Effect of epidemic management and control plan on COVID-19 mortality in Iran: an interrupted time series analysis

Background: Several measures have been taken around the world to decrease  COVID-19 mortality. However, the effectiveness of preventive measures on the mortality related to COVID-19 has not been fully assessed. Thus, the aim of the present study was to evaluate the success of COVID-19 epidemic management and control plan on the mortality related to COVID-19 in Iran since February 19, 2020 to February 5, 2021. Methods: In the current quasi experimental study an interrupted time series analysis (ITS) of daily collected data on confirmed deaths of COVID-19 occurred in Iran and in the world,  were performed using Newey ordinary least squares (OLS) regression-based methods. Results: In Iran the trend of new deaths increase significantly every day until 24 November 2020 according to pre intervention slope of 1.14 (95% CI = [0.96 – 1.32]; P < 0.001). The occurrence of new deaths had a decreasing trend after 24 November 2020 with a coefficient of  -5.12 (95% CI = [-6.04 – -4.20; P <0.001]). But in the global level daily new deaths was increasing before (18.66 (95% CI = [14.41 – 2292]; P < 0.001)) and after the 24 November 2020  (57.14 (95% CI = [20.80–  93.49]; P: 0.002)). Conclusion: Iranian Covid-19 epidemic management and control plan was able to reduce the mortality related to COVID-19, effectively. Therefore, it is essential to continue these measures, in order to  prevent the increase in the number of deaths

Determine the most common clinical symptoms in COVID-19 patients: a systematic review and meta-analysis

Introduction: COVID-19 is an emerging infectious disease. The study about features of this infection could be very helpful in better knowledge about this infectious disease. The current systematic review and meta-analysis were aimed to estimate the prevalence of clinical symptoms of COVID-19 in a systematic review and meta-analysis. Methods: A systematic review using Medline/PubMed, Scopus, and Google scholar has been conducted. In the current systematic review and meta-analysis, the articles published in the period January 1, 2020, to April 2, 2020, written in English and reporting clinical symptoms of COVID-19 was reviewed. To assess, the presence of heterogeneity, the Cochran’s Q statistic, the I2 index, and the tau- squared test were used. Because of significant heterogeneity between the studies the random-effects model with 95% CI was used to calculate the pooled estimation of each symptom prevalence. Results: The most common symptoms in COVID-19 patients include: Fever 81.2% (95% CI: 77.9-84.4); Cough: 58.5% (95% CI: 54.2-62.8); Fatigue 38.5% (95% CI: 30.6-45.3); Dysp- nea: 26.1% (95% CI: 20.4-31.8); and the Sputum: 25.8% (95% CI: 21.1-30.4). Based on the meta-regression results, the sample size used in different studies did not have a significant effect on the final estimate value (P > 0.05). Conclusion: Considering the main symptoms of COVID-19 such as Fever, Cough, Fatigue, and Dyspnea can have a key role in early detection of this disease and prevent the transmission of the disease to other people

Case Fatality Rate of COVID-19: A Systematic Review and Meta-Analysis

Objective: The ongoing novel coronavirus disease 2019 (COVID-19) is the main cause of morbidity and mortality due to its contagious nature and absence of vaccine and treatment. Although there are considerable primary studies that reported extremely variable case fatality rate (CFR) of COVID-19, there is no review study that attempted to estimate CFR of COVID-19. The current systematic review and meta-analysis was aimed to estimate the pooled CFR of COVID-19. Methods: Electronic databases: PubMed, Science Direct, Scopus and Google Scholar were searched to retrieve the eligible primary studies that reported CFR of COVID-19. Keywords: ("COVID-19"OR "COVID-2019" OR "severe acute respiratory syndrome coronavirus 2"OR "severe acute respiratory syndrome coronavirus 2" OR "2019-nCoV" OR "SARS-CoV-2" OR "2019nCoV" OR (("Wuhan" AND ("coronavirus" OR "coronavirus")) AND (2019/12[PDAT] OR 2020[PDAT]))) AND ("mortality "OR "mortality" OR ("case" AND "fatality" AND "rate") OR "case fatality rate") were used as free text and MeSH term in searching process. Random-effects model used to estimate the CFR in this study. I2 statistic, Cochran’s Q test and T2 were used to assess the available heterogeneity between included studies. Results: The overall pooled CFR of COVID 19 was 10.0 %( 95% CI: 8.0-11.0); P<0.001; I2 = 99.7). The pooled CFR of COVID 19 in general population was 1.0% (95% CI: 1.0–3.0); P<0.001; I2 = 94.3), while in hospitalized patients was 13.0 % (95% CI: 9.0–17.0); P<0.001, I2 = 95.6). The pooled CFR in patients admitted in intensive care unit (ICU) was 37.0 % (95% CI: 24.0–51.0); P<0.001, I2 = 97.8) and in patients older than 50 years was 19.0 % (95% CI: 13.0–24.0); P<0.001; I2 = 99.8). Conclusion: The present review results highlighted the need of transparency in testing and reporting policies and denominators used in CFR estimation. It is also necessary reporting the cases age, sex and the comorbidity distribution of all patients which important in comparing the CFR among different segments of population

Productivity and years of life lost due to fatal traffic injuries in Shiraz Shahid Rajaei Hospital during 2009-2013

Background: Road traffic injuries (RTIs) are an important public health concern, and one of the main causes of death leading to loss of productive and effectual years of life. This study aimed to determine the economic burden of fatal crashes for about 5 years in Shahid Rajaei Hospital in Shiraz. Methods: In this cross-sectional study, cost and demographic data related to the people who died in the hospital due to RTIs, during 2009-2013, were obtained from medical records. Economic burden of traffic accidents that led to death was estimated using human capital as direct costs of treatment and potential years of life lost (PYLL) and lost productivity as indirect costs. Results: During 2009-2013, 989 individuals died from traffic accidents in Shiraz, imposing 1.58 million US dollars to hospital costs, 41,298 PYLL, and 67 million US dollars productivity lost. In this study, the mean age of the dead people was 43.3 ± 22.24, and the productivity lost per capita was 67,000 US. Conclusions: The economic burdens of traumatic brain injuries were high in fatal accidents in Fars Province equivalent to 0.0003 of Iran's gross domestic product in 2013. Thus, special attention should be directed toward prevention measures for fatal traffic accidents

Association between parity and obesity: A cross sectional study on 6447 Iranian Females

Objective: The aim of this study was to determine the relationship between parity and obesity in Iranian women.   Methods: In a cross-sectional study, a total of 6447 urban women aged 40-65  were studied. A face-to-face interview was conducted by trained personnel. Statistical associations between parity and obesity using the multivariate logistic regression model were examined.  Results: The mean age of the enrolled women was 48.4 ± 6.1 years. The mean BMI was 27.55 ± 4.5 Kg/m2. Of the total participants enrolled, 3517 (54.6%) had <3 parities, while 2930 (54.4%) had ≥3 parities. The prevalence of obesity (BMI ≥30 Kg/m2) and overweight (30> BMI ≥25) was 27.50 % (95% CI 26.85-28.15) and 43.70% (95% CI 42.98-44.42), respectively. After adjustment for potential confounders, women with ≥3 parities were at higher risk of being obese (OR 1.19, 95% CI 1.05-1.35).  Conclusion: There was a statistically significant positive association between higher parity and obesity. According to the results of this study, Body Mass Index (BMI) is associated with high parity in Iranian women. It is recommended that health policymakers plan appropriate weight loss programs for postpartum

Knowledge and Practice of Nursing Staff about Sharp Waste Management in Selected Hospitals of Military (Tehran) and Non- Military (Qom) in 2012

Healthcare wastes are a major challenge in public health and comprise all types of wastes generated by healthcare centers, research facilities, and laboratories. The aim of this study was surveying the knowledge and practice of nursing staff about sharp waste management in selected military (Tehran) and non- military (Qom) hospitals in 2012. This was a descriptive-analytical study on 143 nursing stuff in Military and Non-Military hospitals. Data was collected using a self-report questionnaire. Statistical tests such as the student t-test, one-way analysis of variance and Pearson correlation were used to data analysis. The mean age of participants was 32(±6.3) and the majority were female. The mean score of knowledge was 54.7(±14.4) and their knowledge classified on a moderate level. Also, the mean score of practice was 65.44(±11.6) and was classified on a moderate level. The means of these variables were higher among personnel of Military than Non-Military. There were positive correlations between knowledge, practice and age variables (

The Prediction Incidence of the Three Most Common Cancers Among Iranian Military Community During 2007-2019: a Time Series Analysis.

Objective. Cancers are one of the most important public health problems in Iran. Because of the importance of cancers, the purpose of the current study was to the prediction of the future incidence of the most common cancers among Iranian military community (MC) by using the time series analysis during 2007 to 2019.Methods. In the current cross-sectional study, all registered cancers among Iranian MC entered the study. To select the best model of prediction, various methods including autocorrelation function (ACF), partial autocorrelation function (PACF), and Akaike information criterion (AIC) statistics were used. All analysis was performed by using ITSM, stata14, and Excel2010 software.Results. The most prevalent cancers among Iranian MC were breast, prostate, and colon cancers respectively. The time series analysis was shown that the trend of all mentioned cancers in Iranian MC will increase in the coming years.Conclusion. the trend of most prevalent cancers among Iranian MC was increasing but the different factors like the growth of population size and improving the registration system

Prevalence of needlestick injuries among health-care workers in iranian hospitals: An updated systematic review and meta-analysis

Background: Needlestick and sharp injuries have been identified as the most dangerous factor among health-care workers. The Centers for Disease Control and Prevention estimates that 385,000 health-care workers experience needlestick each year. Methods: The aim of this study was to determine the prevalence of needlestick injuries (NSIs) in Iranian health-care workers. In this review and meta-analysis, the local and international databases such as Scopus, Medline, PubMed, ScienceDirect, Web of Science, Google Scholar, Scientific Information Database (SID), and Magiran were searched using keywords including prevalence OR needle OR needle stick OR Sharp injury OR Iranian personnel's OR Iranian health care workers OR Iranian hospitals OR Iran. The original researches that determined the prevalence of NSIs among Iranian health-care workers and published from January 2005 to June 2019 were included in the current study. The pooled prevalence of NSIs was determined using a random-effects model with a 95 confidence interval. All analyses were performed using STATA version 11 (Stata Corporation, College Station, TX, USA). P Results: The overall prevalence of NSIs among Iranian health-care personnel was about 50.8 (46.3-55.2). Furthermore, this prevalence in educational, noneducational, both noneducational and educational, and military centers was about 51.1 (46.5-57.7), 40.4.1 (34.2-46.6), 61.0 (32.1-89.9), and 41.5 (23.0-60.0), respectively. The prevalence of NSIs among the nurses was 51.1 (45.4-56.8), which was more than other groups. Conclusions: The prevalence of NSIs in Iranian hospitals was high. Since most of the injuries are caused by nurses, more intervention programs should be designed for nurses in these wards

Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in IRAN: A single center study.

BackgroundAn outbreak of COVID-19 in Iran has spread throughout the country. Identifying the epidemiological characteristics of this disease will help to make appropriate decisions and thus control the epidemic. The aim of this study was characterization of the epidemiological features of COVID-19 in Iran.MethodsIn this retrospective study, data related to the epidemiological characteristics of COVID-19 patients admitted to Baqiyatallah Hospital in Tehran, Iran, from 19 February 2020 to 15 April 2020 have been analyzed and reported. Patient characteristics including age, gender and underlying diseases were investigated. Data were collected through patient records. Sex ratio, Case Fatality Rate (CFR) and daily trend of cases were also determined. A multiple logistic regression analysis was also performed to assess affecting factors on mortality.ResultsFrom February 19, 2020 to April 15, 2020, 12870 patients referred to the hospital emergency department, of which 2968 were hospitalized with COVID-19 diagnosis. The majority of cases were in the age group of 50 to 60 years of old. The male-to-female ratio was 1.93:1. A total of 239 deaths occurred among all cases for an overall CFR of 1.85% based on the total number of patients (both outpatient and inpatient) and 8.06% among hospitalized patients. Out of all patients 10.89% had comorbidity. Diabetes, chronic respiratory diseases, hypertension, cardiovascular diseases, chronic Kidney diseases and cancer were the most common comorbidities with 3.81, 2.02 , 1.99 , 1.25, 0.60 and 0.57 %, respectively. Male gender (OR=1.45, 95% CI: 1.08-1.96), older age (OR=1.05, 95% CI: 1.04-1.06) and having underlying diseases (OR=1.53, 95% CI: 1.04-2.24) were significantly associated with mortality.ConclusionsThe results of this study showed that Male gender, older age and having comorbidities were significantly associated with the risk of death among COVID-19 patients. It is important to pay special attention to male elderly patients with underlying diseases