Iranian patients co-infected with COVID-19 and mucormycosis: the most common predisposing factor, clinical outcomes, laboratory markers and diagnosis, and drug therapies.

BACKGROUND: The newly emerged pandemic of coronavirus disease-2019 (COVID-19) is the world's main health challenge because infected patients become vulnerable to a variety of opportunistic diseases. OBJECTIVE: This study aimed to assess clinical outcomes, diagnosis, utilized drug therapies, and ongoing COVID-19 practices in Iranian cases co-infected with COVID-19 and mucormycosis. PARTICIPANTS AND METHODS: A case-series analysis was conducted in the presence of 10 patients with COVID-19 and mucormycosis co-infection (two men and eight women; mean age of 48.8 years) from March to October 2020. Demographic variables, signs/symptoms, and comorbidities of all patients were recorded. COVID-19 was confirmed with reverse transcription polymerase chain reaction (RT-PCR) nasopharyngeal swab tests and high-resolution computed tomography (HR-CT)_ scans. RESULTS: All patients had a positive RT-PCR for SARS-CoV-2. Eight patients had a history of diabetes, while three of them exhibited a hypertension history. Remarkable laboratory findings were elevated fasting blood sugar in 6 cases and anaemia in four patients. A rhino-orbital-cerebral of mucormycosis in all patients was detected based on HR-CT scans and otorhinolaryngological or ophthalmological examinations. Neurological disorders including facial, trigeminal, optic, and oculomotor nerve involvement resulted in paraesthesia, pain, ptosis, no light perception, blurred vision, and papilledema in five cases. Maxillary and ethmoid sinuses were the most common sites of involvement. CONCLUSION: Vulnerable COVID-19 patients with comorbidities, any facial involvements, or treated by excessive doses of glucocorticoids and antibiotics should undergo precise examinations during the appearance of early signs and hospitalization to diagnose and treat mucormycosis using the standard care and antifungal treatments.

Iranian kidney transplant recipients with COVID-19 infection: Clinical outcomes and cytomegalovirus coinfection.

BACKGROUND: There is a high risk of COVID-19 in kidney transplant recipients (KTRs) because of chronic immunosuppression and severe cytomegalovirus (CMV) pneumonitis. CASE PRESENTATION: A case series of 10 KTRs with COVID-19 in Iran was developed. Participants consisted of two female and eight male patients, aged 46-68 years old. The data related to clinical laboratory tests, outcomes, diagnosis, and drug treatments were collected. The RT-PCR confirmed the COVID-19 infection in KTRs. The assessment of serum biochemical and blood hematological factors showed that there was a strong correlation between COVID-19 intensity and high serum Cr, BUN, and ALT levels, high CRP concentration, and lower lymphocyte and platelet counts in male KTRs. Ground-glass opacity (GGO) was the main radiologic pattern visible on both chest radiographs of computed tomography scans. The COVID-19 and CMV coinfection in KTRs resulted in large-size kidneys with severe parenchymal echogenicity and hydronephrosis. The combined use of effective antibiotic and antiviral drugs was suitable to prevent COVID-19 progression in KTRs. CONCLUSIONS: The coincidence of COVID-19 and CMV in KTRs may potentially increase the mortality risk of patients. The levels of Cr, BUN, ALT, and CRP as well as lymphocytes count in these patients should be continuously controlled.

Structural features of a new water-soluble polysaccharide from the gum exudates of Amygdalus scoparia Spach (Zedo gum).

A new water-soluble polysaccharide (CZGS-1) with molecular weight of 4860kDa and a specific optical rotation of +31.5° (c 1.0, H2O), was extracted from the gum exudate of Amygdalus scoparia Spach by hot water, following by purification with DEAE-cellulose A52 and Sephacryl S-400 HR columns. Monosaccharide composition analysis indicates that CZGS-1 was an arabino galactan including Rha, Ara, Xyl, and Gal with a relative molar ratio of 1.1:20:5.2:17.9. The uronic acid content of CZGS-1 was about 6%. Structural features of CZGS-1 was investigated by a combination of partial acid hydrolysis, methylation and GC-MS analysis, periodic acid oxidation and Smith degradation, FT-IR and NMR spectroscopy. The results indicated that CZGS-1 possesses a backbone of →3,6)-ß-d-Galp-(1→, →3)-ß-d-Galp-(1→, and →3)-α-l-Araf-(1→ residues with side chains attached to O-3 and O-6 positions of 1,3,6-linked ß-d-Galp. The side chains are consisted of ß-d-Xylp-(1→3)-α-l-Araf-(1→3)-α-l-Araf-(1→), α-l-Rhap-(1→6)-ß-d-Galp-(1→), and ß-d-GlcAp-(1→6)-ß-d-Galp-(1→).