The comparison of clinical, laboratory, and radiological findings in immunocompromised and immunocompetent patients with COVID-19: A case-control study.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) with significant morbidity and mortality. We reported and compared the clinical and para-clinical findings of immunocompromised and immunocompetent COVID-19 patients in a case-control study at the Imam Khomeini hospital in Tehran, Iran. METHODS: In this study, 107 immunocompromised COVID-19 patients were recruited as the case group, and 107 immunocompetent COVID-19 patients as the control group. The participants were matched based on age and sex. The patients' information was retrieved from the hospital records in an information sheet. Associations between clinical and para-clinical findings with the immune status were assessed using bivariate and multivariate analyses. RESULTS: The initial pulse rate and recovery time were significantly higher in immunocompromised patients (p < .05). Myalgia, nausea/vomiting, loss of appetite, headache, and dizziness were more frequently reported by the control group (p < .05). Regarding the prescribed medications' duration, Sofosbovir was used longer in the case group, while Ribavirin was used longer in the control groups (p < .05). The most common complication in the case group was acute respiratory distress syndrome, although no major complications were observed in the control group. According to the multivariate analysis, recovery time and Lopinavir/Ritonavir (Kaletra) prescription were significantly higher in the immunocompromised compared to the immunocompetent group. CONCLUSION: Recovery time was significantly longer in the immunocompromised compared to the immunocompetent group, which emphasizes the necessity of prolonged care in these high-risk patients. Also, it is recommended to investigate the effect of novel therapeutic interventions to reduce the recovery time in addition to improving the prognosis of immunodeficient patients with COVID-19.

Predicting diabetic nephropathy in type 2 diabetic patients using machine learning algorithms.

Background: Global healthcare centers today are challenged by the dramatic increase in the prevalence of diabetes. Also, complications from diabetes are a major cause of deaths worldwide. One of the most frequent microvascular complications in diabetic patients is diabetic nephropathy (DN) which is the leading cause of death and end-stage renal disease (ESRD). Despite the different risk factors for DN identified in previous research, machine learning (ML) methods can help determine the importance of the predictors and prioritize them. Objective: The main focus of this investigation is on predicting the incidence of DN in type 2 diabetic mellitus (T2DM) patients using ML algorithms. Methods: Demographic information, laboratory results, and examinations on 6235 patients with T2DM covering a period of 10 years (2011-2020) were extracted from the electronic database of the Diabetes Clinic of the Imam Khomeini Hospital Complex (IKHC) in Iran. Recursive feature elimination using the cross-validation (RFECV) technique was then used with the three classification algorithms to select the important risk factors. Next, five ML algorithms were used to construct a predictive model for DN in T2DM patients. Finally, the results of the algorithms were evaluated according to the AUC criteria and the one with the best performance in terms of prediction and classification was selected. Results: The 18 DN risk factors selected by RFECV were age, diabetes duration, BMI, SBP, hypertension, retinopathy, ALT, CVD, 2HPP, uric acid, HbA1c, waist-to-hip ratio, cholesterol, LDL, HDL, FBS, triglyceride, and serum insulin. Based on a 10-fold cross-validation, the best performance among the five classification algorithms was that of the random forest with 85% AUC. Conclusions: This investigation validates the known risk factors for DN and emphasizes the importance of controlling the blood pressure, weight, cholesterol, and blood sugar of T2DM patients. In addition, as an example of the application of ML approaches in medical predictions, the findings of this study demonstrate the advantages of using these techniques.

A multisystem syndrome compatible with systemic lupus erythematosus: Case report and review of literature.

BACKGROUND: Abdominal pain is a routine symptom. Mesenteric arteritis, intestinal vasculitis, enteric vasculitis, mesenteric vasculitis, lupus peritonitis, and abdominal serositis are the possible differential diagnoses. Therefore, lupus enteritis has an uncertain outbreak. CASE PRESENTATION: A 27-year-old woman presented with clinical presentation of peritonitis suggestive of acute abdominal crisis with three days history of fever, bloody diarrhea, nausea, vomiting and seizure. Further work up revealed microangiopathic hemolytic anemia, thrombocytopenia, proteinuria, polyserositis and her initial autoimmune panel all were negative. Since SLE was at the top of our diagnosis, we considered glucocorticoid and cyclophosphamide pulse therapy. After approximately two months of her initial presentation, when all of her symptoms subsided by initial therapy, her antinuclear antibody became positive at 1:320 titers and renal biopsy was compatible with lupus nephritis (stage III). CONCLUSION: It is crucial to take the diagnosis of lupus into consideration, in case of any young female with multiorgan involvement even without positive antibody tests. As in this case, it took more than two months after initial presentation to confirm the diagnosis via renal biopsy and only after then, serum autoantibodies became seropositive.

Possible role of hypothyroidism in the prognosis of COVID-19.

In patients with COVID-19, certain medical conditions could result in poorer clinical outcomes. However, the prognostic role of hypothyroidism in COVID-19 is still unknown. In the present retrospective study, we estimated the prevalence of hypothyroidism in COVID-19 admitted patients in Tehran, Iran. Among 390 COVID-19 admitted patients, 21 hypothyroid cases (5.4%) were found, in which nearly 90% were aged 50 years and older. Regarding the effect of hypothyroidism on COVID-19 mortality, 60 (15.3%) of total patients and 4 (19%) of hypothyroid patients died, and no significant difference was found between the two groups.