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1.
J Card Surg ; 35(10): 2500-2505, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33043651

RESUMO

BACKGROUND: The disturbance in the international normalized ratio (INR) in patients receiving warfarin therapy is of concern. We aimed to evaluate coagulation features in hospitalized patients under warfarin treatment for prosthetic heart valves during the novel coronavirus disease 2019 (COVID-19) pneumonia pandemic. METHODS: Between 20 February and 28 March 2020, 10 patients (7 males) who were under warfarin therapy for prosthetic heart valves were hospitalized after a diagnosis of COVID-19 in Tehran Heart Center, Tehran, Iran. The clinical, paraclinical, and in-hospital outcomes were described. The patients were followed for 4 weeks. RESULTS: The median age was 62 years. All the patients received antiviral treatment, either lopinavir/ritonavir or oseltamivir. The serum level of high-sensitivity C-reactive protein ranged between 0.24 and 15.24 mg/dL. Alanine aminotransaminase was normal in all the patients except for two, with levels 1.6 and 4.2 times above normal values. The INR increased in all the patients. One (10%) patient died in the hospital. No bleeding, ischemic, or thrombotic events occurred during the hospital stay and within the 4-week follow-up. CONCLUSIONS: Antiviral therapy in patients with COVID-19 with prosthetic heart valves might be an issue responsible for an uncontrolled INR. Liver injury may happen in a minority of patients. Bridging in these patients during the antiviral treatment might be required and because of significant INR fluctuations, it might be safer to prescribe antiviral treatment in an inpatient setting.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Doenças das Valvas Cardíacas/cirurgia , Próteses Valvulares Cardíacas , Pandemias , Pneumonia Viral/epidemiologia , Tromboembolia/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Antivirais/uso terapêutico , Comorbidade , Infecções por Coronavirus/tratamento farmacológico , Feminino , Doenças das Valvas Cardíacas/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/tratamento farmacológico , Estudos Retrospectivos
2.
Comput Math Methods Med ; 2020: 9017157, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029196

RESUMO

This paper deals with the mathematical modeling and numerical simulations related to the coronavirus dynamics. A description is developed based on the framework of the susceptible-exposed-infectious-removed model. Initially, a model verification is carried out calibrating system parameters with data from China, Italy, Iran, and Brazil. Results show the model capability to predict infectious evolution. Afterward, numerical simulations are performed in order to analyze different scenarios of COVID-19 in Brazil. Results show the importance of the governmental and individual actions to control the number and the period of the critical situations related to the pandemic.


Assuntos
Simulação por Computador , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Algoritmos , Betacoronavirus , Brasil/epidemiologia , China/epidemiologia , Doenças Transmissíveis/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Itália/epidemiologia , Modelos Teóricos , Pandemias , Informática em Saúde Pública , Reprodutibilidade dos Testes
3.
Trop Doct ; 50(4): 285-291, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32998656

RESUMO

Although human toxocariasis can lead to serious complications including neurological, ocular and visceral complications, there is a lack of comprehensive epidemiological information about the seroprevalence of Toxocara species in humans. In the present study, we analysed and reviewed the overall seroprevalence of human toxocariasis in Iran. The data collection was systematically undertaken on published articles using the PubMed, Google Scholar, ScienceDirect and Scopus databases. A total of 27 studies from the past two decades reporting seroprevalence of human toxocariasis met our eligibility criteria. The pooled proportion of Toxocara infection was estimated as 6.58% (95% confidence interval = 3.98-9.77). A wide variation between different studies was observed (Q statistic = 799.37, df = 26, P < 0.0001, and I2 = 96.7%). The seroprevalence rate of toxocariasis in the Iranian population is relatively high; contamination of the environment by eggs from the host as well as from household dogs and cats should be blamed.


Assuntos
Larva Migrans Visceral/epidemiologia , Larva Migrans Visceral/transmissão , Zoonoses/epidemiologia , Zoonoses/transmissão , Animais , Gatos , Cães , Humanos , Irã (Geográfico)/epidemiologia , Larva Migrans Visceral/parasitologia , Estudos Soroepidemiológicos , Toxocara/imunologia , Toxocara/isolamento & purificação , Toxocaríase/epidemiologia , Toxocaríase/parasitologia , Toxocaríase/transmissão , Zoonoses/parasitologia
5.
BMC Infect Dis ; 20(1): 736, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028232

RESUMO

BACKGROUND: Blood transfusion is associated with potential risks of transfusion-transmitted infections (TTIs). Different strategies are needed to monitor blood safety and screen the donors' efficacy, such as evaluation of the prevalence and trends of TTIs. This study was conducted to evaluate the prevalence and trends of TTIs, including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and human T-cell lymphotropic virus (HTLV 1/2), and the impact of the donors' characteristics such as age, sex, and donor status on the prevalence of TTIs in blood donors in seven large provinces of Iran from 2010 to 2018. METHODS: This study was conducted on the data collected from all blood donations in seven Iranian Blood Transfusion Centers including Ardabil, Alborz, Guilan, West Azarbaijan, North, Razavi, and South Khorasan from April 2010 to March 2018. Demographic characteristics, number of donations, donor status, and screening and confirmatory serological results of all blood donations were collected from Iranian Blood Transfusion Organizations (IBTO) national database. The prevalence and trend of HBV, HCV, HIV, and HTLV 1/2 infections were reported according to the donation year and donor's characteristics. RESULTS: The analysis of the prevalence and trend of TTIs in 3,622,860 blood donors showed a significant decreasing trend in first-time and regular donors. Additionally, compared to first- time donors, regular donors made safer blood donations with lower risks of HBV, HIV, HCV and HTLV 1/2 (P < 0.0001). Although the prevalence of HTLV 1/2 and HBV was higher in females, TTIs had a significant decreasing trend in males and females. Finally, it was found that the prevalence of HBV and HTLV 1/2 increased with age up to 40-49 years and then decreased thereafter. CONCLUSIONS: The decreasing trends of TTIs in Iranian donors during 9 years may indicate that the various strategies implemented by IBTO have been effective in recent years. Other factors such as a decrease in the prevalence of specific TTIs in the general population might have also contributed to these declines.


Assuntos
Segurança do Sangue , Infecções por HIV/diagnóstico , Infecções por HTLV-I/diagnóstico , Hepatite B/diagnóstico , Hepatite C/diagnóstico , Adolescente , Adulto , Doadores de Sangue/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Infecções por HTLV-I/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Reação Transfusional/diagnóstico , Reação Transfusional/epidemiologia , Reação Transfusional/virologia , Adulto Jovem
6.
Invest Educ Enferm ; 38(2)2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33047546

RESUMO

OBJECTIVES: To assess burnout level during an outbreak of COVID-19 and to identify influencing factors between frontline nurses and nurses from other wards. METHODS: This cross-sectional study makes comparison between two groups of nurses including frontline (exposure group) and other nurses working in usual wards (non-exposure group) in Torbat Heydariyeh city, Iran. Oldenburg Burnout Inventory (OLBI), Job stress questionnaire (JSQ), and questionnaires of hospital resources, family support, and measuring the fear of COVID-19 were used as research instruments. RESULTS: The scores of job stress and burnout in the exposure group with COVID-19 infection were significantly higher than in the non-exposure group (p=0.006 and p=0.002, respectively). Although, in univariate linear regression, employment status (p=0.047), experience in taking care of patient confirmed or suspected with COVID-19 infection (p=0.006), hospital resources (p=0.047), and job stress (p < 0.001) were considered as significant risk factors for COVID-19-related burnout. In multivariate regression analysis, job stress (p=0.031, ß=0.308) was considered as an only factor that has a significant relationship with COVID-19-related burnout. CONCLUSIONS: The burnout level in frontline nurses was higher than other nurses, the most important influencing factor was the job stress. Regarding to negative effects of burnout on both physical and mental health nurses, it is suggested that a strong strategy be considered to reduce nurses' burnout to be able to control ongoing and future outbreaks successfully.


Assuntos
Esgotamento Profissional/epidemiologia , Infecções por Coronavirus/epidemiologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Estresse Ocupacional/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Infecções por Coronavirus/terapia , Estudos Transversais , Surtos de Doenças , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/terapia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
7.
BMC Psychol ; 8(1): 99, 2020 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-32962764

RESUMO

BACKGROUND: Pregnancy as a sensitive period of a woman's life can be affected by various psychological factors that can have adverse effects on the woman, her fetus and future baby. Since COVID-19 is a new phenomenon with limited information available, it may have adverse psychological effects on pregnant women. Therefore, this study was conducted to determine the status of depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. METHODS: This descriptive-analytical cross-sectional study was performed on 205 pregnant women covered by Tabriz health centers in Iran. The sampling method used was cluster sampling. The data collection tool was the socio-demographic characteristics questionnaire and the DASS-21 (Depression, Anxiety and Stress Scale-21), which were completed online by pregnant women. The general linear model was used to determine the predictive factors of depression, anxiety and stress. RESULTS: The mean (SD) score of depression, stress, and anxiety were 3.91 (3.9), 6.22 (4.25), and 3.79 (3.39), respectively; the score range of 0 to 21. Depression, stress, and anxiety symptoms were observed in 32.7, 32.7, and 43.9% of the participants, respectively, with varying degrees from mild to very severe. Based on the adjusted general linear model, variables of education level, spouse's job and marital life satisfaction were the predictors of depressive symptoms. Variables of spouse's education level, spouse's support, marital life satisfaction and the number of pregnancies were the predictive factors of anxiety symptoms and the variables of spouse's education level, household income sufficiency, spouse's support and marital life satisfaction were predictors of stress symptoms. CONCLUSIONS: Considering the role of marital life satisfaction, high level of spouse's education and income in reducing symptoms of stress, anxiety, and depression in pregnant women in critical situations such as the prevalence of COVID-19, it seems that using strategies to promote marital life satisfaction and socio-economic status can play an effective role in controlling anxiety and reducing stress and depression in pregnant women.


Assuntos
Ansiedade , Infecções por Coronavirus , Depressão , Casamento , Pandemias , Pneumonia Viral , Complicações na Gravidez , Estresse Psicológico , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/prevenção & controle , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/prevenção & controle , Complicações na Gravidez/psicologia , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Fatores Socioeconômicos , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estresse Psicológico/prevenção & controle
8.
Tohoku J Exp Med ; 252(1): 73-84, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32908083

RESUMO

The Coronavirus Disease 2019 (COVID-19) pandemic has killed many people worldwide since December 2019, and Iran has been among the most affected countries. In this retrospective study, we aimed to determine the prognostic factors associated with mortality in COVID-19 patients by analyzing 396 survived and 63 non-survived patients in Shahid Modarres Hospital, Tehran, Iran, from January 30th until April 5th, 2020. As the results, the BMI > 35 (p = 0.0003), lung cancer (p = 0.007), chronic kidney disease (p = 0.002), Immunocompromised condition (p = 0.003), and diabetes (p = 0.018) were more frequently observed in the expired group. The history of statins use was more common in the discharged group (p = 0.002), while there was no significant difference in the drug history of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, nonsteroidal anti-inflammatory drugs, aspirin, and/or steroids, and in the past-year influenza vaccination. Multivariable regression demonstrated rising odds of in-hospital death related with age (odds ratio (OR) = 1.055, p = 0.002), levels of C-reactive protein (CRP) (OR = 2.915, p < 0.001), creatinine (OR = 1.740, p = 0.023), lymphocyte count (OR = 0.999, p = 0.008), and magnesium level (OR = 0.032, p < 0.001) on admission. In conclusion, the patients with older age and higher BMI with lymphopenia, hypomagnesemia, elevated CRP and/or raised creatinine on admission are at higher risk of mortality due to the COVID-19 infection, which requires the physicians to use timely and strong therapeutic measures for such patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Pandemias , Pneumonia Viral/mortalidade , Fatores Etários , Idoso , Doenças Cardiovasculares/epidemiologia , Comorbidade , Infecções por Coronavirus/sangue , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Inflamação/epidemiologia , Pacientes Internados/estatística & dados numéricos , Irã (Geográfico)/epidemiologia , Nefropatias/epidemiologia , Linfopenia/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Razão de Chances , Sobrepeso/epidemiologia , Pneumonia Viral/sangue , Prognóstico , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Avaliação de Sintomas
10.
Iran J Kidney Dis ; 14(5): 389-398, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32943594

RESUMO

INTRODUCTION: Seven months after the emergence of SARS-COV-2 virus, there is paucity of data regarding the epidemiology of the virus in hemodialysis patients. We aim to present the results of the screening program implied after outbreak of COVID-19 in a referral hemodialysis ward. METHODS: We started clinical screening and obligatory mask wearing for dialysis patients and personnel on 20-Feb-2020. However 11 symptomatic COVID-19 patients emerged till day +36. On days +39 and +40 a screening program was implied including measurement of SARS-COV-2 PCR and immunoglobulin G and M (IgG/IgM) and chest computerized tomography (CCT) scan. The results of CCT scan, classified according to the coronavirus disease 2019 (COVID-19) Reporting and Data System (CO-RADS) classification; as with very low (grade 1-normal), low, indeterminate, high, and very high likelihood of COVID-19 (grades 2, 3, 4, and 5; respectively), were used for compartmentalization of patients. RESULTS: Among 178 patients (68.2% male, mean age = 58.7 ± 16.6 years), 11 got COVID-19 before screening, two of whom died. CCT scans were normal in 71.3% and grade 2, 3, 4, and 5 in 7.9%, 4.5%, 5.6%, and 10.7%; respectively. PCR and IgG and/or IgM were positive in 27 and 32 patients. Eighty-three patients had evidence of COVID-19 infection, who were significantly older (62.2 ± 16.6 vs. 56.1 ± 16.02, P < .05). There was no difference in the rate of infection considering gender, diabetes mellitus, hypertension and different blood groups. CONCLUSION: Asymptomatic SARS- COV 2 infection may affect a large number of dialysis patients. We highly recommend a screening strategy whenever the number of patients is increasing.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde , Unidades Hospitalares de Hemodiálise , Falência Renal Crônica/terapia , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/imunologia , Betacoronavirus/genética , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/imunologia , Feminino , Humanos , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Incidência , Irã (Geográfico)/epidemiologia , Falência Renal Crônica/complicações , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/imunologia , Diálise Renal , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tomografia Computadorizada por Raios X , Adulto Jovem
11.
Arch Iran Med ; 23(8): 557-560, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32894968

RESUMO

Reducing maternal mortality is one of the Sustainable Development Goals. Although there is no vigorous evidence that pregnant women are in the high-risk groups in response to coronavirus disease 2019 (COVID-19), it is crucial to respond to the pandemic through providing required action plans for confirmed or suspected pregnant women cases while maintaining routine functions. Iran's response and preparedness measures to COVID-19 aimed to meet the essential needs required to protect pregnant women and their families. Establishing a national maternal health network, relying on mechanisms for timely reporting, monitoring, and following-up, preparing guidelines and protocols required for COVID-19 management in pregnant women though a multidisciplinary team working approach, and embedding the precautions of reducing transmission in maternity care were the main measures taken to cope with COVID-19 in pregnancy. Iran's experience in providing maternity care during the COVID-19 can guide other countries affected by COVID-19. However, it should be adapted to local health-care facilities, as well as in response to any further updates on COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Serviços de Saúde Materna/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Gravidez
13.
Arch Iran Med ; 23(8): 578-581, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32894975

RESUMO

In the past two centuries, several fatal infectious outbreaks have arisen in Iran. Presented here is a brief historical account of four fatal epidemics including cholera, plague, Spanish influenza of 1918 and smallpox between1796 and 1979. The lessons from these outbreaks could be helpful for better combatting other deadly epidemics including the present-day disastrous COVID-19 pandemic.


Assuntos
Cólera/história , Controle de Doenças Transmissíveis/história , Epidemias/história , Influenza Pandêmica, 1918-1919/história , Peste/história , Varíola/história , Cólera/epidemiologia , Cólera/prevenção & controle , Epidemias/prevenção & controle , História do Século XIX , História do Século XX , Humanos , Irã (Geográfico)/epidemiologia , Peste/epidemiologia , Peste/prevenção & controle , Varíola/epidemiologia , Varíola/prevenção & controle
14.
Arch Iran Med ; 23(9): 629-632, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32979911

RESUMO

BACKGROUND: The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic broke out in December 2019 and is now characterized as a pandemic. Effective control of this infectious disease requires access to diagnostic techniques, for both case finding and epidemic size estimation. The molecular technique is routinely used worldwide. Although it is the "standard" case detection and management method, it has its own shortcomings. Thus, some easy-to-use rapid serological tests have been developed. METHODS: One hundred and fourteen positive RT-PCR-diagnosed patients were tested by VivaDiag Kit, a brand of rapid serological kits available in hospitals affiliated to Tehran University of Medical Sciences (TUMS), Tehran, Iran. Frozen serum specimens taken from healthy people in summer and fall 2019 were also tested as negative controls. RESULTS: Test sensitivity was 47.9% (95% confidence interval [CI]: 38.8-56.9) for IgM and 47.0% (95% CI: 38.0-56.0) for IgG. There was no difference between IgG and IgM seropositivity except in one case. Specificity was calculated as 99.0% (95% CI: 96.4-99.9) for IgM and of 100.0% (95% CI: 0.98.2-100.0) for IgG. Sensitivity was higher in men and older participants. CONCLUSION: This test can be used for epidemiological investigations, especially for the estimation of the level of infection in the community, after it is properly corrected for sensitivity and specificity. The low sensitivity could be attributed to the technical limitations of the kit or low levels of antibodies after infection. The different sensitivity in age and sex groups supports the hypothesis that different people show different immune responses to this virus.


Assuntos
Anticorpos Antivirais/análise , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Testes Sorológicos/métodos , Adulto , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Pandemias , Pneumonia Viral/epidemiologia
17.
BMC Infect Dis ; 20(1): 710, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993524

RESUMO

BACKGROUND: Since pneumonia caused by coronavirus disease 2019 (COVID-19) broke out in Wuhan, Hubei province, China, tremendous infected cases has risen all over the world attributed to its high transmissibility. We aimed to mathematically forecast the inflection point (IFP) of new cases in South Korea, Italy, and Iran, utilizing the transcendental model from China. METHODS: Data from reports released by the National Health Commission of the People's Republic of China (Dec 31, 2019 to Mar 5, 2020) and the World Health Organization (Jan 20, 2020 to Mar 5, 2020) were extracted as the training set and the data from Mar 6 to 9 as the validation set. New close contacts, newly confirmed cases, cumulative confirmed cases, non-severe cases, severe cases, critical cases, cured cases, and death were collected and analyzed. We analyzed the data above through the State Transition Matrix model. RESULTS: The optimistic scenario (non-Hubei model, daily increment rate of - 3.87%), the cautiously optimistic scenario (Hubei model, daily increment rate of - 2.20%), and the relatively pessimistic scenario (adjustment, daily increment rate of - 1.50%) were inferred and modeling from data in China. The IFP of time in South Korea would be Mar 6 to 12, Italy Mar 10 to 24, and Iran Mar 10 to 24. The numbers of cumulative confirmed patients will reach approximately 20 k in South Korea, 209 k in Italy, and 226 k in Iran under fitting scenarios, respectively. However, with the adoption of different diagnosis criteria, the variation of new cases could impose various influences in the predictive model. If that happens, the IFP of increment will be earlier than predicted above. CONCLUSION: The end of the pandemic is still inapproachable, and the number of confirmed cases is still escalating. With the augment of data, the world epidemic trend could be further predicted, and it is imperative to consummate the assignment of global medical resources to curb the development of COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Modelos Teóricos , Pneumonia Viral/epidemiologia , China/epidemiologia , Infecções por Coronavirus/virologia , Previsões/métodos , Humanos , Irã (Geográfico)/epidemiologia , Itália/epidemiologia , Pandemias , Pneumonia Viral/virologia , Prognóstico , República da Coreia/epidemiologia
18.
PLoS One ; 15(9): e0238398, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870922

RESUMO

OBJECTIVES: Pertussis remains endemic despite high vaccine coverage in infants and toddlers. Pertussis vaccines confer protection but immunity wanes overtime and boosters are needed in a lifetime. Iran, eligible for the Expanded Program on Immunization that includes the primary immunization, implemented two additional booster doses using a whole-cell vaccine (wPV) at 18 months-old and about 6 years-old. Duration of protection induced by the wPVs currently in use and their impact as pre-school booster are not well documented. This study aimed at assessing vaccination compliance and at estimating the duration of protection conferred by vaccination with wPV in children aged < 15 years in Tehran, Iran. METHODS: Detailed information on vaccination history and capillary blood samples were obtained from 1047 children aged 3-15 years who completed the 3 doses-primary pertussis immunization, in Tehran. Anti-pertussis toxin IgG levels were quantified by ELISA. RESULTS: Compliance was very high with 93.3% of children who received the three primary and 1st booster doses in a timely manner. Timeliness of the 2nd booster was lower (63.3%). Rate of seropositive samples continuously and significantly increased from 1-2 to 5-6 years after 1st booster attaining 30.4% of children exhibiting serological sign of recent contact with B. pertussis. Second booster dating back 1 or 2 years was associated with high antibody titers, which significantly decreased within 3 years from injection. Among children who received 2nd booster injection more than 2 years before serum analysis, seroprevalence of pertussis infection was 8.4% and seropositivity rate was higher from the 10 years-old group. CONCLUSION: Seropositivity in children aged 6-7 years with no 2nd booster supports the need for a vaccination at that age. Adolescent booster may also be considered.


Assuntos
Coqueluche/epidemiologia , Adolescente , Fatores Etários , Anticorpos Antibacterianos/sangue , Bordetella pertussis/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Esquemas de Imunização , Imunização Secundária , Imunoglobulina G/sangue , Irã (Geográfico)/epidemiologia , Masculino , Vacina contra Coqueluche/administração & dosagem , Estudos Soroepidemiológicos , Coqueluche/imunologia , Coqueluche/prevenção & controle
19.
Arch Virol ; 165(11): 2555-2560, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32880019

RESUMO

Since the first official report of the spread of SARS-CoV-2 infections in the city of Qom in mid-February, Iran has become the country most affected by the COVID-19 epidemic in the Middle East. All Iranian provinces are now affected, although to a different extent. The aim of the present study was to evaluate whether the distance from the epicenter of the infection (Qom) or demographic factors such as population density and the ratio of the elderly population are associated with the incidence of COVID-19 in different Iranian provinces. For the purpose of determining whether the distance from the virus epicenter could be associated with the spread of infection, linear regression analysis was performed using STATA 12.0 software. The association of the incidence of COVID-19 with the population density and the ratio of the population over 65 years old in 31 Iranian provinces was also evaluated. According to our results, a strong association was found between the incidence of COVID-19 in Iranian provinces and their respective distance from Qom (p < 0.001; C = -0.68). The incidence of COVID-19 in Iranian provinces was also positively associated with the ratio of the population over 65 years old (p = 0.002; C = 0.53), while no significant association with population density was found (p = 0.39; C = 0.16). These results suggest that the implementation of travel restrictions from highly affected areas to other provinces could considerably reduce the rate of transmission of the disease throughout the country. Also, provinces with a higher proportion of elderly people (over 65) were identified as particularly at risk for the spread of SARS-CoV-2 infections. These results will contribute to better management of the COVID-19 outbreak in Iran, taking into account demographic and geographic characteristics of different provinces.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Geografia , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Densidade Demográfica , Viagem
20.
Acta Biomed ; 91(3): e2020007, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921705

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) outbreak is a global and challenging disease that is accompany with mortality and morbidity. AIM OF STUDY: We evaluated the prevalence and the impact of comorbidities in thalassemia Iranian patients affected by COVID-19.  Methods: A multicenter, retrospective, cross-sectional study was conducted across all comprehensive thalassemia centers in Iran, from January to June 15th, 2020. RESULTS: Forty-three confirmed COVID-19 thalassemia patients (32 TDT, and 11 NTDT) were detected. The mean age of patients was 35.3 ± 11.5 years (range 9 - 67); 21 females and 22 males. Overall, 78.1% of TDT and 90.9% of NTDT patients were complicated with at least one comorbidity (P: 0.656). The overall mortality rate of thalassemia patients with COVID-19 was 18.6% while 27.3% was in NTDT patients compared to 15.6% in TDT patients (P:0.401). The dead group had a non-significant higher frequency of endocrinopathies compared to the recovered group (62.5% versus 45.7% P:0.457). Ten female thalassemia patients with positive COVID-19 had hypogonadism, six patients were receiving hormone replacement therapy and all of them recovered (zero death) compared to two deaths from 4 patients who were not receiving hormone replacement therapy (P:0.133). Furthermore, the prevalence of COVID-19 in NTDT patients was significantly higher than the general population (45 per 10,000 versus 22.29 per 10,000 respectively, P:0.018) while the prevalence of TDT was almost similar to the normal population (P:0.539). The mortality rate of COVID-19 was 4.71% in the normal Iranian population compared to 18.6% in ß-thalassemias (P: <0.001) at the same date. CONCLUSIONS: It is important to acknowledge that ß-thalassemia patients, especially young adults/adults, have a chronic condition which may contribute to increase susceptibility to SARS-CoV-2 infection. A higher susceptibility to the infection was observed in patients with NTDT and in untreated hypogonadal female thalassemic patients. However, to confirm these data, more accurate designed studies are needed.


Assuntos
Betacoronavirus , Transfusão de Sangue , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Pneumonia Viral/epidemiologia , Vigilância da População , Talassemia beta/epidemiologia , Adolescente , Adulto , Idoso , Criança , Comorbidade , Infecções por Coronavirus/transmissão , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/transmissão , Prevalência , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Adulto Jovem , Talassemia beta/terapia
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