI: -0.31, 0.00, P < 0.05), body fat mass (-0.144, 95% CI: -0.28, 0.00, P < 0.05), and waist circumference (-0.448, 95% CI: -0.86, -0.03, P < 0.05) in within group analysis, and BMI (-0.769, 95% CI: -1.54, 0.00, P < 0.05) and lean body mass (0.741, 95% CI: 0.07, 1.41, P < 0.05) in the between group analysis was indicated. Resistance training, WP dosage, sex, age group, the type of control group (placebo, different proteins, etc.), the control group dosage, and energy intake before and during the trial, as well as between the WP and control groups, were recognized as the main sources of heterogeneity. CONCLUSION: The data from trials currently available supports the use of WP to improve BC indicators. The benefits of WP on BC are expected to be greatest when combined with resistance training and a reduction in overall calorie consumption.

Understanding the Relationship between Microstructure and Physicochemical Properties of Ultrafiltered Feta-Type Cheese Containing Saturea bachtiarica Leaf Extract.

Microwave-assisted extraction was optimized to prepare Satureja bachtiarica leaf (SBL) extract based on antimicrobial (IZD) and antioxidant activities (DPPH) and extraction yield (EY). At optimum condition, i.e., 800 W power and 8 min, the best extraction results with EY = 16%, IZD = 73.56 mm, and DPPH = 24.2% were obtained. To develop a novel Feta-cheese, the influence of SBL extract, rennet, and starter concentrations were evaluated in terms of rheological, textural, and sensorial properties. At the optimized condition, the acceptance, taste, the strength of the network (A), and the distance between sequential cross-linking points (ξ) were 8.13, 8.07, 34,036.12 Pa·s1/z, and 5.41 nm, respectively. At the 60th day of storage time, the lowest z value (the network extensity parameter) of the cheese samples was observed. SEM image texture indices showed a good correlation with the studied instrumental texture parameters during 60 days of storage. The mold and yeast counts and their growth rate in the SBL extract-added cheese were lower than those for control one; whereas, the former cheese showed a greater LAB population between the 80th and 120th days. The antimicrobial and antioxidant qualities of SBL extract showed a significant influence on cheese properties.

Toxicity and Anti-feeding effect of Aesculushippocastanum, Thymus daenensis, Artemisia abrotanum, and Chrozophora tinctoria on Sitophillus oryzae.

Background and aim: The approach of food storage, especially cereals and basic human food sources, has long been considered as a problem to combat storage pests. the use of plant compounds has been suggested by researchers as an alternative to phosphine in the fight against pests.In this study, four plants such as Aesculushippocastanum, Thymus daenensis, Artemisia abrotanum and Chrozophoratinctoria were evaluated based on their deadly and repellent properties of pests and insectsconsidering Iranian medicine sources. Materials and methods: First, plant extracts were prepared by ethanol solvent method and then, their lethal and Anti-feeding experiments were performed on rice insects (Sitophylusoryzae) in standard laboratory conditions. Results: Extracts of Thymus daenensis, Aesculushippocastanum, Artemisia abrotanum and Chrozophoratinctoria were estimated to be 553.2, 753.6, 878.3 and 987.3 mg / ml effective dose, respectively.The results showed that Thymus daenensis extract with 90.33% with lower concentration compared to Aesculushippocastanum, Artemisia abrotanum and Chrozophoratinctoria extracts has the highest lethal effect against S. oryzae. Also in Anti-feedingtest, Thymus daenensis extract showed the highest Anti-feedingeffect in comparison with Aesculushippocastanum, Artemisia abrotanum and Chrozophoratinctoria extracts, respectively. Conclusions: The use of plants in the control against storage pests such as rice weevils will have favorable environmental results, human health and less storage is dangerous.

Adherence to the MIND dietary pattern and sleep quality, sleep related outcomes and mental health in male adults: a cross-sectional study.

BACKGROUND: A large number of studies have investigated the association of the Mediterranean and DASH diets with psychological health as well as sleep related outcomes. However, only a few number of studies have examined the association of their newly proposed hybrid, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) dietary pattern, with sleep quality and sleep related outcomes. METHODS: This cross-sectional study was conducted on 400 male health professions (mean age 38.67 years). Dietary information was collected using a validated 168-item semi-quantitative food frequency questionnaire. The MIND score was computed based on major dietary components emphasized or minimized in this pattern. The higher the MIND score of a subject, the greater his adherence to the MIND pattern. Mental health was evaluated using the 21-item depression, anxiety, and stress scale (DASS-21). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Sleep-related outcomes (day-time sleepiness and insomnia) were also evaluated using standard questionnaires RESULTS: No significant associations were found between adherence to the MIND diet score and odds of stress, anxiety and depression either in the crude or multivariable-adjusted models (P > 0.05). Nevertheless, participants with the greatest adherence to the MIND diet had lower odds of poor sleep quality (OR for T3 vs. T1: 0.56 (95% CI: 0.34, 0.92), P-trend = 0.023). The results remained significant after full adjustment for confounding variables (P-trend = 0.042). Participants in the highest tertile of MIND diet had a 42% lower odds of daytime sleepiness in the crude and multivariable-adjusted model (P-trend < 0.05). Although no significant association was observed between adherence to the MIND diet and severity of insomnia in the crude model (P-trend = 0.055), the multivariable-adjusted model showed that the highest adherence to the MIND diet was associated with lower odds of insomnia (OR for T3 vs. T1: 0.54 (95% CI: 0.31, 0.93), P-trend = 0.031). CONCLUSION: While no significant associations were found between adherence to the MIND diet and stress, anxiety and depression, greater adherence to the MIND diet were associated with lower odds of poor sleep quality and sleep-related outcomes.

Micro-injection of propranolol within basolateral amygdala impaired fear and spatial memory and dysregulated evoked responses of CA1 neurons following foot shock stress in rats.

The basolateral nucleus of the amygdala (BLA) is responsible for memory retrieval after stress. It regulates hippocampal long-term potentiation (LTP) during stress. Although ß-adrenoceptors of the BLA have a critical role in memory, few studies have addressed this question in the BLA, and the results still have been contradictory. The present study was designed to investigate the involvement of ß-adrenoceptors of the BLA on hippocampus memory, anxiety, and plasticity in intact and stressed rats. Male Wistar rats were submitted to the electrical foot-shock stress for four consecutive days. Over four consecutive days, animals received bilateral micro-injections of either vehicle or propranolol (4 µg in 1 µl/side) into the BLA (5 min before foot-shock stress). Behavioral (memory, as well as anxiety-like behaviors), electrophysiological, and histological (neural arborization in the hippocampal CA1 pyramidal neurons) studies were performed. Results showed that inhibition of ß-adrenoceptors of BLA by propranolol significantly further impaired fear and spatial memory in stressed rats. Similarly, propranolol effectively impaired both memories in the intact animals. Propranolol significantly amplified the slope and amplitude of fEPSP in the CA1 area of the hippocampus only in stressed rats. Foot-shock stress significantly increased the number of dendritic branches in the hippocampus, and propranolol suppressed this effect of stress. It is suggested that ß-adrenoceptors in the BLA promote memory and reduce anxiety-like behaviors under tonic and stress conditions. Propranolol dysregulated LTP parameters and reduced dendritic branches, resulting in memory impairment. Probably ß-adrenoceptors of BLA regulate evoked responses of CA1 neurons only in stress- and not the tonic condition.

Healthy Eating Index-2015 and Dietary Total Antioxidant Capacity as Predictors of Prediabetes: A Case-Control Study.

BACKGROUND: The overall dietary quality, as well as the dietary total antioxidant capacity (DTAC), deserves central attention in the management of borderline high glucose levels since nonpharmacological strategies are imperative in this regard. Thus, we aimed to investigate the association between prediabetes with dietary quality and DTAC. METHODS: A case-control study was conducted on 49 patients with prediabetes and 98 controls. Demographics, anthropometric measures, and fasting blood glucose levels of all participants were obtained. Participants completed a validated 80-item food frequency questionnaire (FFQ). DTAC scores were generated using FFQ data, and Healthy Eating Index-2015 (HEI-2015) was used as a diet quality index. The lowest tertile of HEI-2015 and DTAC was considered as the reference category, and logistic regression was used to estimate the relationship between prediabetes with HEI-215 and DTAC. RESULTS: Mean age and body mass index of participants were 47.42 ± 15.98 years and 27.90 ± 4.96 kg/m2. Patients with prediabetes had lower DTAC scores when compared to controls (11.86 ± 5.77 and 17.81 ± 12.08, P = 0.01). There was a significant inverse association between the highest tertile of the DTAC score when compared with the lowest tertile in crude (OR = 0.11; 95% CI: 0.03-0.43), age-adjusted (OR = 0.13; 95% CI: 0.03-0.48), and fully adjusted (OR = 0.09; 95% CI: 0.02-0.53) models. In contrast, there was no difference between HEI-2015 in patients with prediabetes when compared to controls (74.41 ± 8.91 and 74.41 ± 9.35, respectively; P = 0.85). Correspondingly, no difference was observed between the highest tertile of the HEI-2015 score when compared with the lowest tertile in crude (OR = 1.23; 95% CI: 0.53-2.86), age-adjusted (OR = 1.17; 95% CI: 0.48-2.82), and fully adjusted (OR = 1.53; 95% CI: 0.56-4.16) models. CONCLUSION: This study demonstrates a clear association between prediabetes with less DTAC, but not with HEI-2015.

Vitamin D3 protects against lead-induced testicular toxicity by modulating Nrf2 and NF-κB genes expression in rat.

Lead (Pb) is an environmental toxin that has the ability to alter biological processes by inducing oxidative stress (OS) and inflammation. Nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor-kappa B (NF-κB) are two transcriptional factors that participate in the regulation of cellular responses against OS and inflammation. This study was conducted to evaluate the effects of vitamin D3 (VD) on the prevention of testicular damages of Pb and its association with Nrf2 and NF-κB gene expression levels and their downstream molecules. Forty male Wistar rats were divided into four groups and treatments were performed as following for four weeks: control group received no treatment, VD group were injected intramuscularly with 1000 IU of VD/Kg every other day, Pb group received 1000 mg of Pb/L of drinking water, and Pb + VD group were exposed to Pb and VD simultaneously. The results demonstrated significant decrease in the levels of tissue antioxidants, and increase in inflammatory cytokines in the Pb-intoxicated group, with increased Nrf2 and NF-κB mRNA levels. A remarkable reduction in sperm criteria and a significant disruption in serum hormones were also observed. Anyhow, VD supplementation during exposure to Pb showed a significant protective effect against all pathophysiologic alterations caused by Pb. Furthermore, VD affected the expression of Nrf2 and NF-κB and mitigated the harsh effects of Pb. In conclusion, our findings indicate that VD attenuated the toxic impacts of Pb on testis through modulation of Nrf2 and NF-κB gene expression levels which further regulated the OS and inflammatory responses.

In vitro activity of encapsulated lactic acid bacteria on aflatoxin production and growth of Aspergillus Spp.

This study aimed to investigate the potential ability of simultaneously used L. acidophilus(LA-5), L.rhamnosus(LGG), and L.casei(LC-01) in encapsulated (E) and nonencapsulated (NE) forms in mycelial growth of Aspergillus spp and aflatoxin production by A. flavus. In order to assess the zone of fungal growth inhibition by E and NE lactic acid bacteria, the agar well diffusion method was applied. Quantification of aflatoxin was performed using a high-performance liquid chromatography technique. Lactic acid bacteria exhibited high antifungal activity and significantly reduced AFB1, AFB2, AFG1, and AFG2 production in both E and NE forms compared to the control group. The percentage of reduction in total AFs production in treated samples with E and NE lactic acid bacteria was 94.1% and 95.5%, respectively. These results suggested that simultaneously used lactic acid bacteria in E and NE forms can prevent growth and decrease aflatoxin production of toxigenic aspergilla.

Determine the most common clinical symptoms in COVID-19 patients: a systematic review and meta-analysis.

INTRODUCTION: COVID-19 is an emerging infectious disease. The study about features of this infection could be very helpful in better knowledge about this infectious disease. The current systematic review and meta-analysis were aimed to estimate the prevalence of clinical symptoms of COVID-19 in a systematic review and meta-analysis. METHODS: A systematic review using Medline/PubMed, Scopus, and Google scholar has been conducted. In the current systematic review and meta-analysis, the articles published in the period January 1, 2020, to April 2, 2020, written in English and reporting clinical symptoms of COVID-19 was reviewed. To assess, the presence of heterogeneity, the Cochran's Q statistic, the I2 index, and the tau-squared test were used. Because of significant heterogeneity between the studies the random-effects model with 95% CI was used to calculate the pooled estimation of each symptom prevalence. RESULTS: The most common symptoms in COVID-19 patients include: Fever 81.2% (95% CI: 77.9-84.4); Cough: 58.5% (95% CI: 54.2-62.8); Fatigue 38.5% (95% CI: 30.6-45.3); Dyspnea: 26.1% (95% CI: 20.4-31.8); and the Sputum: 25.8% (95% CI: 21.1-30.4). Based on the meta-regression results, the sample size used in different studies did not have a significant effect on the final estimate value (P > 0.05). CONCLUSIONS: Considering the main symptoms of COVID-19 such as Fever, Cough, Fatigue, and Dyspnea can have a key role in early detection of this disease and prevent the transmission of the disease to other people.

Association between parity and obesity: a cross sectional study on 6,447 Iranian females.

BACKGROUND: The aim of this study was to determine the relationship between parity and obesity in Iranian women. METHODS: In a cross-sectional study, a total of 6447 urban women aged 40-65 were studied. Parity(number of full-term births), age at menarche, menopausal status, age, height, weight, marital status, education level and occupation were gathered by a checklist. Body Mass Index (BMI) was calculated. Statistical associations between parity and obesity using multiple logistic regression model were examined. RESULTS: The mean age of the enrolled women was 48.40 ± 6.13 years. The mean BMI was 27.55 ± 4.47 kg/m2. Of the total participants enrolled, 3517 (54.55%) had < 3 parities, while 2930 (45.44%) had ≥ 3 parities. The prevalence of obesity (BMI ≥ 30 kg/m2) and overweight (30 > BMI ≥ 25) was 27.50 % (95% CI 26.85-28.15) and 43.70% (95% CI 42.98-44.42), respectively. After adjustment for potential confounders, women with ≥ 3 parities were at higher risk of being obese (OR 1.19, 95% CI 1.05-1.35). CONCLUSION: There was a statistically significant positive association between higher parity and obesity. It is recommended that health policymakers plan appropriate weight loss programs for postpartum.

Effect of Social Distancing on COVID-19 Incidence and Mortality in Iran Since February 20 to May 13, 2020: An Interrupted Time Series Analysis.

BACKGROUND AND OBJECTIVE: Numerous actions have been taken to control the COVID-19 pandemic and reduce their morbidity and mortality. One of the most important measures in this regard is social distancing. However, there is limited evidence on the effectiveness of social distancing on COVID-19 incidence and mortality. Thus, the current study aimed to assess the effectiveness of social distancing measures on the COVID-19 incidence and mortality in Iran. MATERIALS AND METHODS: In the current quasi-experimental study, we evaluated the daily incidence cases and the number of deaths of COVID-19 in Iran before and after the implementation of social distancing measures. The segmented regression model was used to analyze the data. We also performed the interrupted time series (ITS) analysis using Newey ordinary least squares (OLS) regression-based methods. RESULTS: After the implementation of social distancing, the trend of both daily new cases and deaths due to COVID-19 was decreasing [(ß = -1.70 (95% CI = [-2.30 - -1.10; P < 0.001])) and (ß = -0.07 (95% CI = [-0.10 - -0.05; P < 0.001], respectively))]. CONCLUSION: Social distancing along with other public health interventions could reduce the morbidity and mortality of COVID-19 to some degrees, and it seems to be crucial to control the pandemic.

Factors Associated with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: The current study aimed to identify effective factors on the death among COVID-19 patients. METHODS: All articles published in the period Jan 1, 2020, to Mar 23, 2020, written in English and reporting factors associated with COVID-19 mortality were reviewed. The random-effects model with 95% CI was used to calculate the pooled Odds Ratio (OR) and Hazard Ratio (HR). Data were analyzed using Stata ver.11.0. RESULTS: The older age OR: 1.21(1.10-1.33) and male gender OR: 1.41(1.04-1.89) were most prone to death due to COVID-19. The Comorbidity with some chronic diseases such as Diabetes type2 OR: 2.42(1.06-5.52), Hypertension OR: 2.54(1.21-5.32), Kidney disorder OR: 2.61(1.22-5.60), Respiratory disorder 3.09 (1.39-6.88) and Heart diseases OR: 4.37 (1.13-16.90) can increase the risk of COVID19 mortality. CONCLUSION: Infection with COVID-19 is associated with substantial mortality mainly in older patients with comorbidities. We found the significant effect of age, gender and comorbidities such as Diabetes Mellitus, Hypertension, Kidney disorders and Heart diseases on the risk of death in patients with COVID-19. The factors associated with mortality found in this research can help to recognize patients with COVID-19 who are at higher risk of a poor prognosis. Monitoring these factors can serve to give early warning for the appropriate interventions.

Estimate of the Basic Reproduction Number for COVID-19: A Systematic Review and Meta-analysis.

OBJECTIVES: The outbreak of coronavirus disease 2019 (COVID-19) is one of the main public health challenges currently facing the world. Because of its high transmissibility, COVID-19 has already caused extensive morbidity and mortality in many countries throughout the world. An accurate estimation of the basic reproduction number (R0) of COVID-19 would be beneficial for prevention programs. In light of discrepancies in original research on this issue, this systematic review and meta-analysis aimed to estimate the pooled R0 for COVID-19 in the current outbreak. METHODS: International databases (including Google Scholar, Science Direct, PubMed, and Scopus) were searched to identify studies conducted regarding the R0 of COVID-19. Articles were searched using the following keywords: "COVID-19" and "basic reproduction number" or "R0." The heterogeneity among studies was assessed using the I2 index, the Cochran Q test, and T2. A random-effects model was used to estimate R0 in this study. RESULTS: The mean reported R0 in the identified articles was 3.38±1.40, with a range of 1.90 to 6.49. According to the results of the random-effects model, the pooled R0 for COVID-19 was estimated as 3.32 (95% confidence interval, 2.81 to 3.82). According to the results of the meta-regression analysis, the type of model used to estimate R0 did not have a significant effect on heterogeneity among studies (p=0.81). CONCLUSIONS: Considering the estimated R0 for COVID-19, reducing the number of contacts within the population is a necessary step to control the epidemic. The estimated overall R0 was higher than the World Health Organization estimate.

Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in IRAN: A single center study.

BACKGROUND: An outbreak of COVID-19 in Iran has spread throughout the country. Identifying the epidemiological characteristics of this disease will help to make appropriate decisions and thus control the epidemic. The aim of this study was characterization of the epidemiological features of COVID-19 in Iran. METHODS: In this retrospective study, data related to the epidemiological characteristics of COVID-19 patients admitted to Baqiyatallah Hospital in Tehran, Iran, from 19 February 2020 to 15 April 2020 have been analyzed and reported. Patient characteristics including age, gender and underlying diseases were investigated. Data were collected through patient records. Sex ratio, Case Fatality Rate (CFR) and daily trend of cases were also determined. A multiple logistic regression analysis was also performed to assess affecting factors on mortality. RESULTS: From February 19, 2020 to April 15, 2020, 12870 patients referred to the hospital emergency department, of which 2968 were hospitalized with COVID-19 diagnosis. The majority of cases were in the age group of 50 to 60 years of old. The male-to-female ratio was 1.93:1. A total of 239 deaths occurred among all cases for an overall CFR of 1.85% based on the total number of patients (both outpatient and inpatient) and 8.06% among hospitalized patients. Out of all patients 10.89% had comorbidity. Diabetes, chronic respiratory diseases, hypertension, cardiovascular diseases, chronic Kidney diseases and cancer were the most common comorbidities with 3.81, 2.02 , 1.99 , 1.25, 0.60 and 0.57 %, respectively. Male gender (OR=1.45, 95% CI: 1.08-1.96), older age (OR=1.05, 95% CI: 1.04-1.06) and having underlying diseases (OR=1.53, 95% CI: 1.04-2.24) were significantly associated with mortality. CONCLUSIONS: The results of this study showed that Male gender, older age and having comorbidities were significantly associated with the risk of death among COVID-19 patients. It is important to pay special attention to male elderly patients with underlying diseases.