An Overview of the Epidemiologic, Diagnostic and Treatment Approaches of COVID-19: What do We Know?

Background: In late December 2019, a new infectious respiratory disease (COVID-19) was reported in a number of patients with a history of exposure to the Huanan seafood market in China. The World Health Organization officially announced the COVID-19 pandemic on March 11, 2020. Here, we provided an overview of the epidemiologic, diagnostic and treatment approaches associated with COVID-19. Methods: We reviewed the publications indexed in major biomedical databases by December 20, 2020 or earlier (updated on May 16, 2021). Search keywords included a combination of: COVID-19, Coronavirus disease 2019, SARS-CoV-2, Epidemiology, Prevention, Diagnosis, Vaccine, and Treatment. We also used available information about COVID-19 from valid sources such as WHO. Results and Conclusion: At the time of writing this review, while most of the countries authorized COVID-19 vaccines for emergency use starting December 8, 2020, there is no a definite cure for it. This review synthesizes current knowledge of virology, epidemiology, clinical symptoms, diagnostic approaches, common treatment strategies, novel potential therapeutic options for control and prevention of COVID-19 infection, available vaccines, public health and clinical implications

Care of newborns born to mothers with COVID-19 infection; a review of existing evidence

Background:The novel Coronavirus disease 2019 (COVID-19) pandemic is already wreaking havoc on families and communities\u27 welfare. It is critical to discuss newborn care of infected mothers with COVID-19 based on the latest international guidelines and national guidelines of countries with the highest incidence of COVID-19 cases. Objective:We discuss how to care for a newborn of a suspected or infected mother with COVID-19 using existing evidence. Method:As of 16 April 2020, we reviewed articles and guidelines related to COVID-19 in the reproductive health field, mother, and newborn health. Our review yielded in 10 categories (i) the risk of diagnostic procedures in suspected mothers on fetus/infant health, (ii) the risk of intrauterine or postpartum transmission to the fetus/infant, (iii) appropriate method and delivery time in women with confirmed COVID-19, (iv) umbilical cord clamping and skin to skin contact, (v) clinical manifestations of infected infants, (vi) confirmation of infection in a suspected neonate/infant, (vii) instructions for infant\u27s care and how to feed her/him, (viii) bathing the baby, (ix) the criteria of discharging baby from the hospital, (x) the impact of isolation on the maternal mental health. Results:Our findings showed that the possibility of intrauterine or perinatal transmission of COVID-19 is still questionable and ambiguous. However, what has been agreed upon in the existing texts and guidelines is that the close contact of mother and infant after birth can transmit the virus to the baby through droplets or micro-droplets. Conclusions:Based on our findings, it is recommended to separate the baby from the mother with confirmed (or suspected) COVID-19 infection for at least 2 weeks. Since the motivation and stable situation of mothers allow breastfeeding during the isolation, infected mothers should be taught about breast expression skills, common breast problems, the symptoms of their baby\u27s infection, and the principles of personal hygiene to protect the infant against COVID-19 infection

COVID-19 and acute kidney injury; a case report

Although there is no definitive evidence that coronavirus disease 2019 (COVID-19) affects the kidneys adversely, amongst those who develop severe COVID-19 infection and require hospitalization, acute kidney injury (AKI) was reported. Here, we report the clinical outcome associated with AKI in a 32-year-old man with confirmed COVID-19 infection with no prior history of renal malfunction. The AKI was identified during intensive care unit (ICU) course with the median creatinine and blood urea nitrogen values of 3.1 mg/dL (normal value: 0.6-1.2 mg/dL) and 145 mg/dL (normal value:15-45 mg/dL), respectively. Renal function of patients hospitalized with COVID-19 infection needs to be monitored regularly to intervene as early as possible and to prevent the development of AKI and further kidney complications

An increase in cesarean section rate during the first wave of COVID-19 pandemic in Iran

Background The COVID-19 pandemic and its impact on healthcare services is likely to affect birth outcomes including the delivery mode. However, recent evidence has been conflicting in this regard. The study aimed to assess changes to C-section rate during the COVID-19 pandemic in Iran. Methods This is a retrospective analysis of electronic medical records of women delivered in the maternity department of hospitals in all provinces of Iran before the COVID-19 pandemic (February-August 30, 2019) and during the pandemic (February-August 30, 2020). Data were collected through the Iranian Maternal and Neonatal Network (IMAN), a country-wide electronic health record database management system for maternal and neonatal information. A total of 1,208,671 medical records were analyzed using the SPSS software version 22. The differences in C-section rates according to the studied variables were tested using the χ2 test. A logistic regression analysis was conducted to determine the factors associated with C-section. Results A significant rise was observed in the rates of C-section during the pandemic compared to the pre-pandemic (52.9% vs 50.8%; p = .001). The rates for preeclampsia (3.0% vs 1.3%), gestational diabetes (6.1% vs 3.0%), preterm birth (11.6% vs 6.9%), IUGR (1.2% vs 0.4%), LBW (11.2% vs 7.8%), and low Apgar score at first minute (4.2% vs 3.2%) were higher in women who delivered by C-section compared to those with normal delivery (P = .001). Conclusions The overall C-section rate during the first wave of COVID-19 pandemic was significantly higher than the pre-pandemic period. C-section was associated with adverse maternal and neonatal outcomes. Thus, preventing the overuse of C-section especially during pandemic becomes an urgent need for maternal and neonatal health in Iran

Online National Health Agency Mask Guidance for the Public in Light of COVID-19: Content Analysis

Background: The rapid global spread of the coronavirus disease (COVID-19) has compelled national governments to issue guidance on the use of face masks for members of the general public. To date, no work has assessed how this guidance differs across governments. Objective: This study seeks to contribute to a rational and consistent global response to infectious disease by determining how guidelines differ across nations and regions. Methods: A content analysis of health agency mask guidelines on agency websites was performed in late March 2020 among 25 countries and regions with large numbers of COVID-19 cases. Countries and regions were assigned across the coding team by language proficiency, with Google Translate used as needed. When available, both the original and English language version of guidance were reviewed. Results: All examined countries and regions had some form of guidance online, although detail and clarity differed. Although 9 countries and regions recommended surgical, medical, or unspecified masks in public and poorly ventilated places, 16 recommended against people wearing masks in public. There were 2 countries that explicitly recommended against fabric masks. In addition, 12 failed to outline the minimum basic World Health Organization guidance for masks. Conclusions: Online guidelines for face mask use to prevent COVID-19 in the general public are currently inconsistent across nations and regions, and have been changing often. Efforts to create greater standardization and clarity should be explored in light of the status of COVID-19 as a global pandemic. Keywords: COVID-19; content analysis; infectious disease; online health information; pandemic; personal protective equipment; public health; public health policy

Targeting the PI3K/Akt/mTOR Signaling Pathway: Applications of Nanotechnology

Mammalian target of rapamycin (mTOR), as an axial mediator of multiple cell growth pathways, is in connection with several other proteins that are involved in the regulation of homeostasis in the cell function. mTOR"s signaling pathway participates in and integrates a variety of environmental cues to control cancer cell and normal tissue development. mTOR and its inhibitors including the rapamycin analogues are attractive therapeutic indication to clinical trials for treating various types of cancers, with or without inhibitors of other signaling pathways. Despite the promising results in cancer treatment, low water solubility of rapamycin is shown to decrease its therapeutic efficacy. To reach an acceptable level of efficacy, high distribution and accepted dispersing of utilized drugs in control of mTOR signaling pathway, nanomaterials-based drug delivery can play an important role. Evaluation of the mechanisms and therapeutic effects of nanoparticle-based mTOR modulation can be useful in developing safe strategies in treatment of cancer. Regarding the clinical importance of mTOR deregulation in human diseases, hereby, we address the recent progress in the field of nanoparticle-based mTOR targeted therapy

Trans-chalcone enhances insulin sensitivity through the miR-34a/SIRT1 pathway

Objective(s): Trans-chalcone as the parent member of the chalcone series reduces circulating levels of insulin and glucose. However, the cellular mechanism of these effects is poorly understood. Sirtuin 1 (SIRT1) as a direct target of miR-34a controls homeostasis of glucose, and also improves insulin sensitivity. Therefore, the present study for the first time investigated the influence of trans-chalcone on the miR-34a/SIRT1 pathway as a possible mechanism for its hypoglycemic and hypoinsulinemic effects. Materials and Methods: In this study, thirty male rats were randomly divided into three groups (n=10): solvent control (NS), oral administration of trans-chalcone for 2 (N2T) and 6 weeks (N6T) groups. Then, hepatic levels of miR-34a and SIRT1 were measured through the qRT-PCR method.Results: Trans-chalcone reduced food intake, body weight gain, and serum glucose as well as insulin levels. Also, this chalcone inhibited hepatic miR-34a expression and significantly elevated SIRT1 mRNA level. Conclusion: Trans-chalcone as an insulin-sensitizing chalcone partly acts through the miR-34a/SIRT1 pathway

Lung cancer and kidney injury: An updated review

Lung cancer is the leading cause of cancer deaths worldwide, accounting for an estimated 1.8 million deaths. Lung cancer is also the most common primary cancer leading to soft tissue (ST) metastasis. Renal disease may occur as a direct or indirect consequence of the cancer itself (e.g., post-renal obstruction, compression, or infiltration), its treatment (e.g., radiotherapy or chemotherapy), or its related complications (e.g., opportunistic infection). Existing evidence shows that the most frequent primary solid tumor responsible for renal metastasis is pulmonary carcinoma, followed by gastric, breast, soft tissue, and thyroid carcinomas. Chronic kidney disease is a potential risk factor in the survival of patients with lung cancer. In this review, we will discuss causes of kidney injury in relation to lung cancer, potential mechanisms of kidney injury, and treatment options

Socioeconomic and environmental factors associated with waterpipe tobacco smoking among Iranian adults: A PERSIAN cohort-based cross-sectional study

BACKGROUND: Waterpipe tobacco smoking (WTS) is associated with several deleterious health outcomes. We sought to estimate the prevalence of WTS and explore socioeconomic inequalities associated with this culturally-rooted tobacco smoking practice among Iranian adults. METHODS: A cross-sectional analysis was conducted among 20,460 adults (ages 18 and older) enrolled in the PERSIAN cohort study during 2020. Data were collected on socioeconomic status (SES), lifestyle, alcohol consumption, cigarette smoking, and several risk factors related to non-communicable diseases. The concentration curve and relative concentration index (RCI) were administered to assess and quantify the SES-based inequality in WTS. RESULTS: Overall age-adjusted prevalence of past-month WTS was 5.1% (95%CI:4.6-5.8), with about 1% for women and 10.6 for men. Age-adjusted prevalence of WTS was higher among younger adults, men, cigarette smokers, obese adults, and those with higher SES. The RCI estimation showed that WTS is more popular among adults with high income and education. WTS was higher among younger adults, cigarette smokers, obese adults, and those with higher SES. CONCLUSION: There is a clear socioeconomic inequality in WTS, with a higher prevalence among adults with higher income and education. The findings suggest the need for targeted interventions to address this inequality and reduce the prevalence of WTS among high-income communities