COVID-19

The COVID-19 pandemic significantly threatens immunocompromised patients. We aimed to investigate the clinical and paraclinical findings and consequences of COVID-19 in kidney transplantation recipients.

In this retrospective study, kidney transplant recipients admitted to Ayatollah Rouhani, Shahid Beheshti, and Shahid Yahyanejad referral hospitals of Babol, North of Iran, with a diagnosis of COVID-19, were examined. Information such as demographic and laboratory findings, clinical symptoms, and treatments received was entered into pre-prepared questionnaires.

Out of the 35 patients included in the study, 19 (54.3%) were males, and 16 (45.7%) were females. The mean age of patients was 47.46±11.28. Among the clinical symptoms, cough and decreased level of consciousness were associated with a higher mortality rate (P= 0.02). Furthermore, the mortality rate was found to be 17.1%. C-reactive protein (CRP) level, oxygen saturation percentage, and diffuse lung involvement were significantly associated with COVID-19 mortality (p <0.05). In this study, no correlation was found between the amount of Cr and the outcome of COVID-19 disease (P = 0.66), and also, no significant relationship was found between the amount of BUN and the outcome of COVID-19 (P = 0.46). Even the patient who was admitted with a Cr of 6.4 did not die and was discharged with a Cr of 3.4.

Due to the higher mortality rate in transplant patients with COVID-19, the need for more clinically severe treatment and intensification of care in this group of patients is essential.

COVID-19 developed a sudden onset of smelling disorders. Researchers used self-reported or special tests to study this issue. We aimed to investigate whether quantitative-test smell disorders have a considerable difference from self-reported or not.

We searched 554 studies published between December 2019 to September 2020 by the PICO model. Our search strategies were based on MeSH terms in the electronic databases Web of Science (136 articles), Scopus (84 articles), and PubMed (334 articles). The duplicated articles were excluded, then the preferred reporting items for systematic reviews and meta-analysis guidance were utilized. Finally, we divided the studies into two (self-report (33 articles) and specific-test (9 articles)) groups.

33 (80%) articles expressed olfactory dysfunction by self-report of patients and 9(20%) studies were conducted by a specific test. Only three studies, one in self-report; ((internal reliability, Cronbach α = 0.84) and validity (r = –0.60, p < 0.001)) and two in specific-test groups; ((test-retest r=0.94) and another study (test-retest r >0.7)) conducted validity and reliability. Self-reported studies published a various range of prevalence (20% _97%) in patients with COVID-19. COVID-19 patients with a specific-test group were found to have a primary incidence of anosmia of over 65%, even reaching 98% depending on the types of tests.

Self-reporting of COVID-19 detection can be affected by sociodemographic factors. Although self-reported questionnaires are economical and easy to use, standardized tests provide more reliable comparisons and professional assessments. Therefore, standardized tests are recommended for more accurate screening over self-reporting.

COVID-19 has rapidly brought many changes to people’s lives. The current research aimed to explore how these changes affected the social resilience of the residents in a local neighborhood. 

  The present case study was conducted in the spring of 2021, using in-depth interviews and field observations in the Tawheed neighborhood of Gonabad City, Iran. Purposive sampling was used to select the interviewees with maximum variation. Interviews continued until data saturation was reached, which occurred after the 17th participant was interviewed. To analyze the data, a directed qualitative content analysis and the complexity approach proposed by David Byrne and Gil Callahan were utilized. 

The local residents’ social resilience during the pandemic was explained in light of the complexity theory. A total number of four categories and 13 sub-categories were extracted: uncertainty of the disease (uncertainty of information about the disease, no common understanding of the disease, no common norms of health behaviors, and unknown aspects of the disease), features of connectivity and network of social relationships (perceived common benefits, family cohesion, access to online social networks), initial states and availability of sources (unstable living conditions, poor health facilities, and structure of the neighborhood), interaction of micro- and macro-factors (trust in healthcare systems and leaders, and financial rules and policies). 

  The social resilience of the residents in the local neighborhood during the pandemic was influenced by many factors, primarily related to their initial conditions. To improve social resilience, it seems necessary to carry out effective interventions based on local and indigenous capacities.

Rituximab is a chimeric monoclonal antibody with binding specificity to CD20-positive B lymphocytes. Patients administered rituximab would not have adequate humoral response to the SARS-CoV-2 vaccine. Rituximab can also affect the durability of immunization. Plasma-secreting antibodies and memory B-cells are two major arms of long-term immunity. The role of memory B-cells becomes prominent by decreasing antibody titers over time. The activated memory B cells have CD20 protein on their surface. Investigating the effect of rituximab on other vaccines has demonstrated attenuated recall response. The evidence in this review suggests that we can also expect a deficit of recall response to SARS-CoV-2, making the rituximab-treated patients susceptible to reinfection with emerging variants. Therefore, it is better to consider other therapeutic options, use lower rituximab doses, and employ booster vaccines at shorter intervals.

The new coronavirus disease (COVID-19) pandemic is a global health problem that appeared in late 2019 through severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This perplexing virus has a high infection rate, and with no specific treatment, the mortality and morbidity rates are rapidly increasing. Moreover, the new virus variant, which is more contagious and has a higher mortality rate than previous variants, has been detected in the United Kingdom. There are few vaccines at clinical stages. However, the distancing, track, and trace will stay with us for at least the next few years. Hence, detecting symptomatic and asymptomatic patients through accurate detective tests such as molecular and serological assays and quarantine is the only preventive method that can be used for controlling the pandemic. It is essential to use highly accurate tests to decrease the number of false negative and false positive results. This research aimed to highlight and critically assess the specificity and sensitivity of coronavirus tests available for detecting the SARS-CoV-2 virus. Currently, this is a multibillion-dollar industry, and many tests enter the clinical setting without having fully been validated.

A novel coronavirus disease (COVID-19) have raised in Whuan in December 2019. This disease kept spreading rapidly until World Health Organization have declared a pandemic on COVID-19. Despite all the efforts made there are no definite treatments for this disease. Recent papers on pathophysiology of COVID-19 have shown possible mechanism of T-Cell exhaustion caused by virus is responsible for lymphopenia observed in these patients. PD-1/PD-L1 have a major role in T-Cell exhaustion so we have proposed targeting PD-1/PD-L1 using anti-PD-1/PD-L1 agent. Using anti-PD-1/PD-L1 agents including Pembrolizumab and Nivolumab could potentially decrease T-Cell exhaustion and increases survival of COVID-19 patients. In order to overcome the shortcoming of this approach we have proposed using clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) which can be highly efficient in targeting PD-1/PD-L1. Using CRISPR/Cas9 in this regard could be more efficient, feasible and economical and potentially lower side effects. In conclusion targeting PD-1/PD-L1 through approved medications or CRISPR/Cas9, in order to block their interactions, may remarkably prevent the cytotoxic lymphocytes functional exhaustion, especially CD8+ T-cells and help to decrease the mortality rate in COVID-19 patients. In addition, to evaluate the clinical outcome of using anti-PD-1/PD-L1 agents or CRISPR/Cas9 system in COVID-19 patients, it is recommended to measure lymphocyte, CD8+ T-cells, NK cells and total T-cells count.

It has been more than six decades since Artificial Intelligence (AI) was introduced to outperform humans in accuracy and speed. Ever since, many algorithms have been developed that gained success in fulfilling the claims of AI. Their high speed and accuracy have made them perfect candidates for substituting humans in many settings. Even though AI has changed the face of many industries, its application in some others is still a subject of debate. Besides AI, which, over decades, has changed the face of industries for good, there is another phenomenon that has changed it: the novel coronavirus (COVID-19) pandemic. Unlike AI, this pandemic has changed every aspect of human life. Due to its fast spread through human contact, stay-inshelter orders have been placed to slow the person-to-person transmission. This is a source of concern for industries as many of them may fade away due to the pandemic. However, there is one industry at risk of burning out rather than fading away: the healthcare industry. Limited resources, on the one hand, and increased demand, on the other hand, have made the healthcare industry one of the main victims of the pandemic. Emergency departments are flooded with patients, yet non-emergent medical services have been nearly shut down. Therefore, solutions are sought to help both lighten the burden on emergency departments and facilitate providing non-emergent medical services. AI and automated systems can be the key to such solutions. They have proved their efficacy in many instances in the healthcare industry, from emergency department triage to assisting surgeries. Thus far, their widespread use has been halted due to legal and ethical debates. However, the COVID-19 pandemic can be a turning point in the integration of AI into the healthcare system, just as improving AI integration with healthcare can be a turning point in this pandemic. Herein, we overview how AI can help deliver non-emergent medical services during the pandemic and possibly thereafter

There are few reports related to the possible side effects of injected vaccines, and evaluating the frequency and severity of the complications of COVID-19 vaccines can increase the knowledge, safety and importance of vaccines and reduce mistrust towards them. Therefore, we assessed the frequency and severity of the complications of COVID-19 vaccines in the medical staff of Khatam Al-Anbia and Ali Ibn Abi Talib hospitals in Zahedan.

In this cross-sectional study, 200 medical staff working in two hospitals, Khatam Al Anbia and Ali Bin Abitalib Zahedan were studied. The frequency of side effects after COVID-19 vaccination was recorded in the questionnaire.

The distribution of the frequency of the type of vaccine received in the studied treatment group is equal to 83 people (41.5%) AstraZeneca vaccine, 82 people (41%) Sinopharm vaccine, 22 people (11%) Sputnik vaccine and 13 people (6.5 %) had received Barekat vaccine. The frequency distribution of side effects in the first dose and the second dose after receiving the COVID-19 vaccine was equal to 135 people (67.5%) and 96 people (48%), respectively. Distribution of the percentage of the type of side effect that occurred after receiving the first dose of COVID-19, according to fever (80.7%), headache (46.7%), weakness (40%), disorder Sleep (33.3%), myalgia (n19.2%), sweating (10.3%), dizziness (9.6%), tachycardia (18.8%), sore throat (6.7%), chest pain (5.2%), arthralgia (5.2%), rhinorrhea (3.7%), diarrhea (2.9%) and loss of appetite (2.9%).

It can be stated that the COVID-19 vaccine did not show severe side effects and with timely management and supportive treatment and control of side effects, patients were encouraged to get vaccinated and as a result, the collective immunity level of the society improved.

Mass vaccination against COVID-19 infection has been able to substantially alleviate the consequent mortalities and the spread of the disease. The paced design and administration of novel mRNA-based vaccines paved the way for the production against cancers and acquired immunodeficiency syndrome. Various side effects, lethal in some instances, are described for COVID-19 vaccines, including the instigation of incidence or relapse of autoimmune disorders, including autoimmune hepatitis (AIH). Molecular mimicry with the spike protein S1 and cross-reactions, adjuvants-induced autoimmune/autoinflammatory syndrome, epitope spreading, and bystander activation are among the molecular mechanisms that are hypothesized to mediate vaccine-induced autoimmunity. Pathological and serologic evaluations of patients with liver injury following COVID-19 vaccination have displayed that most cases can be categorized as probable or definite for the diagnosis of AIH. AIH and AIH-like liver injuries following COVID-19 vaccination are generally manageable with the administration of corticosteroids and other immunosuppressive therapies if required. Data on the safety of subsequent vaccination is scarce; however, vaccination during maintenance therapy with steroids seems safe. More importantly, the recognition of asymptomatic cases with altered liver aminotransferase levels necessitates the design of prospective cohorts to assess the long-term consequences of sub-clinical liver dysfunction induced by COVID-19 vaccines.

The ongoing COVID-19 pandemic inflicted a considerable burden on health systems and individuals worldwide. Thus, scientists intended to propose beneficial treatments and vaccines to fight against this virus. However, vaccination remained the only effective way to reduce death and hospitalization due to COVID-19 infection. To date, about five proposed COVID-19 vaccines have been approved as WHO emergency use listings (EUL). Yet, their safety profile needs the following actions to be revealed: (1) more follow-up registry systems and (2) global clinical trials in various countries in a period that they are experiencing a peak. By searching keywords 'COVID-19' and 'vaccination' in PubMed and Scopus databases, we aimed to summarize the current evidence in the literature regarding the safety profile (i.e., local and systemic adverse events) of ten COVID-19 vaccines: (1) Pfizer/BioNTech, (2) Moderna, (3) Sputnik V, (4) Bharat, (5) CanSino, (6) Sinovac, (7) AstraZeneca, (8) Johnson & Johnson, (9) Novavax, and (10) Sinopharm. Moreover, we demonstrated the data on the safety of heterologous schedules of these vaccines alongside further considerations in people with comorbidities and particular circumstances. Most of the COVID-19 vaccine adverse effects possess a mild-to-moderate, self-limiting nature. However, special circumstances such as severe hyper-sensitivity necessitate the use of an alternate COVID-19 vaccine. Vaccination is the only way to exit the global pandemic, and its benefits outweigh its adverse effects. Meanwhile, people should be aware of the signs of the probable rare, severe reactions to the vaccine.

The development of COVID-19 vaccines with high efficacy has given people hope to overcome the pandemic. However, the increasing number of reports of side effects could affect the number of people who are adherent to vaccination. In most cases, pain, fever, and fatigue have been reported, which is the normal side effect of many vaccines. More serious side effects have also been reported, such as Guillain-Barre syndrome, thrombotic thrombocytopenia, anaphylaxis, and death. Although these side effects seem to be lethal, they are rare, and vaccination is the most efficient strategy to overcome this disease.

Currently, the novel coronavirus disease (COVID-19) is one of the global challenges that remains inadequately addressed and is not being treated effectively. It is essential to acknowledge the role of supplements in strengthening the immune system to reduce the risk of infection. Food provides a well-established source of adequate macronutrients and micronutrients, all essential for the proper functioning of the immune system. Among the micronutrients, vitamins A, C, D, E, and B play crucial roles in the immune system's effective response to infections. This study explores the role of vitamins in the immune system and their impact on defense against COVID-19.

The COVID-19 pandemic, caused by SARS-CoV-2, has presented a global health challenge. Older people and patients with underlying conditions such as hypertension, diabetes, and obesity are more susceptible to severe disease outcomes. Obesity or high body mass (BMI) index is a significant risk factor for creating diabetes and plays a crucial role in the pathogenesis of COVID-19 infection. Obesity has been shown to increase vulnerability to infections, making it a significant risk factor for COVID-19. This study aims to investigate the relationship between BMI and COVID-19 severity and outcomes in patients with and without diabetes.

This case-control study was conducted on 400 patients with confirmed COVID-19 infection, referred to teaching hospitals in Sari City, Iran, during April and May 2019. The study population consisted of 192 diabetic patients (case group) and 208 non-diabetic individuals (control group), matched for age and sex. Participants’ data, including demographics, medical history, laboratory findings, and disease progression details, were collected using a comprehensive questionnaire. According to CDC criteria, COVID-19 disease severity was defined as mild, moderate, and severe. The relationship between BMI and COVID-19 severity was compared between the diabetic and non-diabetic groups.

This study was conducted on 192 diabetic and 208 non-diabetic COVID-19 patients with an average age of 62.85±0.88 and 53.21±1.18 years, respectively. The average BMI in the diabetic group was 28.68±0.4, whereas it was 26.94±0.31 (P=0.001) in the non-diabetic group. There was a statistically significant difference in the severity of COVID-19 infection between diabetic and non-diabetic patients (P=0.008). The results showed a statistically significant difference in disease severity based on BMI in the diabetic group (P=0.02). Significant differences were observed in the need for mechanical ventilation (P=0.000) and mortality in people with diabetes compared to nondiabetics. A significant association was observed between BMI and ICU admission in both diabetic (P=0.001) and non-diabetic (P=0.000) groups.

The study concluded that BMI may be a significant risk factor for severe COVID-19 outcomes, particularly among people with diabetes. This finding emphasizes the importance of BMI in disease prevention and control strategies, especially for populations with underlying conditions like diabetes.

The pharmaceutical supply chain (PSC) faced numerous challenges, particularly during the COVID-19 crisis. Due to the supply chain (SC) 's vulnerabilities, it requires enhanced capabilities to address these challenges. In Iran, specific economic and political issues have intensified the vulnerabilities of the PSC.

This study investigates the issues caused by the COVID-19 crisis in the PSC, identifies and characterizes these issues, and recommends appropriate courses of action to address future SC disruptions.

This study is a qualitative-quantitative analysis conducted in Iran during the COVID-19 crisis. Qualitative thematic analysis was performed from July 2022 until May 2023. Semi-structured, in-depth, face-to-face interviews with 23 Iranian PSC specialists were conducted until saturation was reached. The qualitative phase was analyzed using MAXQDA 2021. The quantitative phase included a survey of 547 individuals working in pharmaceutical manufacturing in Iran, with the questionnaires analyzed using SPSS 26.

In the qualitative phase, the research identified two main themes: (1) vulnerabilities and (2) capabilities, along with 15 subthemes providing solutions to enhance the resilience of the PSC. In the quantitative phase, findings from 64 questionnaires highlighted major vulnerabilities and capabilities necessary to create a resilient SC. The median score for vulnerabilities was 5.12, while the median score for capabilities was 5.39.

According to the questionnaire results, the quantitative findings indicate that capabilities received a higher score, suggesting that this sector of the PSC demonstrated better resilience against the pandemic. This study, with its contextual focus, mixed-method approach, comprehensive analysis of vulnerabilities and capabilities, and sector-specific insights, offers a novel contribution to the understanding of SC resilience within Iranian pharmaceutical manufacturing. It also has the potential to promote further research in other sectors of the PSC.

Trace elements play crucial roles in metabolic processes and serve as cofactors for various enzymes, although their specific involvement in fungal pathogenesis remains unclear. This study aimed to explore the impact of essential trace elements, iron (Fe), manganese (Mn), zinc (Zn), and copper (Cu), in conjunction with D-dextrose, on conidial germination and growth of Aspergillus fumigatus and A. flavus.

The research involved determining the minimum inhibitory concentrations (MIC) of Fe, Mn, Zn, and Cu for Aspergillus ATCC strains. The study commenced by determining the MIC of the four trace elements, followed by evaluating the impact of selected trace elements on the kinetic growth and germination rates of Aspergillus species by the micro-broth method. Following MIC assessment, optimized concentrations of the trace elements (~140 and 550 pM) and various concentrations of D-dextrose (1-3% w/v) were introduced to assess their effects on fungal growth in RPMI 1640 broth. Growth was measured in optical density, while conidial germination rates were also observed.

The MICs for Fe, Mn, and Zn exceeded 35 µM, while Cu exhibited lower MICs of 2 and 7.6 µM against A. fumigatus and A. flavus, respectively. Fe, Mn, Zn, and Cu significantly enhanced fungal growth in both Aspergillus species at optimized concentrations. Additionally, growth rates increased proportionally with higher D-dextrose concentrations. Notably, combining enriched trace elements and D-dextrose resulted in up to 98% conidial germination.

The findings demonstrate that optimized concentrations of essential trace elements and D-dextrose significantly promote conidial germination and growth of Aspergillus species in vitro. These results suggest that trace element supplementation might have important implications for immunocompromised and hyperglycemic patients. Further studies are warranted to explore the interactions between these micronutrients in fungal physiology and pathogenesis.

This study aimed to summarize the baseline and radiological characteristics of patients with COVID-19 and investigate the correlation between clinical outcomes and radiological findings in the first week after admission.

A single-center retrospective study was carried out on confirmed cases of COVID-19 based on RT-PCR and chest CT scan findings according to Iran’s National Guidelines for defining COVID-19 in patients admitted to Imam Hossein Hospital, Tehran, Iran. Baseline and chest CT scan characteristics of patients were investigated, and their correlation with the change in clinical outcome was reported.

72 patients (50%) with a mean age of 54.65±16.2 years were in two periods of time including the first day of diagnosis and 6.0±3.4 days later. Based on CT scan Severity Score (CTSS) changes (decrease/no change or increase) during the study, patients were divided into two groups of CTSS progression (n=47) and CTSS no-progression (n=25). Diabetes mellitus (20%) and hypertension (19.1%) were the most frequent comorbidities among the patients in the non-progression and progression groups, respectively. There was no significant difference in demographic features including age and gender, and comorbidities (P>0.05). On the first day of diagnosis, there was no significant difference in blood tests and radiological findings and the number of patients who managed out-patients or in-patients in both groups. However, on the second evaluation day, patients in the progression group had significantly higher CTSS in comparison with the non-progression group (13.11±4.7 vs. 9.48±4.2, P=0.003), and the clinical situation in 15 patients in progression changed from out-patient to in-patient (p=0.033).  Only chest CT imaging score was a potential parameter associated with the change in clinical progression (P=0.030, RR=10.18, 95, CI=1.25-89.72).

Increasing CTSS is a strong predictor of worsening clinical outcomes during hospitalization in COVID-19 patients.

During the COVID-19 pandemic, disease coding significantly influenced national and international strategies for prevention, treatment, and control. This study aimed to assess the factors influencing COVID-19 records' coding errors in teaching hospitals in South Khorasan province.
In 2022, researchers conducted a cross-sectional study in South Khorasan Province, Iran. Data was gathered using a self-developed questionnaire distributed among medical coders in all hospitals. Descriptive statistics were employed in the data analysis using SPSS version 19.
The study's results showed that non-observance of diagnostic principles by physicians (66 out of 92), a lack of specialized medical coding specialists (52 out of 92), and the use of ambiguous and non-standard abbreviations (51 out of 92) were the most significant factors affecting COVID-19 coding errors. Among the three main factors affecting COVID-19 records' coding errors, factors related to the medical coder (47.66 out of 92), factors related to healthcare providers (29.8 out of 92), and organizational and environmental factors (21.4 out of 92) were the most significant.
This study revealed that multiple factors contribute to coding errors in COVID-19 records, with the most critical being physicians' non-adherence to diagnostic principles, the shortage of medical coding specialists, the use of unclear and non-standard abbreviations, and the absence of COVID-19 coding continuing education. Therefore, we recommend conducting workshops on diagnosis and coding for medical coders, particularly emphasizing the precise coding of COVID-19 records.

There have been safety concerns regarding the COVID-19 vaccines because of their unprecedented speed of development. Therefore, systematic reviews are necessary to address these concerns and reduce public hesitancy regarding COVID-19 vaccines. This study aims to systematically review the reported adverse events related to viral vector COVID-19 vaccines.

We performed a systematic search in the databases of PubMed, Scopus, Web of Science, and Cochrane on September 15th, 2021. This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The records underwent two-step title/abstract and full-text screenings, and the eligible records were included in the data extraction process. We used the Newcastle-Ottawa Scale (NOS) for the Bias Assessment of included articles.

The adenovirus vector-based COVID-19 vaccines, including the Janssen COVID-19 vaccine, the AstraZeneca COVID-19 vaccine, and the Sputnik V vaccine were included in this review. Among these vaccines, the AstraZeneca has presented enormous side effects with most being systemic and a few sporadic cases of life-threatening events such as thrombosis and capillary leak syndrome and even death in a few cases. Prominent systemic side effects of the adenovirus vaccines include fever, fatigue, malaise, arthralgia, myalgia, sweating, and dizziness. Erythema, swelling, tenderness, itching, and numbness at the injection site are the most common local reactions.

It appeared that the frequency of serious adverse events is negligible, and vaccination to prevent severe COVID-19 and mortality has greater benefits than adverse events in the general population.

Medication errors can lead to damage to patients with various disabilities or death. This study aims to identify factors affecting the incidence of medication error and its association with patient safety culture from the nurse’s perspective during the COVID-19 pandemic.

This cross-sectional study was conducted among 340 employed in the hospitals affiliated with Shiraz University of Medical Sciences in 2021. Data were collected by applying a questionnaire for medication error and the standard questionnaire of the Hospital Survey on Patient Safety Culture. Descriptive statistics, the independent t-test, ANOVA, and Pearson correlation were applied using SPSS software version 23.

The main reasons for medication errors were fatigue due to the workload (3.13±1.16 out of 5), method of supervision in the hospital units (3.06±0.98 out of 5), and massive pile-up of duties (3.00±1.19 out of 5). Other results indicated a significant negative association between factors affecting medication error and patient safety culture (r=-0.574, p=0.002). A significant correlation was observed among factors affecting medication error and patient safety culture with demographic determinants of age and years of working experience (p<0.05). Significant differences were also observed among the two main studied variables, the number of monthly work shifts, and the number of patients (p<0.05).

Applying strategies for the reduction of physical fatigue and mental exhaustion along with balancing work shifts and managing the accumulative duties and massive tasks can help decrease the rates of medication errors.

Forecasting the longevity of patients' immune stability could be the most effective approach to preventing illnesses. This study investigates immunoglobulin M (IgM) serum longevity, immunoglobulin G (IgG), and corresponding risk factors in the first phase seropositive patients in Mazandaran, Iran.
This descriptive cross-sectional study aimed to assess IgM and IgG serum levels in a cohort of 184 seropositive patients during six months. The data analysis involved various statistical methods including descriptive statistics, the chi-square test, independent and paired t-tests, and single and multivariate logistic regression.
A total of 103 (56%) patients lacked the necessary antibodies, whereas 81 (44%) remained seropositive. According to the results of multivariable logistic regression, patients with a travel history, hospital admissions, and end-stage renal disease (ESRD) had 3.24 (P=0.04), 12.63 (P=0.018), and 9.79 (P=0.001) times higher chances of stable seropositivity, respectively. The average IgG and IgM serum levels fell by 4.5 and 3 units, respectively (P<0.001). In addition, serum levels of IgM and IgG increased by 12% and 12.5%, respectively, and dropped by 75.5% in both serums. There was no increase in either serum level for any of the patients.
The duration of immune serum stability in patients can significantly reduce disease mortality. The concurrent detection of IgM and IgG antibodies also assists in identifying the infectious stage.