Clinical Characteristics and Outcomes of COVID-19 in Children in Northern Iran

Objective. Since December 2019, the coronavirus disease 2019 (COVID-19) has been spread rapidly all over the world, infecting all age groups with this novel virus. In this manuscript, we report characteristics of children with COVID-19 in Mazandaran province, northern Iran. Method. From 12 February to 28 July 2020, medical records of 100 children diagnosed with COVID-19 admitted to the hospitals of Mazandaran province were collected. Patients’ age, gender, clinical symptoms, and signs, in addition to therapeutic management and outcomes, were reported. Results. 57 (57%) boys and 43 girls with the mean age of 104.63 ± 79.14 months were evaluated. 20 patients (20%) were transferred to the PICU (pediatric intensive care unit), and 13 children experienced a severe form of the disease, pediatric inflammatory multisystem syndrome (PIMS). The mean duration of hospitalization was 5.3 ± 4.7 days. Fever (81%), respiratory (79%), gastrointestinal (47%), and neurologic complaints (29%) were experienced by the patients in addition to skin rash (14%). Sixty-two patients needed supplemental oxygen, and 6 of them underwent endotracheal intubation. Leukopenia was reported in 7, anemia in 24, and thrombocytopenia in 12 patients. 4 patients with underlying diseases including chronic renal failure, Down syndrome with cerebral palsy, and morbid obesity died. Conclusion. COVID-19 can cause symptoms in children in two stages. In the first week, upper and lower respiratory symptoms can occur which has lower severity and prevalence compared to adults. But after 2-3 weeks following infection, symptoms of MIS-C or multisystem involvement can occur and COVID-19 should be considered. The most common indication for admission is fever, rash, and respiratory problems.

Download Full-text

Demographic and Clinical Characteristics of Early Travel-Associated COVID-19 Cases

Frontiers in Public Health ◽

10.3389/fpubh.2020.573925 ◽

2020 ◽

Vol 8 ◽

Author(s):

Reham M. Marei ◽

Mohamed M. Emara ◽

Omar M. Elsaied ◽

Gheyath K. Nasrallah ◽

Tawanda Chivese ◽

...

Keyword(s):

Clinical Data ◽

Clinical Symptoms ◽

Age Groups ◽

The Elderly ◽

World Health ◽

Female Ratio ◽

Younger Age ◽

The Mean ◽

Health Organization ◽

Male To Female

Background: SARS-CoV-2 continues to claim hundreds of thousands of people's lives. It mostly affects the elderly and those with chronic illness but can also be fatal in younger age groups. This article is the first comprehensive analysis of the epidemiological and clinical outcomes of the travel-associated SARS-CoV-2 cases until April 19, 2020.Methods: Demographic and clinical data of travel-associated SARS-CoV-2 cases were collected for the period between January 16, 2020 and April 19, 2020. More than one hundred and eighty databases were searched, including the World Health Organization (WHO) database, countries' ministries websites, and official media sites. Demographic and clinical data were extracted and analyzed.Results: A total of 1,186 cases from 144 countries meeting the inclusion criteria were reported and included in the analysis. The mean age of the cases was 44 years, with a male to female ratio of 1.6:1. Travel-associated cases originated from more than 40 countries, with China, Italy, and Iran reporting the highest numbers at 208, 225, and 155, respectively. Clinical symptoms varied between patients, with some reporting symptoms during the flights (117 cases; 9.87%). A total of 312 (26.31%) cases were hospitalized, of which 50 cases (4.22%) were fatal.Conclusion: Major gaps exist in the epidemiology and clinical spectrum of the COVID-19 travel-associated cases due to a lack of reporting and sharing data of many counties. The identification and implementation of methodologies for measuring traveler's risk to coronavirus would help in minimizing the spread of the virus, especially in the next waves.

Download Full-text

Clinical and CT scan findings in patients with COVID-19 pneumonia: A comparison based on disease severity

10.21203/rs.3.rs-476408/v1 ◽

2021 ◽

Author(s):

Sonia Hesam-Shariati ◽

Susan Mohammadi ◽

Morteza Abouzaripour ◽

Behzad Mohsenpour ◽

Bushra Zareie ◽

...

Keyword(s):

Ct Scan ◽

Disease Severity ◽

Clinical Laboratory ◽

Clinical Symptoms ◽

White Blood Cells ◽

Severe Pneumonia ◽

Duration Of Hospitalization ◽

The Mean ◽

Severity Of The Disease ◽

Interlobular Septal Thickening

Abstract Background The SARS-CoV-2 can cause severe pneumonia and highly impact general health. We aimed to investigate different clinical features and CT scan findings of patients with COVID-19 based on disease severity to have a better understanding of this disease. Methods 90 patients with coronavirus were divided into three categories based on the severity of the disease: mild/moderate, severe, and very severe. Clinical, laboratory and CT scan findings of the patients were examined retrospectively. Any association between these features and disease severity were assessed. Results The mean age and duration of hospitalization of patients increased with increasing the severity of disease. The most common clinical symptoms were shortness of breath, cough, and fever. As the severity of the disease increased from mild/moderate to very severe, there was an increase in neutrophile counts and a decrease in lymphocytes and white blood cells (WBC) showing excessive inflammation associated with severe forms of COVID-19. Subpleural changes (81%) and ground-glass opacification/opacity (GGO) lesions (73%) of the lung were the most common features among CT images of COVID-19 patients, and interlobular septal thickening (10%) was the lowest CT feature among patients. Regarding the affected parts of the lung in COVID-19 patients, bilaterial, peripheral and multiple lesions had the highest prevalence. Conclusions It has been shown that clinical, laboratory and CT scan findings varied in COVID-19 patients based on disease severity, which need to be considered carefully in timely diagnosis and treatment of this illness.

Download Full-text

Geospatial analysis and epidemiological aspects of human infections with Blastocystis hominis in Mazandaran Province, northern Iran

Epidemiology and Health ◽

10.4178/epih.e2019009 ◽

2019 ◽

Vol 41 ◽

pp. e2019009 ◽

Cited By ~ 3

Author(s):

Shabnam Asfaram ◽

Ahmad Daryani ◽

Shahabeddin Sarvi ◽

Abdol Sattar Pagheh ◽

Seyed Abdollah Hosseini ◽

...

Keyword(s):

High Risk ◽

Infection Rate ◽

Demographic Data ◽

Spatial Association ◽

Age Groups ◽

Blastocystis Hominis ◽

Mazandaran Province ◽

Intestinal Protozoan ◽

Northern Iran ◽

The North

OBJECTIVES: Blastocystis hominis is a very common large intestinal protozoan with global prevalence in humans and non-human hosts. No precise statistics exist regarding the geographical distribution of Blastocystis that would enable the identification of high-risk communities. Therefore, the current research aimed to characterize the spatial patterns and demographic factors associated with B. hominis occurrence in northern Iran.METHODS: The current study was performed among 4,788 individuals referred to health centers in Mazandaran Province, from whom stool samples were obtained. Socio-demographic data were gathered using a questionnaire. Samples were examined by a direct wet mount, the formalin-ethyl acetate concentration technique, and trichrome staining. Moran local indicators of spatial association and a geographically weighted regression model were utilized to analyze the results.RESULTS: Generally, the infection rate of Blastocystis parasites was 5.2%, and was considerably higher in the age group of 10-14 years (10.6%) than in other age groups (p=0.005). Our data showed important associations between the occurrence of B. hominis and age, residence, job, contact with domestic animals, anti-parasitic drug consumption, and elevation above sea level (p<0.001).CONCLUSIONS: The current study characterized for the first time the infection rate and risk of B. hominis in the north of Iran, and produced a prediction map. It is expected that this map will help policymakers to plan and implement preventive measures in high-risk areas and to manage already-infected patients.

Download Full-text

Demographic and clinical characteristics of severe Covid-19 infections: a cross-sectional study from Mashhad University of Medical Sciences, Iran

BMC Infectious Diseases ◽

10.1186/s12879-021-06363-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ladan Goshayeshi ◽

Mina Akbari Rad ◽

Robert Bergquist ◽

Abolghasem Allahyari ◽

Kamila Hashemzadeh ◽

...

Keyword(s):

Clinical Characteristics ◽

Clinical Symptoms ◽

Age Groups ◽

Multivariate Logistic Regression Analysis ◽

Cross Sectional Study ◽

Cardiovascular Disorders ◽

Medical Sciences ◽

Cross Sectional ◽

Duration Of Hospitalization ◽

Polymerase Chain

Abstract Background Coronavirus Disease 2019 (Covid-19) is expanding worldwide. The characteristics of this infection in patients varies from country to country. To move forward, clinical data on infected patients are needed. Here, we report a comparison between fatalities and recovery of patients with severe Covid-19, based on demographic and clinical characteristics. Methods Between 5 March and 12 May 2020 in Mashhad, Iran, 1278 of 4000 suspected Covid-19 patients were confirmed positive by real-time reverse-transcriptase–polymerase-chain-reaction assay of upper respiratory specimens. We compared the demographic, exposure history and clinical symptoms of 925 survivors and 353 fatal cases with confirmed disease. Results Mean (SD) age for all confirmed patients was 56.9 (18.7) years, 67.1 (15.9) years in fatal cases and 53.0 (18.3) years in survivors. Multivariate logistic regression analysis showed that the outcome of patients was associated with age (odds ratio = 1.049, P = 0.0001, 95% CI = 1.040–1.057). Despite a high burden of Covid-19 infections in the 30–39 and 40–49 year age groups, most of these (89.6 and 87.2%, respectively) recovered. The median (IQR) duration of hospitalization was 9.0 (6.0–14.0) days. The most prevalent co-morbidities were cardiovascular disorders (21%) and diabetes (16.3%). Dyspnoea (72.7%), cough (68.1%) and fever (63.8%) were the most frequent clinical symptoms. Healthcare workers, of whom two (3%) died, comprised 5.2% of infected cases. Combination antiviral and antibiotic therapy was used in 43.0% of cases. Conclusions The characteristics of severe Covid-19 varied substantially between fatal cases and survivors, with diabetes and cardiovascular disorders the most prevalent co-morbidities. In contrast to other studies, there were a higher number of fatalities in younger patients in our setting.

Download Full-text

Evaluation of the Relationship between Malaria Infection and Significant Spread of Electrolyte Variation in Patients: Within and Outside Limit Analytic Model.

10.21203/rs.3.rs-32061/v1 ◽

2020 ◽

Author(s):

James A. Ndako ◽

Charles E. Okolie ◽

Victor T. Dojumo ◽

Victor O. Fajobi ◽

Jeremiah A. Akinwumi

Keyword(s):

Malaria Infection ◽

Clinical Symptoms ◽

Standard Procedure ◽

Age Groups ◽

Electrolyte Imbalance ◽

Normal Limits ◽

Blood Smears ◽

The Mean ◽

And Gender ◽

The Relationship

Abstract Background: Malaria is one of the most common diseased conditions across most developing countries caused by one of four species of Plasmodium. Electrolyte imbalance and mineral disturbances are majorly identified clinical symptoms in various infectious diseases including malaria. Malaria infection has also been shown to be associated with abnormalities in fluids, electrolytes and acid base balances which are capable of enhancing disease severity. The aim of this study was to investigate the effects of malaria infection on electrolytes parameters. Methods: Finger prick blood samples were collected from Two-Hundred (200) malaria-suspected subjects representing all age groups and gender. The Giemsa-stained blood smears were carefully examined according to standard procedure. Demographic information was obtained using structured questionnaires. Results: Pearson's Correlation Coefficient technique was used to investigate the relationship, and the strength of association between the variables. The mean bound of patients’ sodium level was observed to fall within the specified normal limits of 125mmol/L – 145mmol/L; except for positive malaria patients belonging to the MP-(++) which will fall below the 125mmol/L (i.e. 126.25mmol/L – 1.77mmol/L = 124.48mmol/L). Conclusion: In our study we found that Plasmodium falciparum showed more alteration in electrolytes parameters than Plasmodium vivax. This study discovered a significant linear relationship based on the Pearson product-moment correlation between creatinine and urea, potassium and chloride, potassium and creatinine, potassium and urea. The mean sodium and chloride level of positive malaria [MP-(++)] patients were observed to fall outside the normal limit.

Download Full-text

Morphological and molecular identification of four isolates of the entomopathogenic fungal genus Akanthomyces and their effects against Bemisia tabaci on cucumber

Bulletin of Entomological Research ◽

10.1017/s0007485321000298 ◽

2021 ◽

pp. 1-9

Author(s):

Fereshteh Broumandnia ◽

Ali Rajabpour ◽

Mohamad Hamed Ghodoum Parizipour ◽

Fatemeh Yarahmadi

Keyword(s):

Bemisia Tabaci ◽

Biological Control Agent ◽

Aphis Gossypii ◽

Microbial Control ◽

Control Agent ◽

High Rate ◽

Limited Information ◽

Mazandaran Province ◽

Northern Iran ◽

The Mean

Abstract The cotton whitefly, Bemisia tabaci Gen. (Hem., Aleyrodidae), is a key pest of many vegetables. Entomopathogenic fungi are promising microbial control agents against B. tabaci, but limited information is available concerning indigenous Iranian isolates. In this study, three isolates of Akanthomyces lecanii (PAL6, PAL7, and PAL8) and one isolate of A. muscarius (AGM5) were obtained from citrus hemipteran pests, Pulvinaria aurantii Cock. and Aphis gossypii Glover, in Mazandaran province, northern Iran. The isolates were then morphologically and molecularly identified. The efficacies of five different agar media for vegetative growth and conidiation of each isolate were determined. Potato dextrose agar was the medium on which the fungal mycelia developed at a relatively high rate. However, the highest rate of conidiation was found on Sabouraud dextrose agar. To determine the effects of the isolates on B. tabaci, a dose–response bioassay was carried out to estimate lethal concentration (LC50) and lethal time (LT50) values of each fungal isolate to second instar nymphs. The mean LC50 values of A. lecanii isolates ranged from 4.22 × 106 to 7.35 × 1013 conidia ml−1 at 5 to 7 days after the treatment. For A. muscarius, the values varied from 9.2 × 104 to 8.7 × 1010 conidia ml−1 at 5 to 7 days after the treatment. The lowest and the highest mean LC50 values were observed for A. mucarius (AGM5) and A. lecanii (isolate PAL6), respectively. The mean LT50 values of A. lecanii and A. muscarius isolates were 7.1–9.0 and 4.9–7.2 days, respectively. The LT50 values of A. muscarius were significantly lower than the other isolates. Overall, all isolates, especially A. muscarius (AGM5), exhibited appropriate potential as a biological control agent against B. tabaci.

Download Full-text

Relationship Between Prevalence of Malaria Infection and Significant Spread of Electrolyte Variation in Malaria Patients: Within and Outside Limit Analysis

10.20944/preprints202004.0261.v1 ◽

2020 ◽

Author(s):

James A. Ndako ◽

Charles E. Okolie ◽

Victor T. Dojumo ◽

Victor O. Fajobi ◽

Jeremiah A. Akinwumi ◽

...

Keyword(s):

Clinical Symptoms ◽

Age Groups ◽

Electrolyte Imbalance ◽

Correlation Technique ◽

Malarial Infection ◽

Normal Limits ◽

Standard Procedures ◽

Blood Smears ◽

Coefficient Corrélation ◽

The Mean

Background: Malaria is one of the most common diseased conditions across most developing countries caused by one of four species of Plasmodium. P. falciparum and P.vivax are the main agents responsible for malaria in Nigeria. Malarial infection has been shown to be associated with abnormalities in fluids, electrolytes and acid base balances. Electrolyte imbalance and mineral disturbances are majorly identified clinical symptoms in various infectious diseases including malaria. Electrolyte imbalance in malarial infection is capable of enhancing disease severity. The aim of this study was to investigate the effects of malarial infection on electrolytes parameters. Methods: Finger prick blood samples, Thick and Thin Giemsa-stained blood smears, were collected from 100 malaria-suspected individuals representing all age groups. The Giemsa-stained blood smears were examined microscopically. Demographic information was obtained using structured questionnaires. The electrolytes levels (Na, K, Cl- and HCO3-) in malarial patients were analyzed using standard procedures, Pearson's Correlation Coefficient correlation technique was used to investigate the relationship, and the strength of association between the variables. Results: The mean bound of patients’ sodium level was observed to fall within the specified normal limits of 125mmol/L – 145mmol/L; except for positive malaria patients belonging to the MP-(++) which will fall below the 125mmol/L (i.e. 126.25mmol/L – 1.77mmol/L = 124.48mmol/L). The spread of the sodium data taken from the patients were observed to fall within the normal limits leaving only the boxplot’s lower whisker out, that is, observations falling within the first quartile, except for MP-(++) patients with observations in the first to second quartile spreading outside the normal lower limit, in contrast for the negative tested patients, the box and its whiskers were almost engulfed within the normal limits. Conclusion: In our study we found that Plasmodium falciparum altered more in electrolytes parameters than Plasmodium vivax. The biochemical markers can be used as biomarkers to confirmation of malaria. This study discovered a significant linear relationship based on the Pearson product-moment correlation between creatinine and urea, potassium and chloride, potassium and creatinine, potassium and urea. The mean sodium and chloride level of positive malaria [MP-(++)] patients were observed to fall outside the normal limit.

Download Full-text

The mixed AII and BIII genotypes of human Giardia lamblia isolates circulating in Mazandaran Province, northern Iran

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666200127155118 ◽

2020 ◽

Vol 20 ◽

Author(s):

Elham Kialashaki ◽

Mahdi Fakhar ◽

Mehdi Sharif ◽

Ahmad Daryani ◽

Reza Saberi

Keyword(s):

Abdominal Pain ◽

Giardia Lamblia ◽

Clinical Symptoms ◽

Statistical Tests ◽

Health Centers ◽

Mazandaran Province ◽

Northern Iran ◽

High Prevalence ◽

Pcr Rflp ◽

Stool Samples

Objectives: Giardiasis is one of the human parasitic diseases by a flagellate protozoan named Giardia lamblia. This parasite is one of the most common organisms causing diarrhea in human and a common gastrointestinal parasite in vertebrates. The purpose of this investigation was to determine the molecular epidemiology of Giardia lamblia (G.lamblia) by PCR-RFLP method in the Mazandaran Province and to investigate possible relationship between parasite genotype and clinical symptoms. Methods: In this study, 50 stool samples were collected from human cases of G. lamblia. referred to health centers in Sari, Babol, Nowshahr cities. The samples were examined by formalin-ether concentration procedure. DNA extraction was carried out on samples containing adequate Giardia cysts, and then PCR-RFLP was done on glutamate dehydrogenase (gdh) marker. Results: In these patients, the most common signs were abdominal pain (42.9%), diarrhea (47.6%) and least marked common signs was malaise (4.7%). Of all 21 isolates, 9 samples (42.8%) were found as genotype mixed AII and BIII, 6 samples (28.6%) belonged to genotype BIII and 6 ones (28.6%) were genotype AII. Additionally, there was a significant correlation between AII genotype and clinical symptoms (P <0.05). According to the statistical tests there was a significant relation between abdominal pain and intensity of infection (P<0.05). Conclusion: However, genotype AII and mixed AII and BIII genotypes were more common respectively. The relatively high prevalence of mixed infection of these genotypes indicated the potential of zoonotic source of giardiasis among patients in Mazandaran Province.

Download Full-text

Laboratory Abnormalities in Patients with COVID-19 in Mazandaran Province, Iran

Iranian Red Crescent Medical Journal ◽

10.5812/ircmj.106510 ◽

2020 ◽

Vol 22 (7) ◽

Author(s):

Reza Alizadeh-Navaei ◽

Majid Saeedi ◽

Reza Valadan ◽

Fatemeh Roozbeh ◽

Omolbanin Amjadi ◽

...

Keyword(s):

Clinical Symptoms ◽

Rna Virus ◽

Laboratory Data ◽

Age Groups ◽

Laboratory Diagnosis ◽

Cross Sectional Study ◽

Clinical Findings ◽

Mazandaran Province ◽

Cross Sectional ◽

Significance Level

Background: Coronavirus is a single-stranded RNA virus, causing an epidemic of pneumonia and acute respiratory distress syndrome (ARDS) worldwide in late 2019. Objectives: In addition to the clinical symptoms, laboratory diagnosis can greatly help diagnose the diseases; therefore, this study aimed to analyze laboratory parameters in patients with COVID-19. Methods: In this cross-sectional study, the laboratory data of 2563 patients with COVID-19 admitted to hospitals affiliated with Mazandaran University of Medical Sciences were extracted from hospital information systems (HIS). The data were recorded on Excel and analyzed through t-test, chi-squared, and Fisher’s exact tests in SPSS 19 at the significance level of P < 0.05. Results: Out of 2563 patients with a mean age of 55.1 ± 16.7 years, 1409 (55%) were male, and 1154 (45%) were female with a mean age of 55.7 ± 16.8, and 54.3 ± 16.6 years, respectively. As the most frequent clinical findings, ESR, CRP, and LDH were increased by 83.5%, 71%, and 69.3% of the patients, respectively. Other research findings included lymphopenia, disturbed INR, abnormal SGOT, abnormal alkaline phosphatase (ALP), and increased lactate dehydrogenase (LDH), which were significantly higher in men than in women and was different between age groups. Conclusions: Conducting simple, convenient, and inexpensive laboratory tests can be helpful in the diagnosis of COVID-19.

Download Full-text

Clinical significance of genetic diversity of hepatitis A virus

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.17816/eid40806 ◽

2014 ◽

Vol 19 (4) ◽

pp. 12-17

Author(s):

V. P Chulanov ◽

I. V Karandashova ◽

N. N Pimenov ◽

V. P Molochniy ◽

G. S Tomilka ◽

...

Keyword(s):

Hepatitis A ◽

Hepatitis A Virus ◽

Clinical Symptoms ◽

Age Groups ◽

Direct Bilirubin ◽

Duration Of Hospitalization ◽

The Republic ◽

Biochemical Indices ◽

Alt Activity

Aim: to identify features of the clinical course of hepatitis A (HA) caused by viruses of different subtypes. Patients and methods: In the study there were included 195 patients with hepatitis A (130 males and 65 females) at the age from 15 to 72 years residing in the territories with various manifestations of the epidemic process of HA (Moscow, the Khabarovsk region, the Republic of Sakha (Yakutia), the Republic of Tajikistan and Ukraine). All patients were examined for the presence of Hepatitis A virus (HAV) RNA in blood, with following determination of the genotype of the virus by PCR. Biochemical blood tests (concentration of total and direct bilirubin, ALT activity) were performed from 2 to 9 times depending on the duration of hospital stay and severity of infection. The dynamics of biochemical indices was evaluated in accordance with the period of the disease: the first period -from the 1 st to 10 th day, the second -from 11 th to 20 th day, the third -from the 21 st day and later. Results: A direct moderate correlation (The Spearman correlation coefficient r = 0,3; p = 0,002) between the duration of jaundice and patients ’ age has been revealed. A significant relationship was observed in the group ofpatients with subtype IIIA (r = 0,4; p = 0,003) and was absent in patients with subtype IA. There were no statistically significant differences between the groups of patients with subtypes IA and IIIA, in dependence on the duration of hospitalization, the variant of the course ofprejaundice period, severity of the course disease, duration of the persistent jaundice and symptoms of intoxication. Absolute values and the dynamics of the reduction of total and direct bilirubin, as well as the dynamics of decrease of ALT activity in groups of patients with various subtypes were not differed significantly. Cholestatic forms of HA were observed only in patients with HAV isolates belonging to subtype IIIA. Conclusion: HAV subtype has no effect on the severity of the course of the disease neither major clinical symptoms and laboratory indices in patients from different age groups. A direct correlationship between the duration ofjaundice syndrome and age in patients with subtype IIIA may indicate a trend towards the formation of cholestatic forms of HA in patients with this subtype of the virus in older age groups.

Download Full-text