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Sadat Larijani M, Biglari A, Sorouri R, Salehi-Vaziri M, Doroud D, Azadmanesh K, Fotouhi F, Mostafavi E, Ramezani A. Lessons from COVID-19 Pandemic: A Successful Policy and Practice by Pasteur Institute of Iran. IRANIAN BIOMEDICAL JOURNAL 2024; 28:1-7. [PMID: 38224028 PMCID: PMC10994636 DOI: 10.61186/ibj.3964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/10/2023] [Indexed: 01/16/2024]
Abstract
The present study aims to provide an insight to the comprehensive efforts of Pasteur Institute of Iran (PII) regarding COVID-19 management, research, achievements, and vaccine production, though there are many challenges. The relevant literature review was investigated through national and international database and also reports from the related research departments. Six strategies were taken by PII to manage the pandemic of COVID-19. While this pandemic has been hopefully controlled, SARS-CoV-2 could still be a potential threat. Therefore, COVID-19 data management and updated studies, as well as long-term safety and efficacy of the SARS-CoV-2 vaccines are still on the agenda.
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Affiliation(s)
| | - Alireza Biglari
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Sorouri
- IPI Directorate, Pasteur Institute of Iran, Tehran, Iran
| | | | - Delaram Doroud
- Quality Control Department, Production and research Complex, Pasteur Institute of Iran, Tehran, Iran
| | - Keyhan Azadmanesh
- Department of Molecular Virology, Pasteur Institute of Iran, Tehran, Iran
| | - Fatemeh Fotouhi
- Department of Influenza and Other Respiratory Viruses, Pasteur Institute of Iran, Tehran, Iran
| | - Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Amitis Ramezani
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
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Taheri Soodejani M, Tabatabaei SM, Lotfi MH, Nazemipour M, Mansournia MA. Adjustment for collider bias in the hospitalized Covid-19 setting. GLOBAL EPIDEMIOLOGY 2023; 6:100120. [PMID: 38111522 PMCID: PMC10726228 DOI: 10.1016/j.gloepi.2023.100120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/14/2023] [Accepted: 08/22/2023] [Indexed: 12/20/2023] Open
Abstract
Background Causal directed acyclic graphs (cDAGs) are frequently used to identify confounding and collider bias. We demonstrate how to use causal directed acyclic graphs to adjust for collider bias in the hospitalized Covid-19 setting. Materials and methods According to the cDAGs, three types of modeling have been performed. In model 1, only vaccination is entered as an independent variable. In model 2, in addition to vaccination, age is entered the model to adjust for collider bias due to the conditioning of hospitalization. In model 3, comorbidities are also included for adjustment of collider bias due to the conditioning of hospitalization in different biasing paths intercepting age and comorbidities. Results There was no evidence of the effect of vaccination on preventing death due to Covid-19 in model 1. In the second model, where age was included as a covariate, a protective role for vaccination became evident. In model 3, after including chronic diseases as other covariates, the protective effect was slightly strengthened. Conclusion Studying hospitalized patients is subject to collider-stratification bias. Like confounding, this type of selection bias can be adjusted for by inclusion of the risk factors of the outcome which also affect hospitalization in the regression model.
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Affiliation(s)
- Moslem Taheri Soodejani
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyyed Mohammad Tabatabaei
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hassan Lotfi
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Nazemipour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Doosti-Irani A, Haji-Maghsoudi S, Haghdoost A, Eybpoosh S, Mostafavi E, Karami M, Mahjub H. The Dynamic Effective Reproductive Number of COVID-19 during the Epidemic in Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:886-894. [PMID: 35936541 PMCID: PMC9288400 DOI: 10.18502/ijph.v51i4.9250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/19/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND We aimed to determine the generation time, the best model for estimating reproduction number (R), and to estimate the basic reproduction number (R0) and effective reproduction number (Rt) for COVID-19 in Iran. METHODS We used the daily incidence cases of COVID-19, hospitalized due to a probable diagnosis of COVID-19 from 19 February 2020 to 17 November 2020 in Iran. Four models, including maximum likelihood (ML), exponential growth (EG), time-dependent (TD), sequential Bayesian (SB) were evaluated. The weekly reproduction number with a 95% confidence interval (CI) was calculated. RESULTS TD model shows the best fit compared to other models for estimating reproduction number in Iran. The R0 in Iran in the first week of the epidemic, leading up to 21 February 2020 was 7.19, 95% CI: 5.56, 9.00. The lowest value for the Rt was equal to 0.77 between 3 to 10 March 2020 and 4 to 11 December 2020. From 11 June 2020 up to13 August 2020, the Rt was more than one but after then to 24 September 2021 was less than one. CONCLUSION TD model was the best fit for estimating the R in Iran. The worst situation of the epidemic in Iran was related to the weeks leading up to 26 February 2020 and 28 October 2020, and better status was related to the weeks leading up to 10 March 2020 and 11 December 2020.
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Affiliation(s)
- Amin Doosti-Irani
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Research Center for Health Sciences, Hamadan Iran
| | - Saiedeh Haji-Maghsoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Aliakbar Haghdoost
- Department of Epidemiology and Biostatistics, School of Public Health, HIV/STI Surveillance Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sana Eybpoosh
- Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Ehsan Mostafavi
- Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Manoochehr Karami
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Mahjub
- Department of Biostatistics, School of Public Health, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Mohammadpour M, Yazdi H, Bagherifard A, Jabalameli M, Moghtadaei M, Torkaman A, Yahyazadeh H, Ghaderi MT, Fanaeian MM, Langeroudi MK, Hashemi P, Razi S, Karimpour A, Lirgeshasi SB, Bahari M. Evaluation of early complications, outcome, and mortality in Coronavirus Disease 2019 (COVID-19) infection in patients who underwent orthopedic surgery. BMC Musculoskelet Disord 2022; 23:64. [PMID: 35042507 PMCID: PMC8764495 DOI: 10.1186/s12891-022-05010-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/10/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND A higher mortality and morbidity rate has been reported in COVID-19 patients undergoing surgery. To reduce the morbidity and mortality rate in COVID-19 patients undergoing orthopedic procedures, we aimed to increase the threshold for surgical planning. METHODS In a prospective cohort study, COVID-19 patients who underwent elective or emergent orthopedic surgery in three orthopedic surgery centers from February 2020 to September 2020 were included. In this period, 6751 patients were scheduled for orthopedic surgery. To increase surgical threshold planning, all patients with grade 5 of the American Society of Anesthesiologists (ASA) classification and patients with COVID-19 related moderate to severe pulmonary involvement were identified as high-risk patients and were excluded. RESULTS 35 deaths occurred during the study. The frequency of deaths was significantly higher in patients with COVID-19, 6 (9.4%) than patients without COVID-19, 29 (0. 43%). The average hospitalization stay was 12.8 ± 12.1 days. The odds ratio (OR) for death was significantly higher in patients with COVID-19 than patients without COVID-19. [OR: 8.13, Confidence interval 95% (CI95%) (5.02-11.25), P: 0.001]. Four (6.3%) COVID-19-associated complications were recorded in this series that all were respiratory failure requiring unexpected postoperative ventilation. Twenty surgical complications (31.3%) were recorded. The odds ratio for ICU admission was significantly higher in patients with COVID-19 than patients without COVID-19. [OR: 5.46, CI 95% (2.68-8.68), P: 0.001]. CONCLUSIONS An increased threshold for orthopedic surgery is suggested for COVID-19 patients with a mortality rate of 9.3%, which is less than the mortality rate in other studies. Level of evidence III.
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Affiliation(s)
- Mehdi Mohammadpour
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Yazdi
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Bagherifard
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Jabalameli
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Moghtadaei
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Torkaman
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hooman Yahyazadeh
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taher Ghaderi
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdi Fanaeian
- Division of Gastroenterology and Liver Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Khaleghi Langeroudi
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Peyman Hashemi
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Razi
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Amer Karimpour
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sam Bemani Lirgeshasi
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Milad Bahari
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Ahmadi S, Jorjoran Shushtari Z, Shirazikhah M, Biglarian A, Irandoost SF, Paykani T, Almasi A, Rajabi-Gilan N, Mehedi N, Salimi Y. Social Determinants of Adherence to COVID-19 Preventive Guidelines in Iran: A Qualitative Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221084185. [PMID: 35349357 PMCID: PMC8968392 DOI: 10.1177/00469580221084185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Adherence to COVID-19 preventative guidelines may be influenced by a variety of factors at the individual, societal, and institutional levels. The current study sought to investigate the social factors of adherence to those preventive measures from the perspective of health professionals. METHODS In October 2020, we performed qualitative research in Tehran, Iran, using the directed content analysis method. For the preparation of our interview guide and data analysis, we employed the WHO conceptual framework of socioeconomic determinants of health. Semi-structured interviews were conducted with 15 health professionals and policymakers who were chosen using a purposive sampling approach. MAXQDA-18 software was used to analyze the data. The Goba and Lincoln criteria were used to assess the quality of the results. RESULTS There are 23 subcategories and 9 categories, which include socio-economic and political context (unstable macroeconomic environment, poor management of the pandemic, media and knowledge transfer), cultural and social values (fatalism, cultural norms, value conflicts, social customs), socio-economic positions (livelihood conditions), social capital (social cohesion, low trust), living conditions (housing conditions), occupational conditions (precarious employment), individual characteristics (demographic characteristics, personality traits, COVID-19 knowledge, and attitude), psycho-social factors (normalization of the disease, social pressure, and stigma), and health system leadership (health system problems, not taking evidence-based decisions, non-comprehensive preventive guidelines, non-operational guidelines, inadequate executive committee) were obtained. CONCLUSION To limit the new COVID-19 transmission, people must be encouraged to follow COVID-19 prevention instructions. Improving adherence to COVID-19 preventive guidelines necessitates dealing with the complexities of responding to social determinants of those guidelines. Increasing public health literacy and knowledge of COVID-19, informing people about the consequences of social interactions and cultural customs in the spread of COVID-19, strengthening regulatory lockdown laws, improving guarantees for adhering to preventive guidelines, providing easy access to preventive supplies, and strengthening financial support for households with precarious employment are all important.
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Affiliation(s)
- Sina Ahmadi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zahra Jorjoran Shushtari
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Marzieh Shirazikhah
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Akbar Biglarian
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Fahim Irandoost
- Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Toktam Paykani
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Ali Almasi
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Rajabi-Gilan
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nafiul Mehedi
- Department of Social Work, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Yahya Salimi
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Arman A, Tajik M, Nazemipour M, Ahmadinejad Z, Shahrestanaki SK, Hazrati E, Mansournia N, Mansournia MA. Risk factors of developing critical conditions in Iranian patients with COVID-19. GLOBAL EPIDEMIOLOGY 2021; 3:100046. [PMID: 33521624 PMCID: PMC7833422 DOI: 10.1016/j.gloepi.2020.100046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 12/12/2022] Open
Abstract
COVID-19 due to novel Coronavirus was first reported in Wuhan, China. Nowadays, the Islamic Republic of Iran stands among countries with high COVID-19 prevalence and high burden of disease. Since the medical resources are limited, we aimed to identify the risk factors for patients developing critical conditions. This can help to improve resource management and treatment outcomes. In this retrospective study, we included 12,677 patients who were from 26 hospitals, supervised by Tehran University of Medical Sciences with signs and symptoms of COVID-19, until April 12. University integrated IT system was adopted to collect the data. We performed Logistic regression to evaluate the association between death in COVID-19 positive patients and other variables. Cough, respiratory distress and fever were the most common symptoms in our patients, respectively. Cancer, chronic lung diseases and chronic neurologic diseases were the strongest risk factors for death in COVID-19 patients.
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Affiliation(s)
- Alireza Arman
- Medical-Surgical Department School of Nursing & Midwifery Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Tajik
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Nazemipour
- Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Ahmadinejad
- Liver Transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Keyvanloo Shahrestanaki
- Nursing Care Research Center(NCRC), School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Ebrahim Hazrati
- Department of Anesthesiology, AJA University of Medical Sciences, Tehran, Iran
| | - Nasrin Mansournia
- Department of Endocrinology, AJA University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Kaffashi A, Huang J, Bairami A, Fallah Mehrabadi MH, Yaslianifard S, Bashashati M, Banihashemi SR, Soleimanifar F, Lotfi M, Taghizadeh M, Soleimani A, Khorasani A, Moshiri F, Mozhgani SH. Complete genome sequencing and molecular characterization of SARS-COV-2 from COVID-19 cases in Alborz province in Iran. Heliyon 2021; 7:e08027. [PMID: 34549097 PMCID: PMC8447724 DOI: 10.1016/j.heliyon.2021.e08027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/05/2021] [Accepted: 09/15/2021] [Indexed: 12/03/2022] Open
Abstract
Iran was among countries which was hard hit at the early stage of the coronavirus disease 2019 (COVID-19) pandemic and dealt with the second wave of the pandemic in May and June 2020; however, there are a very limited number of complete genome sequences of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from Iran. In this study, complete genome sequences of the virus in the samples obtained from three patients in Alborz province in May and June 2020 were generated and analyzed using bioinformatic methods. The sequenced genomes were positioned in a cluster with B.4 lineage along with the sequences from other countries namely, United Arab Emirates and Oman. There were seven single nucleotide variations (SNVs) in common in all samples and only one of the sequenced genomes showed the D614G amino acid substitution. Three SNVs, 1397 G > A, 28688T > C, 29742 G > T, which had already been reported in February, were found with high frequency in all the sequenced genomes in this study, implying that viral diversity reflected in the early stages of viral transmission in Iran were established in the second wave. Considering the importance of molecular epidemiology in response to ongoing pandemic, there is an urgent need for more complete genome sequencing and comprehensive analyses to gain insight into the transmission, adaptation and evolution of the virus in Iran.
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Affiliation(s)
- Amir Kaffashi
- Agricultural Research Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Jiabin Huang
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amir Bairami
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Somayeh Yaslianifard
- The Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohsen Bashashati
- Agricultural Research Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - S Reza Banihashemi
- Agricultural Research Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Fatemeh Soleimanifar
- Department of Medical Biotechnology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohsen Lotfi
- Agricultural Research Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Morteza Taghizadeh
- Agricultural Research Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Alireza Soleimani
- Department of Infectious Disease, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Akbar Khorasani
- Agricultural Research Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Farzaneh Moshiri
- Department of Medical Biotechnology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Sayed-Hamidreza Mozhgani
- The Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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