Trend of COVID-19 Hospital Cases Fatality Rate in Iran: A Multicenter Study of 5318 Hospitalized COVID-19 Patients from March 2020 to March 2021

Background and Aim: Case fatality ratio (CFR) is an indicator of disease severity that can help policymakers make decisions. This study aims to evaluate the trend of CFR of hospitalized COVID-19 patients since the outset of the pandemic in Iran and identify variables that affect CFR. Methods: 5318 confirmed COVID-19 inpatients were enrolled in this multicentric observational study. Patients admitted from March 20, 2020, to March 18, 2021, in three general hospitals were collected. The medical team gathered patients’ demographics, past medical history, and outcomes by reviewing patients’ medical records. The time trend of CFR was investigated by joinpoint regression analysis to calculate weekly percent change (WPC) and confidence interval (CI). Results: Significant upward trend was observed in CFR of hospitalized COVID-19 patients during study weeks (WPC= 1.2, 95% CI: 0.7, 1.7; P < 0.001). The increase was more evident in men than in women (WPC: 1.4 vs. 1.1). The rise of CFR was observed in patients with cancer (WPC: 4.5), dialysis (WPC: 2.1), diabetes (WPC: 1.0), and old age (WPC: 1.0). Conclusion: There was a significant rise in the trend of in-hospital CFR from March 2020 to March 2021 in Iran. This rise was also evident with the same rate in patients with old-age and DM. However, the rate of this rise was higher in male and cancerous patients. Worldwide variation was reported by few studies investigating the trend of hospital CFR, and further studies are warranted

Factors that impact evaluation of left ventricular systolic parameters in myocardial perfusion gated SPECT with 16 frame and 8 frame acquisition models | [16 ve 8 frame görüntüleme modelli miyokard perfüzyon gated SPECT çalışmasında sol ventrikül sistolik parametrelerinin değerlendirilmesini etkileyen faktörler

Objective: Evaluating the effects of heart cavity volume, presence and absence of perfusion defect, gender and type of study (stress and rest) on the difference of systolic parameters of myocardial perfusion scan in 16 and 8 framing gated SPECT imaging. Methods: Cardiac gated SPECT in both 16 and 8 framing simultaneously and both stress and rest phases at one-day protocol was performed for 50 patients. Data have been reconstructed by filter back projection (FBP) method and left ventricular (LV) systolic parameters were calculated by using QGS software. The effect of some factors such as LV cavity volume, presence and absence of perfusion defect, gender and type of study on data difference between 8 and 16 frames were evaluated. Results: The differences in ejection fraction (EF), end-diastolic volume (EDV) and end-systolic volume (ESV) in both stress and rest were statistically significant. Difference in both framing was more in stress for EF and ESV, and was more in rest for EDV. Study type had a significant effect on differences in systolic parameters while gender had a significant effect on differences in EF and ESV in rest between both framings. Conclusion: In conclusion, results of this study revealed that difference of both 16 and 8 frames data in systolic phase were statistically significant and it seems that because of better efficiency of 16 frames, it cannot be replaced by 8 frames. Further well-designed studies are required to verify these finding