COVID-19 Vaccines Cost-Effectiveness Analysis: A Scenario for Iran

COVID-19 vaccines are supposed to be critical measure for ending the pandemic. Governments had to decide on the type of vaccine to provide for their population. In this decision-making process, cost-effectiveness analysis is considered a helpful tool. This study is a cost-effectiveness analysis utilized to calculate the incremental cost per averted disability-adjusted life year (DALY) by vaccination compared to no vaccination for different COVID-19 vaccines. The incremental cost-effectiveness ratio (ICER) for a vaccination with COVID-19 vaccines was estimated at 6.2 to 121.2 USD to avert one DALY and 566.8 to 10,957.7 USD per one death. The lowest and highest ICERs belong to Ad26.COV2.S and CoronaVac, respectively. Considering the scenario of Iran, vaccines that are recommended include ad26.cov2.s, chadox1-S, rAd26-S + rAd5-S, and BNT162b2 in the order of recommendation

Importance of the COVID-19 Vaccine Booster Dose in Protection and Immunity

Background: There is debate on the necessity of booster doses of COVID-19 vaccination, especially in countries with limited resources. Methods: This cross-sectional study was conducted in a referral laboratory in Tehran, Iran. The level of COVID-19 antibodies was measured and compared between individuals regarding the number of COVID-19 vaccine shots. Results: In this study, 176 individuals with a mean age of 36.3 (±11.7) years participated. A total of 112 individuals received two doses of the COVID-19 vaccine, and 64 individuals received three doses. Level of all antibodies was higher in those who received three doses than in those who received two doses of the COVID-19 vaccine. Considering the SARS-CoV-2 Spike IgG, the difference was not statistically significant but for the SARS-CoV-2 RBD IgG and SARS-CoV-2 NAB the difference was statistically significant. Regarding to the background variables, receiving influenza vaccine in the past year, history of autoimmune diseases and past medical history of chicken pox showed a significant association with the number of vaccine doses received. Their effects on the outcome variables assessed with multivariate logistic regression analysis. Conclusion: The results of our study show that a booster dose of the COVID-19 vaccine enhances the antibody response

Mental Health of Healthcare Workers During the Third Wave of the COVID-19 Pandemic: Did We Forget them after the First Wave?

Background: Since December 2019, countries experienced different numbers of COVID-19 pandemic waves. The COVID-19 pandemic led to adverse psychologic problems in the communities and among healthcare workers (HCWs), but the dynamic of these problems through different waves needs to be established more. Materials and Methods: This cross-sectional study was conducted in October 2020, through the third wave of the COVID-19 pandemic, in Isfahan, Iran. We studied HCWs' depression, anxiety, and stress using Depression, Anxiety, Stress Scale-21 (DASS-21) and insomnia using Insomnia Severity Index (ISI) questionnaires. Multiple linear regression was used to evaluate the association of some characteristic factors with different psychologic symptoms. Results: Our results showed that about 80% of HCWs had one or more psychological problems. The prevalence of depression, anxiety, stress, and insomnia was 46.0%, 50.2%, 44.6%, and 66.5%, respectively. Female sex, working in ICU, and having a history of chronic disease were predictors of psychological symptoms in our participants. Conclusion: HCWs' mental health state could be underestimated or neglected. The third pandemic wave negatively affected the mental health of the HCWs. Since mental health problems of HCWs may reduce the quality of care, the potential impact of not addressing this issue should be highlighted

Steroid in the treatment of outpatient COVID-19: A multicenter randomized controlled trial

Background: Early treatment of COVID-19 patients could reduce hospitalization and death. The effect of corticosteroids in the outpatient setting is still unknown. This study aimed to determine the effect of corticosteroids in the prevention of hospitalization of nonsevere cases. Materials and Methods: This study is a multicenter randomized controlled trial. Seventy five nonsevere COVID-19 patients presented between days 7 and 14 of their symptoms received either prednisolone or placebo. The primary outcome was hospitalization. The study protocol was registered in the Iranian Registry of Clinical Trials on December 2, 2020 (IRCT20171219037964N2). Results: Although the rate of hospitalization in the prednisolone group was higher than the placebo group (10.8% vs. 7.9%, respectively), it was not statistically significant (P value.,6). One patient in each group reported an adverse event and withdrew the medication. Conclusion: Considering the null effect of corticosteroids in the prevention of hospitalization in outpatient settings, it is suggested not to consider corticosteroids for outpatient treatment

The Seroprevalence and Seropositivity of SARS-CoV-2 among Healthcare Workers during the Third Pandemic Wave

Background: Due to the unclear protective role of produced antibodies and the need for seroepidemiologic studies, we surveyed the COVID-19 seroprevalence among healthcare professionals who had direct or indirect contact with COVID-19 patients. Methods: From 19 October 2020 to 17 February 2021, 300 healthcare workers were enrolled and tested for serum antibodies in this prospective cohort study. Demographic information, risk factors, and infection history were collected. Anti- SARS-CoV-2 IgG and IgM antibody titers were determined to estimate the seroconversion rate. Results: During the first and second phases of the study, the positive seroconversion rates were 31.7 and 26.6%, respectively. In seronegative individuals, sixteen (10.6%) new cases of COVID-19 and five (6.3%) reinfections were identified. Among those with a positive antibody level, forty-one (36.9%) healthcare workers reported no symptoms in the preceding months. There was no association between occupational exposure and an increased probability of seroconversion. Conclusions: The seropositivity rate and the rate of asymptomatic individuals with seroconversion was remarkable and could be an indicator of a high infection rate among healthcare workers

COVID-19 in Iran: Forecasting Pandemic Using Deep Learning

COVID-19 has led to a pandemic, affecting almost all countries in a few months. In this work, we applied selected deep learning models including multilayer perceptron, random forest, and different versions of long short-term memory (LSTM), using three data sources to train the models, including COVID-19 occurrences, basic information like coded country names, and detailed information like population, and area of different countries. The main goal is to forecast the outbreak in nine countries (Iran, Germany, Italy, Japan, Korea, Switzerland, Spain, China, and the USA). The performances of the models are measured using four metrics, including mean average percentage error (MAPE), root mean square error (RMSE), normalized RMSE (NRMSE), and R2. The best performance was found for a modified version of LSTM, called M-LSTM (winner model), to forecast the future trajectory of the pandemic in the mentioned countries. For this purpose, we collected the data from January 22 till July 30, 2020, for training, and from 1 August 2020 to 31 August 2020, for the testing phase. Through experimental results, the winner model achieved reasonably accurate predictions (MAPE, RMSE, NRMSE, and R2 are 0.509, 458.12, 0.001624, and 0.99997, respectively). Furthermore, we stopped the training of the model on some dates related to main country actions to investigate the effect of country actions on predictions by the model