Journal of Health Sciences and Surveillance System
Volume:11 Issue: 3, Jul 2023

Strict adherence to safety precautions and, most importantly, social distancing and isolation of people infected with the Coronavirus disease-19 (COVID-19) virus have considerably affected the daily life activities of individuals and overshadowed their routine lifestyle. We conducted a systematic review to provide evidence-based information for clinicians, health policymakers, and social workers in developing useful interventions to effectively mitigate the adverse impacts of the pandemic on people’s life and health condition.

In this systematic review and meta-analysis, studies assessing quality of life (QOL) among the population during the COVID-19 pandemic were searched in four main databases and Google Scholar from the onset of the epidemic to May 2021 with Mesh terms of quality of life and Covid-19.

We included 23058 people who participated in 33 studies; the total quality of life score was estimated at 59.45 (95% CI, 56.33-62.58). Based on the analysis, for each year added to participants’ age, their quality of life score was reduced by -0.3%. Furthermore, a significant association between gender and QOL was affirmed, indicating a more favorable condition among men. The highest score of QOL was reported in AMRO at 66.77 (95% CI, 60.55-73) and WPRO at 64.79 (95% CI, 59.30-70.28), respectively, while SEARO with 47.95 (95% CI, 47.67-48.23) got the lowest score.

Our review robustly recommends the necessity for community health promotion programs to be implemented in vulnerable community segments and adds corresponding knowledge to the existing literature about the status of quality of life in people with different socio-demographic characteristics living in different regions worldwide.

Sleep health is a relatively new term in the sleep literature and an emerging concept in sleep medicine. Lack of attention to health sleep, leads to an increase in the incidence of various physical, mental, and immune disorders against infectious diseases.

This Narrative review study was conducted in September 2021. Studies and articles published in PubMed Databases, Web of Science, and Google search engine from 1983 to January 2021 were included in the study. All reviews and cross-sectional studies found through the keywords, including Sleep, sleep Health, Sleep Hygiene, Underlying diseases, COVID-19, and coronavirus, were reviewed regardless of the publicationlanguage.

According to the collected evidence, sleep deprivation is one of the main causes of underlying diseases, and people with underlying diseases are most vulnerable to COVID-19. Also, East Asian countries such as China, Japan, and South Korea, with more scientific production in the field of healthy sleep, compared to EU member states, can protect themselves from diseases caused by unhealthy sleep and have lower mortality rate of COVID-19 infection.

given the vulnerability of underlying diseases to coronavirus, one of the most important functional areas and preventive factors in the occurrence of the underlying diseases that should be considered is sleep health. Encouraging and promoting sleep health is also important as a protective factor in preventing and managing COVID-19 infectious diseases. Sleep health might also be one of the important factors playing a role in the vulnerability of COVID-19 in different societies.

In 2020, shortly after recognizing the COVID-19 virus in China on March 11, the World Health Organization (WHO) declared the Covid-19 outbreak a pandemic. It is estimated that COVID-19 is responsible for millions of morbidities and deaths globally, causing devastating health, social and economic crises. This ecologic study aimed to define the correlation between a few key elements of a national health system (i.e., quality of health care services, rate of provided COVID-19 diagnostic tests, and coverage of flu vaccine in the preceding years of the COVID-19 pandemic) and the fatality rate of COVID-19 in countries that were affected by the Covid-19 epidemic in the early phase of the pandemic. In this ecological study, data regarding the total population, number of active cases, total cases, mortality, and time to peak of the COVID-19 epidemic for the countries with defined criteria and the required data available were collected from the Worldmeter database. Thehealth system quality of the selected countries was obtained using a report by WHO (Measuring Overall Health System Performance for 191 Countries). The Flu vaccine coverage of the selected populations was ordered and ranked using graphs provided by a joint VENICE–ECDC–WHO survey. The analysis was done by fitting meta-regression using rates and confidence intervals. A forest graph was used to show the summary of the results. R version 6.3 (package meta) was used to do the analysis. The average Case fatality rate (CFR) of the 26 selected countries was 115 per 1000 for COVID-19. Testing for heterogeneity suggested that CFR was highly heterogeneous among the countries. The regression analysis results suggested that CFR for COVID-19 was inversely related to the rate of COVID-19 diagnostic tests and was directly related to the rate of flu vaccine coverage). The direct correlation between flu vaccine coverage and CFR of COVID-19 may suggest a positive effect of the natural circulation of flu infection on the effectiveness of the individuals’ immune response. Also, the natural flu infection may protect those who could not tolerate the respiratory complications of COVID-19 infection. The results may help NHSs to cope better with future pandemics. In addition, to provide a faster and more effective response to any future infectious pandemic, better access to diagnosis tests seems to be an effective approach in reducing morbidity and mortality.

The success of the vaccination programs against covid-19 depends on the level of community vaccine acceptance. The present study aimed to investigate the predictors of older adults’ intention to uptake the covid-19 vaccine in older adults. This cross-sectional study was conducted on 345 older adults in Jahrom, southern Iran. Participants were enrolled by stratified random sampling. The data collection tool was a researcher-made questionnaire consisting of items based on the health belief model (HBM), Theory of planned behavior (TPB) constructs and demographic information. Descriptive statistics, Spearman’s correlation, and Ordinal logistic regression analysis were used for data analysis using SPSS version 25. The level of significance was set at 0. 05. The mean age of participants was 67.7 (7.2) years. Most of the participants (51.3%) intended to receive the vaccine. Perceived barriers (r=-0.201), perceived benefits (r=0.302), selfefficacy (r=0.269), and subjective norms (r=0.387) had significant associations with the intention to vaccine (P<0.001). Subjective norms (β=0.159, P<0.001) were the most powerful predictor of intention to vaccine, followed by perceived benefits (β=0.112, P=0.035) and self-efficacy (β=0.086, P=0.038). health professionals should promote positive attitudes toward the covid-19 vaccine and reports about vaccination by celebrities and trusted people to persuade older adults to receive the covid-19 vaccine.

Health literacy and preventive behaviors can be considered important factors in healthcare workers’ decisions and how they function in the health system to promote the health of society. Therefore, the present study determined the relationship between health literacy and Covid-19 preventive behaviors among healthcare workers in Sistan and Baluchestan province, southeast Iran. This descriptive-analytical (cross-sectional) study was conducted on 300 healthcare workers in Sistan and Baluchistan province in 2021. Samples were collected by convenience method through social media. Data were collected electronically using the Health Literacy and Covid-19 preventive behaviors questionnaire. Data were analyzed by frequency, mean, Pearson correlation coefficient, and linear regression. Only 24.4% of healthcare workers had sufficient health literacy. The healthcare workers’ health literacy mean score was 58.39±8.57 out of 88. Also, the score of health literacy in the dimension of access was 16.38±3.45, in the dimension of understanding was 17.06±3.74, in the dimension of appraisal was 14.28±3.40, and in the dimension of the use of health information was 13.74±2.93. The mean score of preventive behaviors was 30.54±6.16 out of 48. A positive and significant relationship was observed between health literacy and preventive behaviors. Demographic variables predicted 29% of the variance of Covid- 19 preventive behaviors, with health literacy being the strongest predictor (β=0.225). The results of this study confirmed the predictive role of health literacy in Covid-19 preventive behaviors. Also, poor and borderline health literacy concerning Covid-19 was a common problem among healthcare workers in Sistan and Baluchistan province, so it reduced the probability of performing Covid-19 preventive behaviors. Therefore, it is essential to design and implement interventions to improve the health literacy of healthcare workers.

Up to this time, screening for people infected with coronavirus disease 2019 (COVID-19) relies on clinical symptoms. As a result, our study focused on establishing a relationship between clinical manifestations, risk factors, and the prognosis of COVID-19 for prompt intervention. This cross-sectional study was performed on patients with positive COVID-19 tests in Shiraz, Iran, from 2020 through 2021. Patients were randomly selected from those registered as COVID-19 positive in various family clinics affiliated with Shiraz University of Medical Sciences Health Centers. A telephone interview was conducted to gather necessary data about the clinical symptoms of 401 patients, their risk factors, and their prognosis of the disease in two weeks. Body pain, followed by fever, were the most reported symptoms. Except for dyspnea that was related to hospitalization, no relation was found between initial clinical symptoms and hospitalization or 2-week recovery. We observed a statistically significant difference between different blood groups of patients concerning their rate of hospitalization and recovery after two weeks. A significant relationship between hypertension and hospitalization was seen. Body pain, fever, certain demographic aspects (such as older age), and comorbidities like hypertension showed strong associations with the severity and prognosis of COVID-19. Our results add to the growing body of evidence suggesting blood type may play a role in the prognosis of COVID-19.

High mental workload can negatively affect nurses’ mental and physical health, quality of life, and workability. Therefore, the present study aimed to determine the relationship between mental workload and the workability among nurses. Using the multi-stage sampling method, the researchers selected 142 nurses working in Qazvin hospitals in Covid-19 patient care units to participate in a cross-sectional descriptive study. Data collection tools included a demographic information questionnaire, the NASA Workload Index, and Workability Index. Data were analyzed by independent t-test, Pearson correlation coefficient, and ANOVA in SPSS software. The mean age of participants was 31.3±6.1 years, and the work experience mean was 7.6±5.8 years. The results showed a high mental workload (80.4±13.4) and moderate workability (31.8±7.3). The number of nurses’ shifts per month was negatively correlated with workability (P=0.032). ICU nurses had the highest mental workload score and the lowest workability score. Also, workability there was a significant negative correlation between mental workability and workload (r=-0.579 & P<0.001). A reverse correlation was observed between mental workload and workability. To improve the performance and mental health of nurses, frequent training programs and management interventions should be practiced.

Knowledge and awareness of disease transmission modes and basic hygiene principles during a public health crisis are crucial for developing effective control measures. The researchers aimed to evaluate Iranians’ knowledge, attitude, and practice (KAP) throughout the coronavirus disease 2019 (COVID-19) pandemic to detect related sociodemographic variables. This cross-sectional, web-based survey was conducted from the 2nd - 8th March 2020 among the general population of Iran above 15 years of age. A 76-item self-designed questionnaire regarding KAP towards COVID-19 was used, and the participants’ demographic characteristics and sources of information were collected. The Snowball sampling method was applied for data collection, and responses were scored based on the Likert scale. Simple and multiple linear regression was performed using SPSS version 26. The statistical significance level was P<0.05. Among 8591 participants, the overall achieved knowledge, attitude, and practice score regarding COVID- 19 characteristics were 90%, 90%, and 89%. Also, an overall score of 85% was achieved regarding the knowledge of the transmission mode and high-risk groups for COVID-19. There was a significant association between female gender, higher age, and higher education with knowledge, attitude, and practice. Male gender, being single, and lower education levels were associated with lower scores in knowledge and practice (P<0.001) and poorer attitudes towards COVID-19 (P<0.001, 0.002, and <0.001, respectively). During its outbreak, the Iranian population demonstrated decent knowledge, appropriate practice, and a positive attitude towards COVID-19. Furthermore, health education programs, mainly targeting lower-knowledge individuals regarding COVID-19, are essential for encouraging a positive attitude and maintaining safe practices. Hopefully, by increasing knowledge via public health policymakers and the cooperation of the Iranian authorities and the general population, optimistic control and elimination of the disease can be anticipated.

The COVID-19 pandemic reminded scientists of the importance of designing and implementing efficient research. In this study, the frequency and quality of Iranian researchers’ manuscripts about COVID-19 were evaluated.

A comprehensive search was conducted on June 30, 2020, to assess the quality of published articles. PubMed, Embase, and Scopus databases were searched. The inclusion criteria were all articles in the field of COVID-19 published by an Iranian author in English. The authors reviewed the original research articles and systematic reviews using the Critical Appraisal Skills Programme (CASP) Checklists. Descriptive statistics and frequency distributions were reported.

After removing duplicates, 347 out of 871 related retrieved articles were remained. Among 35 original articles, thirty-one (88.6%) of them were Cross-sectional articles. There were only one Randomized clinical trial article, one Casecontrol, and two diagnostic articles. Among original researches, deficiency in reporting the sampling method, data analysis, the accuracy of the measurements, sample size calculation method, and choosing comparison groups and blinding (in RCTs) were the most common problems. Nearly 40% of original articles and 81.3% of systematic reviews andmeta-analyses were classified as good-quality articles.

Most original articles did not have good quality, while the decisions about treatment and prevention of COVID-19 and policy-making about social restriction depend on the quality of the articles. Journals should be more careful in reviewing articles critically.

This study aimed to investigate the relationship between nutritional performance and physical activity in patients with COVID-19. In this causal-comparative ex-post facto study, after obtaining a license from Shiraz University of Medical Sciences, 600 people who volunteered to participate in the present study were selected as the statistical sample. After completing the demographic information and informed consent forms, subjects completed the Nutritional Knowledge Questionnaire and the International Physical Activity Questionnaire (IPAQ). Onesample t-test, Spearman correlation coefficient, Mann-Whitney U and regression tests were used to analyze the data. The data were analyzed using SPSS software version 22, and a significant level of 0.05 for data analysis was considered. The levels of BMI, nutritional attitude, nutritional knowledge, and nutritional performance of men and women with COVID-19 were unsatisfactory (P≥0.05). Nutritional knowledge scores in women were significantly higher than in men (P≥0.05). With decreasing physical activity, nutritional performance levels increased in women and men; with decreasing nutritional attitudes, physical activity levels increased in men. Also, BMI levels improved with increasing nutritional knowledge scores (P≥0.05). It seems that lack of proper physical activity, attitude, and poor nutritional performance are the factors affecting the increase in the number of COVID-19 patients; therefore, it is recommended that health centers provide the necessary training on the optimal role of physical activity, attitude, and nutritional performance in the prevention of COVID-19 disease.

The rise of COVID-19 in the 21st century has posed challenges for national and international communities. Meanwhile, people who work in high-risk jobs in terms of biological exposure, such as banks, are more likely to be exposed to coronavirus. This study aimed to investigate the risk of probability and clinical severity of COVID-19 infection among employees of one of the bank branches in Shiraz, Iran. In this study, the risk of infection to Covid-19 among the desired bank branch employees was assessed using the Covid-age index. The related information was gathered through observation and face-to-face interviews using workplace risk assessment for exposure to SARS-COV-2 virus guidelines. Moreover, the International Labor Organization risk assessment standard was used to quantify the individuals’ risks. The average COVID-19 risk score among studied employees was 4.6, categorized as low. Moreover, the employees’ mean age and Covid-age index were 44.7±3.65 and 47.6±4.52, respectively. The severity of the clinical picture was evaluated as mild to moderate (levels 1 and 2). Moreover, the risk of disease was considered 2 for all employees, considering the work environment. The results of this study showed that the Covid-age index could effectively evaluate and quantify the risk of exposure to COVID-19. Bank personnel is exposed to the biological risk of COVID-19. People with the underlying disease are at higher risk of COVID-19 consequences.

Considering the high prevalence of COVID-19 in Iran, it is necessary to allocate health resources in response to this pandemic. Due to limitations in the number of hospital beds, analysis of the length of hospital stay in COVID-19 patients may be helpful for decision-making. This retrospective cohort study (survival study) was conducted through a follow-up of 1465 COVID-19 patients in Yazd Province, Iran. Demographic, diagnostic, and clinical data were collected using the COVID-19 data dashboard of Shahid Sadoughi University of Medical Sciences. The Kaplan-Meier method and Cox regression were used to calculate the survival probability and hazard ratio; the log-rank test was applied to compare survival function according to qualitative variables. The median and mean survival time was 25 days (95% CI: 19.10-30.89 days) and 28.38 days (95% CI: 25.6-31.16 days), respectively. The Survival probability for one week, two weeks, three weeks, four weeks, five weeks, six weeks, and seven weeks and more was 92%, 76%, 57%, 48%, 45%, 33%, and 20%, respectively. There was a significant relationship between survival time and age categories, CT scan results, history of chronic pulmonary disease, history of diabetes, history of cardiovascular disease, and disease severity (P<0.05). According to the results, age, history of cardiovascular and pulmonary diseases, and history of diabetes increased the length of hospital stay. Preventive measures should be followed to prevent COVID-19 infection and manage hospital beds required for efficient treatment of patients.

The effectiveness of COVID-19 vaccination determines the resource allocation for saving lives in this pandemic. Certainly, the efficacy of all vaccines has been studied in laboratory situations. However, the present study aims to estimate the effectiveness of vaccination in real conditions of Iranian populations by controlling the effect of demographic factors and the history of chronic diseases. This historical cohort study used information on 1988 hospitalized COVID-19 patients with less than 93% blood oxygen levels. Cox regression, Survival Tree, and Forests were applied to estimate the effect of immunity from vaccination on survival, while the effect of demographic characteristics and history of chronic diseases was controlled. The analysis showed that 10% of the patients were immunized, while the Sinopharm vaccine and the rest by Sputnik induced 86% of the immunity. Although there was no difference in the effectiveness of the vaccines, it was found that the immunity from each vaccine increased survival. Patient age was identified as the most influential factor in survival. Other contributing factors include the history of opium/smoking, cancer, the history of chronic lung disease, kidney disease, high blood pressure, and cardiovascular problems. Although age is the most influential factor in patient survival, immunity can control the risk of COVID-19. Therefore, it is recommended to prioritize the old and patients with any of the above underlying problems for vaccination and timely treatment.

Due to the unpredictability of Covid-19, policymakers should look at this issue as a complex system in developing and providing solutions to deal with it. This research aimed to provide a policy model for dealing with Covid-19. This is a qualitative study and used the theme analysis method. Data collection tools were semi-structured interviews and data analysis in open, centralized, and selective coding stages. The research area was the universities of medical sciences affiliated with the Ministry of Health. The research population of this study included senior managers and their successors who worked in the Corona headquarters with sufficient familiarity with coronavirus issues and practical and managerial experience and supervision of universities and hospitals. In this research, the required data were collected using field methods and interviews with 15 people theoretically and purposefully until the theoretical saturation was reached. The validity of the interview questions was reviewed and confirmed by experts. After analyzing the interviews and integrating the duplicate codes in several stages, 168 codes were obtained and divided into three main categories. These categories included information on the covid-19 in nine subcategories, sections dealing with covid-19 in seven subcategories, and a policy formulation framework in four subcategories. Given the interdependence of economic, social, and cultural systems in the development of policies related to covid-19 and systemic threats, all aspects should be considered.

HIV, Tuberculosis, and Malariaare neglected due to the high pressure imposed on healthcare systems by COVID-19; however, since these diseases afflict a large number of patients globally, their effect on COVID-19, as a world pandemic, should be assessed. We aimed to assess the relationship between the prevalence of these diseases and COVID-19 indices. In this ecological study, a data set was provided, which included the epidemiologic indices of COVID-19 for each country. The scatter plots of the social capital for the studied countries based on the epidemiologic indices of COVID-19 and HIV (human immunodeficiency virus), and Malaria were drawn. The prevalence of HIV, Tuberculosis, and Malaria were inversely correlated with the cumulative incidence rate of cases, the cumulative incidence rate of death, and COVID-19 tests performed per million, and was directly correlated with the recovery rate. No correlation was seen between case fatality rate and the prevalence of these infectious diseases. However, the results of this study were in favor of people afflicted with HIV, and Further studies should be conducted on the concurrence of infectious events and their adverse consequences with future analytical protocols.

The pandemic of COVID-19 affect all healthcare systems globally, and its effect on different hospital performance indicators has been debated. The study aimed to compare the impacts of COVID-19 on hospital performance indicators using pre-and post-pandemic data from training hospitals. We conducted an observational cohort study of hospital performance indicators from two healthcare facilities affiliated with Qazvin University of Medical Sciences in the north-west of Iran. The R statistical software was used to analyze monthly data on three basic performance indicators, including bed turnover, average length of stay (LOS), and bed occupancy rate before and during the outbreak of Coronavirus disease-19 (COVID-19). The pandemic had a remarkable effect on the level of bed turnover, the average length of stay (LOS), and the bed occupancy rate after one month from the COVID-19 outbreak (P<0.05). Moreover, regression results showed that after the pandemic, the first two mentioned indicators increased monthly at 108.18 and 0.15, respectively, while LOS decreased by 0.09 monthly (P<0.05). Based on the study findings, a significant decline in hospital occupancy rate and bed turnover was observed after one month since the beginning of the outbreak. This reduction was associated with a longer LOS. Using ITS in pandemics such as COVID-19 can evaluate the effect of various policies on outcome measures and help policymakers make effective decisions.

The rapid response of governments to overcome COVID-19 is increasingly important. In this study, we investigated the epidemiological changes of Covid-19 and the vaccination status of this disease in the Eastern Mediterranean Region (EMRO).

This research is a descriptive ecologic study. Data on vaccination status in the EMRO region were collected and Also the daily cases, daily COVID-19 mortality, the total number of deaths, and cases from January 3, 2020, to June 13, 2022.

Iran had the highest number of known cases and deaths, while Bahrain and Tanzania had the highest cumulative rates of cases and deaths, respectively. The highest average monthly incidence rate changes were observed in Iraq, with 41.74%. Iran had the highest average monthly death rate changes with 25.75% and the highest number of known cases and deaths.The United Arab Emirates had the highest total vaccinations per 100 individuals and the highest percentage of persons fully vaccinated.

It appears that cooperation among countries in the region regarding vaccination can lead to a decline in the disease and ultimately control its spread. Furthermore, there is a noticeable decrease in the percentage of monthly changes after the start of vaccination in the EMRO countries. The gradual increase in some countries during the last segment highlights the importance of booster vaccinations.

Through the fifth wave of the Covid-19 outbreak in Jahrom, the fatality and incidence of the virus increased. The quick spread of infection is one of the causes of this dreadful situation. Therefore, recognizing the future epidemic trend can be a useful instrument to decrease mortality and morbidity. This study aimed to determine the time trends and select the best model to predict the sixth wave of the COVID-19 outbreak using ARIMA models.

We used daily data of 9533 hospital cases (Suspected and PCR-confirmed COVID-19 cases) between 4th March 2020 and 31st December 2021. Nine different ARIMA models were fitted to our data. Autocorrelation functions (ACF) and partial autocorrelation (PACF) plots were used to determine model parameters. Likelihood-ratio test for comparison of the reduced and full model was used. In addition, Akaike Information Criteria (AIC) was also used to choose the final model. Data were analyzed by STATA 14 software with a significant level of 0.05.

The ARIMA (3, 0, 3) model was selected among the potential models, with lower AIC (999) and MAPE (3.18%) values. This model showed that the daily number of hospitalized patients may increase from 5.85 (2.16-15.79) to 8.55 (1.47-49.48) in two months. By March 01, 2022, the predictable daily hospitalized cases could reach 468.36 (03.79-2209.88).

Time series models is a useful tool for predictingthe hospitals’ admission trend during an epidemic. Thus, they can be used as early warning models in the readiness of hospital systems during epidemics.

The COVID-19 pandemic has become a big challenge for the health systems of all countries. Since there were no reliable data on the efficacy of various drugs for COVID-19 in the early months of the pandemic, medical staff had to rely on constantly changing temporary recommendations and their experience in managing patients with COVID-19. In this regard, it is important to study the actions of medical personnel in a pandemic. In this study, we investigated the administration of drugs to treat COVID-19 in Uzbekistan. We demonstrated that physicians were swiftly adapting to new therapy recommendations; however, some drugs were not used appropriately, e.g., antibiotics and dexamethasone.