Relationship between Vitamin D, Vitamin C, and Selenium Intake and Disease Severity and Outcomes in Patients Hospitalized with COVID-19: A Retrospective Study

Background and purpose: COVID-19 is a viral respiratory disease that results in high mortality. Evidence suggests that micronutrients affect viral and bacterial infections. This study was performed to evaluate the effectiveness of micronutrients (vitamin D, vitamin C, and selenium) on the disease severity in patients hospitalized with COVID-19. Materials and methods: This retrospective cross-sectional study was carried out in patients with diagnosis of COVID-19 in Qaemshahr Razi Hospital, 2020. Medical records were reviewed and 42 were selected. Data of patients that received micronutrients including vitamin D, vitamin C, and selenium and those that did not receive these supplements were compared. Duration of hospitalization, respiratory support, oxygen therapy, requiring invasive/non-invasive mechanical ventilation, and incident of death were investigated. Statistical analysis was done in SPSS V25. Results: Survival rates in the groups receiving vitamin C, D, and selenium were not significantly different from the groups that did not receive these supplements (P= 0.42, 0.63, 0.084, respectively). The study showed no significant relationship between vitamin D, C, and selenium intake and the need for ventilation due to respiratory distress (P= 0.139, 0.2, and 0.8, respectively). Conclusion: No remarkable difference was seen between the recipients of vitamin C, D, and selenium and those who did not receive supplements in terms of survival and the need for mechanical ventilation. So, these supplements did not affect the clinical outcomes of patients with COVID-19

Examining the effectiveness of virtual education on clinical medical teaching during COVID-19 pandemic in Razi educational hospital of Ghaemshahr

Introduction: The global health crisis caused by the COVID 19 pandemic that began in 2019 has turned higher education around the world into a challenging issue. Therefore, this study was conducted to evaluate the effectiveness of virtual education on learning of medical students during COVID 19. Methods: This descriptive cross-sectional study was performed with a census on 145 medical students through a standard questionnaire derived from clinical education standards. In comparison of effectiveness average, we used t-test and one-way ANOVA tests for two and three level and more respectively. All analyses were performed on STATA‌‌/16. Results: During COVID 19 pandemic, virtual education had the most effectiveness (26% variance and 7. 41% specificity) in compare to NAVID system (14% variance and 3. 99% specificity) on medical students learning. Effectiveness of virtual method (morning report, virtual conference, NAVID, text review and journal club) regarding to any level of medical students was significant (P-value=0. 002). Comparison of gender variables and educational department did not indicate any difference. With the exception that the text review domain of the internal training group obtained a lower effectiveness score than the infectious group (p-value = 0. 048). Conclusion: Based on medical students’ comments virtual journal club and NAVID had most and least effectiveness. As a result, students find new content available through up-to-date articles from reputable online and group journals with discussion and exchange more effective than a system set up offline. Therefore, it is recommended to move NAVID to online and interactive approach to make active space accessible for students

Impact of Covid-19 Pandemic on Some Aspects of HIV Surveillance in North of Iran

Background and purpose: COVID-19 could potentially disrupt routine care management in health systems. One of such problems is associated with HIV surveillance. The aim of this research was to study the effects of COVID-19 pandemic on HIV care indicators. Materials and methods: This retrospective cohort study was performed using data at individual and aggregate levels obtained from center for disease control and prevention in Mazandaran province affiliated with Mazandaran University of Medical Sciences. We modulated upon Poisson regression for analyzing the impact of COVID-19 pandemic on HIV incidence, mortality, treatment failure, hospitalization, refer to counselling center, HIV viral load (VL), and CD4 cell count monitoring.  Results: One year after COVID-19 pandemic, the incidence of HIV was 0.44 per 100,000 people less compared with one year earlier (P= 0.051). CD4 counting and patients follow up at this time were 0.32 less (P< 0.001) and 1.11 more (P= 0.045) per 100,000 people, respectively compared with those before the COVID-19 pandemic. Conclusion: Current study showed that COVID-19 pandemic disrupted HIV care. It seems that despite regular follow up services provided by health center staff, coronaphobia was a huge barrier to care programs in HIV patients

Antibiotic use during the first 6 months of COVID-19 pandemic in Iran : a large-scale multi-centre study

WHAT IS KNOWN AND OBJECTIVE: Although antibiotics are ineffective against viral infections, epidemiological studies have revealed that the COVID‐19 pandemic resulted in the overuse of antibiotics and disruption of antimicrobial stewardship programmes. We investigated the pattern of antibiotic use during the first 6 months of the COVID‐19 pandemic in Iran. METHODS: A multi‐centre retrospective study was designed to investigate the use of 16 broad‐spectrum antibiotics in 12 medical centres. The rate of antibiotic use was calculated and reported based on the Defined Daily Dose (DDD) per 100 hospital bed‐days. The bacterial co‐infection rate was also reported. RESULTS AND DISCUSSION: Totally, 43,791 hospitalized COVID‐19 patients were recruited in this study. It was found that 121.6 DDD of antibiotics were used per 100 hospital bed‐days, which estimated that each patient received approximately 1.21 DDDs of antibiotics every day. However, the bacterial co‐infections were detected only in 14.4% of the cases. A direct correlation was observed between the rate of antibiotic use and mortality (r[142] = 0.237, p = 0.004). The rate of antibiotic consumption was not significantly different between the ICU and non‐ICU settings (p = 0.15). WHAT IS NEW AND CONCLUSION: In this study, widespread antibiotic use was detected in the absence of the confirmed bacterial coinfection in COVID‐19 patients. This over‐consumption of broad‐spectrum antibiotics may be associated with increased mortality in hospitalized COVID‐19 patients, which can be an alarming finding