مجله طب دریا
سال سوم شماره 3 (پیاپی 12، پاییز 1400)

Acceptance and hesitation of COVID-19 vaccine have great importance for public health. Understanding the key factors that influence vaccine preferences and desires by the community can help develop strategies to improve the vaccination schedule. The present study aimed to predict the acceptance and hesitation of COVID-19 vaccine based on psychological resilience and positive and negative affect.

The present study was a descriptive-correlational study performed on the Iranian adult population by available sampling method. A total of 461 people participated in the study online in June 1400 by completing questionnaires. Data were collected using the Knowledge, Attitude, Practice and Concern questionnaires of COVID-19 vaccine (KAPC), Connor-Davidson Resilience Scale (CD-RISC) and Positive and Negative Affect Schedule (PANAS).

 A positive relationship exists between psychological resilience and acceptance of COVID-19 vaccine and there is a significant positive relationship between negative affect and hesitation about COVID-19 vaccine. Furthermore, the results of regression analysis showed that psychological resilience explained 14% of the variance of COVID-19 vaccine acceptance and negative affect explained 25% of the variance of COVID-19 vaccine hesitation acceptance.
 

 According to the findings, programs designed to increase COVID-19 vaccination rate can include interventions to increase psychological resilience and reduce negative affect to create more acceptance and less hesitation about the vaccine.

During the pandemic of COVID-19, the basic strategy to reduce the prevalence of the disease is to observe hygiene and personal protective behaviors; which is recommended for people in the community, especially teenagers, who are less committed to health protocols. The aim of this study was to evaluate the observance of health protocols introduced by the World Health Organization and the type of social behaviors of students during the COVID-19 pandemic.

This cross-sectional study was conducted with the participation of 762 (562 girls and 200 boys) high school students in Bandar Abbas, Iran during the COVID-19 pandemic in 2020. Data was collected using a questionnaire by Dominika Guzek et al. and an infographic published by the University of Texas which were made available to students online.

among students, the highest compliance was related to the use of masks (95.7%), and the lowest compliance was related to wearing gloves (31.2%). The maximum duration of handwashing was 11 to 20 seconds (38.1%), and the maximum frequency of washing in a day was 3 to 5 (31. 8%). In terms of performing social behaviors, most students observed the desired level, and as the risk of infection increased, the rate of performing dangerous behaviors decreased.

The present results showed that adhering to health protocols and performing low-risk behaviors with infection COVID-19 is very desirable, but still some behaviors need more training to implement among students. However, normalization of health protocols and behaviors is a big risk in this regard.

Public confidence in receiving the vaccine is essential for the success of communities in controlling COVID-19. The aim of this study was to determine the role of trust in receiving or not receiving COVID-19 vaccine among the people of Bushehr province, Iran.

This cross-sectional study was performed on the fifth wave of coronavirus (delta strain) in Iran. Data were collected using an online questionnaire distributed among adults in Bushehr province (over 18 years old) for two weeks (July 25 to August 8, 2021). The questionnaire included 5 demographic questions and 19 main questions in the form of three dimensions of trust in vaccines, trust in vaccine manufacturers, and trust in government and health authorities.

384 people submitted a completed questionnaire. Mean trust in vaccine products was 3.34±1.08, trust in vaccine manufacturers was 3.12±0.29, trust in government and health officials was 3.24±0.38 and overall trust was 3.23±0.48. The relationship between trust and its dimensions with receiving or not receiving the vaccine was confirmed (p <0.05). Among those who received the vaccine, trust in the vaccine (4.18), manufacturers (3.18), and health officials (3.41) were good, but among those who did not receive the vaccine, trust in the vaccine (2.07) Manufacturers (3.03) and health officials (2.98) were recorded as weak, moderate and moderate, respectively. The relationship between gender, education, age, underlying disease, and history of COVID-19 with or without vaccination was also confirmed (p <0.05).

Among the respondents, those who had higher trust in the vaccine, manufacturers, and government and health officials received the vaccine, which shows the importance of trust in vaccination. Therefore, it is necessary to pay attention to the options of building trust for the success of the national vaccination.

Homeless drug addicts are one of the high-risk groups for COVID-19 mortality and morbidity. Therefore, early diagnosis in this group, in addition to reducing mortality in them, will prevent the transmission of the disease in the community. Tehran University of Medical Sciences has made a special effort to screen COVID-19 in drug addicts, the results are mentioned here.

In this descriptive study, the available data of Covid-19 screening in the areas covered by Tehran University of Medical Sciences were used. The collected data were analyzed after initial refinement using descriptive methods such as frequency and bar and line graphs.

A total of 11485 PCR tests were performed during the study period to screen COVID-19 in drug addicts. The results of screening were 696 positive cases of Covid-19 (6.04% out of the total tests) among drug addicts. The positive cases in Shafaq and Fashafoyeh camps were 9.62 % and 3.77 %, respectively. Most tests were performed in May, June, August and November 2020.

Performing more than 11,000 diagnostic tests in the group of addicts, indicates the special efforts of Tehran University of Medical Sciences to provide fair services and early diagnosis of COVID-19 in this vulnerable group.

Hospitals are one of the most important centers in confront epidemics and the proper preparation of these centers ensures rapid response and epidemic management. The aim of this study was to determine the readiness of hospitals affiliated to Yazd University of Medical Sciences after the third peak of corona in Iran.

This cross-sectional study was performed in 2021 to determine the readiness of 3 designated Corona hospitals affiliated to Yazd University of Medical Sciences in Iran. The data collection tool was a checklist provided by the World Health Organization on Hospital Readiness in the COVID-19 epidemic, including hospital specifications and 11 items with 107 questions, completed by Matron or the Secretary of the Hospital Crisis Committee.

In total, the three hospitals were 80% ready. Hospital C, with a total score of 203 out of 214, had the highest level of readiness compared to other medical centers. Hospital B and Hospital A were next with 157 and 155, respectively. In the study of each key element, the results showed that in three hospitals, the lowest percentage (58%) is related to communication and continuity of essential health services and patient care

According to the present results, it is necessary for hospitals to give more priority to these areas in future planning for the next wave of corona and other epidemics, and to equip and develop guidelines in the field of communication. Regarding the continuation of services to patients, planning to provide specialized manpower and related diagnostic and treatment equipment and the construction of crisis hospitals in Yazd province is proposed.

The World Health Organization has some recommendations for early diagnosis of COVID-19 for appropriate treatment. In the present study, automatic and accurate diagnosis of COVID-19 by chest CT scan images using the deep learning method was performed.

The steps performed in this algorithm for segmentation and identification of images of healthy lungs and lungs affected by COVID-19 were a selection of appropriate images, preprocessing of images including noise reduction, extraction of image properties, finally segmentation and image classification using a combination of the deep learning method and water wave optimization algorithm to detect COVID-19 in lung images. All modeling was done based on Matlab software.

By applying the water wave optimization algorithm to the deep learning algorithm, its accuracy improved by some 7% in the diagnosis of COVID-19. Therefore, the proposed algorithm with an average accuracy of 98% has a high ability to be used in the clinic for accurate and rapid diagnosis of COVID-19, which can be of great help to the medical staff.

In the diagnosis phase of COVID-19, artificial intelligence can be used to detect patterns of medical images taken by CT scan.

COVID-19 pandemic can be considered an effective factor in increasing physical and psychological manifestations, especially anxiety in patients with multiple sclerosis (MS). Therefore, the aim of this study was to determine the level of anxiety in patients with MS during the COVID-19 pandemic.

This cross-sectional study was performed in Jahrom city in 2020 during the second wave of coronavirus in Iran. 191 patients with definite MS (multiple sclerosis) were included in the study by the census. Data collection tools included the demographic data questionnaire and Corona Disease Anxiety Scale.

The mean overall score of anxiety in patients with MS during the COVID-19 pandemic in Jahrom was 8 out of 54. The mean score in the dimension of psychological symptoms was 6.4 and in the dimension of physical symptoms was 1.7 out of 27. These scores indicate that the level of anxiety in patients with MS is low.

Patients with MS in Jahrom city are in a good condition in terms of anxiety about COVID-19 disease; which can be a good indication of the low impact of pandemic conditions on the symptoms of patients with MS.

Preventive behaviors are one of the most important strategies to combat COVID-19. COVID-19 anxiety, COVID-19 exposure levels, and risk perception are predictor variables of preventive behaviors. But it is still unclear whether, one year after the outbreak of COVID-19 in Iran, these variables still play an important role in predicting preventive behaviors, and if so, what level of these variables and to what extent they predict COVID-19 preventive behaviors. The purpose of this study is to answer these questions.

This is a descriptive-correlational study. The researcher-made questionnaire of demographic data, preventive behaviors questionnaire, risk perception and anxiety of COVID-19 was administered by 184 male students and staff working in a military medical university in Tehran, Iran. All questionnaires were distribute online.

The results showed that 6% of students and staff had high COVID-19 anxiety and 36.4% had high risk perception and 82.1% of them followed COVID-19 preventive behaviors to a large extent. People with a history of suspected symptoms of COVID-19 were less likely to follow COVID-19 preventive behavior than those without a history (z=-2.36, p<0.02). People with low risk perception were more likely to follow COVID-19 preventive behavior than those with high risk perception (z =-2.95 p<0.003) or moderate risk (z=-2.76, p<0.006). There was no significant difference between those with moderate and high risk perception in observing COVID-19 preventive behavior. There was no significant relationship between the variables of age, marital status, different levels of education, history of COVID-19, history of close contact with a person with COVID-19 and COVID-19 anxiety with preventive behavior of COVID-19. The results of logistic regression showed that the only predictor of low risk perception was the significant predictive behavior of COVID-19 with a possible ratio of 0.21 (OR=0.21)

Low risk perception is a more important predictor of preventive behavior than COVID-19 anxiety and coronavirus exposure levels in male students and staff working at the Military Medical University studied in Tehran. Screening and training programs are recommended rising risk perception to improve health in the COVID-19 pandemic.

Many physical diseases are affected by cognitive and behavioral factors. The aim of this study was to determine the effect of neuropsychological function and self-care behaviors on COVID-19 anxiety in diabetic patients.

This was a descriptive correlational study. The statistical population included women with type 2 diabetes in the Iranian Diabetes Association in Urmia in the spring of 2021. Sample selection was done by simple random method. Corona Anxiety Questionnaire of Alipour et al (2019), Neuropsychological Function Questionnaire of Nejati (2013) and Self-Care Behavior Questionnaire of Toobert and Glasgow (1994) were used.

The mean age of 165 women with type 2 diabetes was 45.7±18.4 years. There was a negative relationship between neuropsychological function and self-care behaviors with COVID-19 anxiety. Neuropsychological function and self-care behaviors had a negative effect of 0.20 and 0.25 on COVID-19 anxiety, respectively.

The findings of this study emphasize the role of cognitive factors on COVID-19 anxiety in patients with type 2 diabetes.

Rapid transmission of COVID-19 and its rising mortality increased anxiety in medical staff. The aim of this study was to compare the effect of exercise, practice of religious beliefs and listening to music on COVID-19 anxiety in the medical staff.

This quasi-experimental study was performed in a pre-test and post-test with 6 experimental groups and a control group. The study population was the medical staff of hospitals in the south of Iran (Fars, Kohgiluyeh and Boyer-Ahmad, Chaharmahal-Bakhtiari and Khuzestan provinces) that provided services to COVID-19 patients. The sample size was 77 who were randomly selected in clusters sampling. The research tool was the COVID-19 Anxiety which was administered online in two stages of pre-test and post-test.

There is a significant difference between pre-test and post-test scores in the groups of voluntary exercise, voluntary religious practice, voluntary listening to music and casual exercise, which shows their effect on reducing COVID-19 anxiety in the medical staff. There is no significant difference between the pre-test and post-test scores of the control group, the casual group performing religious practices and the casual group listening to music. The results of ANOVA and LSD test showed that the voluntary group performing religious practice has the greatest effect on reducing COVID-19 anxiety.  

 Exercise and physical activity due to the predominance of its physical and physiological aspects, whether it is the will of the medical staff or not according to their desire, reduces anxiety in them. However, practicing religious beliefs and listening to music, due to the predominance of its spiritual dimension, reduces the anxiety of the medical staff only when it is based on one's desires.

The Covid-19 pandemic, with its widespread prevalence, confronted the nursing profession with specific occupational stressors. Job stress has a significant effect on nurses' performance and jeopardizes the provision of high quality and safe care. The aim of this study was to determine the factors affecting job stress in nurses caring for Covid-19 patients.

This cross-sectional study was performed in the first 6 months of 2020. 90 nurses caring for Covid-19 patients were selected by census method. Data were collected using a researcher-made questionnaire on nurses' occupational stressors (validity score between 0.7 and 1 and reliability with Cronbach's alpha of 84%) which was provided to nurses online.

37 (41.1%) nurses were male and 53 (58.9%) were female. The mean age of nurses was 31.39±6.32 years (range 21-45 years) and the mean job history was 10.82±5.31 years. Managerial, personal, physical, patient care and interpersonal factors were identified as sources of stress in nurses caring for Covid-19 patients, respectively.

Since managerial factors were recognized as the most source of stressors, it is preferable to plan on the managerial level to reduce stressors in nurses and subsequently improve the quality of nursing care for COVID-19 patients.

SARS-CoV-2 was identified in late 2019 as a respiratory disease agent called COVID-19. Several drug therapies have been studied to treat COVID-19, none of which have had a definite effect so far. In mild cases of the disease, treatment is careful to reduce the symptoms of the disease, and in severe cases, the patient must be hospitalized to receive different treatments. There are several medications available, many of which are still being evaluated, and there is still no definitive cure for COVID-19

In this study, an attempt is made to investigate various treatment methods, including the use of L-CapA-L-CapC Anticancer-L-Rib-fusion protein in the treatment of COVID-19 in terms of bioinformatics. In this study, the use of bacterial peptides antiviral drugs is emphasized to introduce appropriate treatment to control SARS-CoV-2

L-CapA-L-CapC Anticancer-L-Rib- fusion protein and Spike virus sequences were extracted using NCBI database. Then, using various software such as SWISS-MODEL and Expasy, the structural model of the protein and its quality were determined. The immunogenicity of L-CapA-L-CapC Anticancer-L-Rib fusion protein was also evaluated.

Based on the bioinformatics results, L-CapA-L-CapC Anticancer-L-Rib fusion protein has a dense and complex structure and in addition to its anti-cancer and anti-viral properties, it can be used in the treatment of COVID-19.

In order to prevent the further spread of the COVID-19 pandemic caused by SARS-CoV-2, there is a need to develop rapid and reliable diagnostic tests. Given that there is currently no effective antiviral drug for COVID-19, the most important current strategy is to identify patients as soon as possible. Therefore, scientists and researchers are conducting experiments for rapid detection of asymptomatic carriers of COVID-19, to control and prevention of this epidemic. Although some aspects of the structural and molecular characteristics of SARS-CoV-2 are unknown, various strategies for the correct diagnosis of COVID-19 have been proposed by research laboratories and medical companies, some of which are presented in the present study. According to studies, rapid antigen and antibody tests, immunoenzymatic serological tests, and RT‑PCR-based molecular tests are the most widely used and valid diagnostic methods worldwide. In addition to these common methods, other methods include; techniques based on nucleic acid isothermal amplification, CRISPR/Cas based methods, new generation sequencing (NGS) techniques and biosensors are used in research fields to identify SARS-CoV-2. In the present study, the recent technologies and techniques of various research institutes, as well as devices and commercial kits produced by companies for the diagnosis of COVID-19 are presented, so that familiarity with these efficient diagnostic methods is an important step in advancing scientific goals.

Due to the spread of COVID-19 worldwide (pandemic), various dimensions including the health and economy of communities have been affected. Protecting workers from COVID-19 contamination poses major challenges that need to be addressed in order to learn more about how the disease has spread and how to prevent it. Exposure to COVID-19 is a risk because it can cause disease. Risk analysis is the systematic use of available data to identify risks and assess risks to individuals, the environment, assets and values. After risk analysis, a risk assessment should be performed. Risk assessment involves comparing the results of risk analysis with risk acceptance criteria. After the risk assessment, risks that are unbearable should be eliminated or reduced using control measures. All of these steps in a system or activity and identifying and introducing risk control measures to reduce harm to people, the environment, assets and values ​​are called risk management. In the present review study, risk identification, assessment and risk management of COVID-19 in work environments were performed by categorizing studies. The results of this study can help experts in identifying the risks associated with COVID-19, risk assessment and provide risk control strategies in the context of risk management and provide them with useful information to do so.

Health care workers have direct contact with COVID-19 infected patients and healthy people, so ensuring the safety of health care workers is important not only to protect them against the coronavirus but also to prevent the spread of the coronavirus in the community. The aim of this review was to determine the risk factors of COVID-19 among health care workers.

In this systematic review, papers related to COVID-19 risk factors among health care workers were assessed. Search for papers was done with focusing on the risk factors of COVID-19 and healthcare professionals and combining appropriate keywords, without limiting the type of study and publishing year, in the scientific databases Pubmed, MEDLINE, Embase, Google Scholar and EBSCOHost.

Out of 1750 papers, after removing duplicate papers and reviewing title, abstract and full text, 15 papers remained for data extraction. According to these papers, the risk factors of COVID-19 among health care workers include exposure to infected people, lack of appropriate personal protective equipment, heavy workload, poor infection control and direct contact with contaminated surfaces, lack of hand hygiene and underlying disease (hypertension, diabetes, cardiovascular disease, chronic lung disease, and immunodeficiency).

In the COVID-19 pandemic, health care workers are exposed to the occupational risk of morbidity and mortality, so the development of rapid and sustainable measures for comprehensive protection of health care workers is needed.

In late 2019, people around the world became involved with the outbreak of the emerging COVID-19 and its subsequent pandemic. For this reason, researchers in various fields are looking to solve problems related to crisis control and management. The strong transmission power of the SARS-CoV-2 has led experts to use artificial intelligence to combat the pandemic. Artificial intelligence refers to software that, in addition to analyzing data, can have decision-making power, in fact, it is an imitation of expert human intelligence. This study investigates the use of artificial intelligence during the COVID-19 pandemic. Advantages of using artificial intelligence in COVID-19 are presented in the areas of rapid detection and treatment, assistance with rapid diagnosis, monitoring of treatment stages, epidemiology and tracking of infected areas, pandemic status prediction, drug system management, reducing the workload of medical personnel, predicting and monitoring of COVID-19 outbreaks, follow-up of patients, vaccine planning and design. Also, high potential for the application of artificial intelligence in clinical and research laboratories has been estimated. Another potential use of artificial intelligence is to predict mutations that may occur in coronaviruses in the future and cause new symptoms and complications of the disease.

School closures, home quarantine, and change in social relationships during the COVID-19 pandemic are the most important factors that influence physical and mental health status in children and teenagers and cause numerous psychological problems in these people who are highly vulnerable. The aim of the current study was to assess, identify and present the psychological interventions affecting the mental health status of children and teenagers.

This narrative review examines published papers on the consequences and presentation of psychological interventions for the mental health of children and teenagers during the COVID-19 pandemic from July 21, 2020, to December 25, 2021. A comprehensive search was done using the keywords of COVID-19 pandemic, the mental health of children and teenagers, and psychological interventions in crises on scientific databases of Pubmed, Science Direct, Scopus, Google Scholar.

In total, out of 128 papers, 46 papers were analyzed. According to the results, factors such as long-term fear of infectious with SARS-CoV-2, reduced communication with people in the educational environment, lack of adequate home space, feelings of failure and boredom, and finally financial problems of parents are the most important factors that may have significant effects on the mental health of children and teenagers.

Since most psychological disorders are rooted in childhood and children and teenagers are in a very sensitive period of their mental development, mental health cares during crises such as the COVID-19 pandemic is very important. Therefore, by early examination and identification of mental health disorders in children and teenagers and subsequently, identify the causes of these disorders during the COVID-19 pandemic, and finally, by providing useful solutions and preventive interventions, the occurrence of these disorders may be prevented in children and teenagers during this pandemic.

With the onset of the emerging coronavirus disease-2019 (COVID-19) in late December 2019 in China and its rapid spread around the world, scientists began research to develop and produce an effective vaccine. COVID-19 is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). One of the most important structural features of this coronavirus is the presence of spike protein on its surface. This spike protein has been considered by many scientists as a suitable target for the development of vaccines against COVID-19. The SARS-CoV-2 spike protein binds directly to the ACE2 receptor on the surface of human alveolar epithelial cells (AECs), which facilitates virus entry and replication. By August 2021, more than 150 vaccines are developing in various stages of research and clinical trials to combat the pandemic. Most of these vaccines are based on attenuated infectious agent or mRNA, which can induce cellular and humoral immune systems to make antibodies to reduce the risk of death and severe complications when exposed to SARS-CoV-2. With the introduction of the first effective vaccine against COVID-19 by an American-German company called Pfizer–BioNTech on December, 2020, nine months after the first case of COVID-19, scientists were able to complete the multi-year process of producing a new vaccine in less than 10 months and the hopes for saving human beings and returning to normal life came alive. Other reputable companies around the world have since introduced the vaccine, including Moderna, Johnson & Johnson, Oxford/AstraZeneca, Sputnik V, Covaxin, Novavax, Sinovac, and Sinopharm. However, most of these vaccines have not received final approval from reputable organizations such as the FDA and WHO. Iran has also made efforts to develop and produce vaccines in this regard. With the introduction of these vaccines, by August 11, 2021, about 4.4 billion doses of vaccine have been injected worldwide, and global vaccination continues. Leading countries in vaccination include China, India, the United States, Brazil, and Japan, respectively. The major challenge facing existing vaccines is the variety of SARS-CoV-2 mutations that lead to the development of new strains that may be resistant to the vaccine. Therefore, scientific efforts to develop and upgrade vaccines continue.