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Boukandou Mounanga MM, Mezui A, Mewono L, Mogangué JB, Aboughe Angone S. Medicinal plants used in Gabon for prophylaxis and treatment against COVID-19-related symptoms: an ethnobotanical survey. Front Pharmacol 2024; 15:1393636. [PMID: 39035990 PMCID: PMC11258373 DOI: 10.3389/fphar.2024.1393636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/04/2024] [Indexed: 07/23/2024] Open
Abstract
Background: Gabon faced COVID-19 with more than 49,000 individuals tested positive and 307 recorded fatalities since the first reported case in 2020. A popular hypothesis is that the low rate of cases and deaths in the country was attributed to the use of medicinal plants in prevention and treatment. This study aimed to document the plants used for remedial and preventive therapies by the Gabonese population during the COVID-19 pandemic and to pinpoint specific potential plant species that merit further investigation. Methods: An ethnobotanical survey involving 97 participants was conducted in Libreville. Traditional healers and medicinal plant vendors were interviewed orally using a semi-structured questionnaire sheet, while the general population responded to an online questionnaire format. Various quantitative indexes were calculated from the collected data and included the relative frequency of citation (RFC), use value (UV), informant consensus factor (ICF), relative importance (RI), and popular therapeutic use value (POPUT). One-way ANOVA and independent samples t-test were used for statistical analyses. p-values ≤0.05 were considered significant. Results: The survey identified 63 plant species belonging to 35 families. Prevalent symptoms treated included fever (18%), cough (16%), fatigue (13%), and cold (12%). The demographic data highlighted that 52.58% of male subjects (p > 0.94) aged 31-44 years were enrolled in the survey, of which 48.45% (p < 0.0001) and 74.73% (p < 0.99) of informants had university-level education. In addition, the results indicated that a total of 66% of the informants used medicinal plants for prophylaxis (34%), for both prevention and treatment (26%), exclusively for treatment (3%), and only for prevention (3%) while suffering from COVID-19, against 34% of the participants who did not use plants for prevention or treatment. Annickia chlorantha, Citrus sp., Alstonia congensis, Zingiber officinale, and Carica papaya emerged as the most commonly cited plants with the highest RFC (0.15-0.26), UV (0.47-0.75), and RI (35.72-45.46) values. Most of these plants were used either individually or in combination with others. Conclusion: The survey reinforces the use of traditional medicine as a method to alleviate COVID-19 symptoms, thereby advocating for the utilization of medicinal plants in managing coronavirus infections.
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Affiliation(s)
- Marlaine Michel Boukandou Mounanga
- Institut de Pharmacopée et de Médecine Traditionnelle (IPHAMETRA), Centre National de la Recherche Scientifique et Technologique (CENAREST), Libreville, Gabon
| | - Annais Mezui
- Centre Hospitalier Universitaire Mère- Enfant, Fondation Jeanne EBORI, Libreville, Gabon
| | - Ludovic Mewono
- Groupe de Recherche en Immunologie 2, Microbiologie appliquée, Hygiène et Physiologie, Département des Sciences de la Vie et de la Terre-Ecole Normale Supérieure, Libreville, Gabon
| | - Jean Bertrand Mogangué
- Institut de Pharmacopée et de Médecine Traditionnelle (IPHAMETRA), Centre National de la Recherche Scientifique et Technologique (CENAREST), Libreville, Gabon
| | - Sophie Aboughe Angone
- Institut de Pharmacopée et de Médecine Traditionnelle (IPHAMETRA), Centre National de la Recherche Scientifique et Technologique (CENAREST), Libreville, Gabon
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Fathi F, Ameri A, Safa O, Hassaniazad M, Fathalipour M. Evaluation of short-term adverse events of COVID-19 vaccines: An observational study. Medicine (Baltimore) 2024; 103:e35549. [PMID: 38394514 DOI: 10.1097/md.0000000000035549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) vaccines are the most effective tools in managing the pandemic. However, the concern about these vaccines is the occurrence of unwanted adverse events (AEs). This study aimed to evaluate the short-term AEs of COVID-19 vaccines (Sputnik V, Astrazenka, and Sinopharm). A cross-sectional study using an online questionnaire was conducted among 321 vaccinated individuals. Demographic information, history of drug use, prior infection with COVID-19, the type of vaccine, vaccination stage, local injection site complication, systemic complication, and allergic reactions were collected and evaluated. Local complications, including pain and swelling at the injection site, and systemic complications, including fever, fatigue, lethargy, lymphadenopathy, and diarrhea, were reported after the injection of the AstraZeneca vaccine was more than the other 2 vaccines; The prevalence of fatigue and lethargy was higher than other systemic complications. The least reported complication was due to lymphadenopathy. The Sinopharm vaccine showed a lower prevalence of AEs than the other 2. The rare AEs, such as facial paralysis, nasal bleeding, and urticarial, were further reported after injection of the AstraZeneca vaccine. In general, the severity of systemic complications after the second dose of the vaccine was also higher than the first dose. All 3 vaccines were safe and tolerable. The most commonly reported AEs were injection site pain (local) and fatigue and lethargy (systemic). These expected AEs occurred shortly after vaccination and indicated an early immune response after vaccination.
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Affiliation(s)
- Fatemeh Fathi
- Student Research Committee, Faculty of Pharmacy, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ali Ameri
- Student Research Committee, Faculty of Pharmacy, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Omid Safa
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Hassaniazad
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammad Fathalipour
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Department of Endocrinology and Metabolic Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Shiraz, Iran
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Tabatabaei SR, Babaie D, Hoseini-Alfatemi SM, Shamshiri A, Karimi A. Determining the coverage and efficacy of the COVID-19 vaccination program at the community level in children aged 12 to 17 in Tehran. GMS HYGIENE AND INFECTION CONTROL 2024; 19:Doc04. [PMID: 38404412 PMCID: PMC10884833 DOI: 10.3205/dgkh000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Background The vaccination is one of the acceptable and recomended solution to prevent and control of COVID-19. The aim of this study was to determine the efficacy of sinopharm vaccination in children aged 12-17 in Tehran. Methods The case population study was performed from October 2021 to March 2022 among 1,500 children with positive PCR test reffered in Mofid Children's Hospital in Tehran. 64 children aged 12-17 years were included. The data were collected by the hospital information system (HIS), vaccination information registration systems and questionnaire with their families. The coverage and efficacy of vaccination determined with equels commented by WHO. Results Out of 64 children, 52 children were 12 to 15 years old (13.35±1.08), 12 children were 16 to 17 years old (16.55±0.52). 48.4% had received two doses of vaccine. The highest rate of positive PCR was observed in February 2022. Sinopharm vaccine coverage in this age group was 93.6% for the first dose and 81.1% for the second dose. Based on this information, 48.4% children in this study have received two complete doses of the COVID-19 vaccine. The efficacy of the vaccine was estimated as 94.4% (95% CI 90.2 to 97.7). Conclusion It seems the coverage of Sinopharm vaccination in the age group of 12-17 years in Tehran is favorable and has high efficacy in this age group. In order to obtain more accurate and comprehensive estimation, it is recommended to take a sample on a wider level of the community.
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Affiliation(s)
- Sedigheh Rafiei Tabatabaei
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delara Babaie
- Department of Allergy and Clinical Immunology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Mahsan Hoseini-Alfatemi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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SeyedAlinaghi S, Afsahi AM, Mirzapour P, Afzalian A, Shahidi R, Dashti M, Ghasemzadeh A, Paranjkhoo P, Parsaei Z, Pashaei A, Mohammadi P, Najafi MS, Mahrokhi S, Matini P, Moradi A, Karimi A, Afroughi S, Mehraeen E, Dadras O. Comparison of Omicron and Delta Variants of SARS-CoV-2: A Systematic Review of Current Evidence. Infect Disord Drug Targets 2024; 24:e050324227686. [PMID: 38445691 DOI: 10.2174/0118715265279242240216114548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/21/2024] [Accepted: 02/07/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) caused the outbreak of coronavirus disease 2019 (COVID-19) in late 2019 in Wuhan, China. In early 2020, the disease spread rapidly around the world. Since the pandemic, SARS-CoV-2 has evolved dramatically into a wide variety of variants endowed with devastating properties. As of March 6, 2022, five SARS-CoV-2 variants of concern, including Alpha, Beta, Gamma, Delta, and Omicron strains have been identified. Due to the crucial importance of understanding the differences between the Omicron and Delta variants, this systematic review was conducted. METHODS This systematic review investigated new variants of Omicron SARS-CoV-2 based on current studies. Online databases were searched for English articles as of January 03, 2023. Selection of publications was a two-step process of title/abstract and full-text assessment against eligibility criteria. The relevant data from the included articles were systematically collected and organized in a designed table for analysis. To ensure the quality of the review, the PRISMA checklist and Newcastle- Ottawa Scale (NOS) of quality assessment were utilized. RESULTS The data extracted from 58 articles were analyzed, including 10003 pieces of evidence. Lower risk of hospitalization, ICU admission, and mortality after vaccination were reported in the Omicron variant compared to the Delta variant. Additionally, the Delta variant led to more severe clinical symptoms in comparison to the Omicron variant. CONCLUSION The Omicron variant of SARS-CoV-2 results in less severe disease outcomes as compared to Delta. Nevertheless, it remains crucial to maintain ongoing monitoring, implement containment measures, and adapt vaccination protocols to effectively address the evolving variants.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Arian Afzalian
- School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Shahidi
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohsen Dashti
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Afsaneh Ghasemzadeh
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parinaz Paranjkhoo
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, 0019, Armenia
| | - Zahra Parsaei
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ava Pashaei
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Parsa Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadeq Najafi
- Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sona Mahrokhi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Matini
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Moradi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Solaiman Afroughi
- Department of Biostatistics and Epidemiology, School of Health and Social Determinants of Health Research Center, Postal Code 7591875114, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, 5007, Norway
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Mansoori A, Hosseini N, Ghazizadeh H, Aghasizadeh M, Drroudi S, Sahranavard T, Izadi HS, Amiriani A, Farkhani EM, Ferns GA, Ghayour-Mobarhan M, Moohebati M, Esmaily H. Association between biochemical and hematologic factors with COVID-19 using data mining methods. BMC Infect Dis 2023; 23:897. [PMID: 38129798 PMCID: PMC10734144 DOI: 10.1186/s12879-023-08676-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND AND AIM Coronavirus disease (COVID-19) is an infectious disease that can spread very rapidly with important public health impacts. The prediction of the important factors related to the patient's infectious diseases is helpful to health care workers. The aim of this research was to select the critical feature of the relationship between demographic, biochemical, and hematological characteristics, in patients with and without COVID-19 infection. METHOD A total of 13,170 participants in the age range of 35-65 years were recruited. Decision Tree (DT), Logistic Regression (LR), and Bootstrap Forest (BF) techniques were fitted into data. Three models were considered in this study, in model I, the biochemical features, in model II, the hematological features, and in model II, both biochemical and homological features were studied. RESULTS In Model I, the BF, DT, and LR algorithms identified creatine phosphokinase (CPK), blood urea nitrogen (BUN), fasting blood glucose (FBG), total bilirubin, body mass index (BMI), sex, and age, as important predictors for COVID-19. In Model II, our BF, DT, and LR algorithms identified BMI, sex, mean platelet volume (MPV), and age as important predictors. In Model III, our BF, DT, and LR algorithms identified CPK, BMI, MPV, BUN, FBG, sex, creatinine (Cr), age, and total bilirubin as important predictors. CONCLUSION The proposed BF, DT, and LR models appear to be able to predict and classify infected and non-infected people based on CPK, BUN, BMI, MPV, FBG, Sex, Cr, and Age which had a high association with COVID-19.
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Affiliation(s)
- Amin Mansoori
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nafiseh Hosseini
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Faculty of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran
| | - Hamideh Ghazizadeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Division of Clinical Biochemistry, CALIPER Program, Pediatric Laboratory Medicine, the Hospital for Sick Children, Toronto, ON, Canada
| | - Malihe Aghasizadeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Drroudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Toktam Sahranavard
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanie Salmani Izadi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Amiriani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Mosa Farkhani
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, BN1 9PH, Sussex, UK
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Shibafar S, Jafarlou F. A review on the impacts of COVID-19 on the auditory system: Implications for public health promotion research. Health Promot Perspect 2023; 13:280-289. [PMID: 38235010 PMCID: PMC10790126 DOI: 10.34172/hpp.2023.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/26/2023] [Indexed: 01/19/2024] Open
Abstract
Background Currently, there are few studies on the relationship between COVID-19 and the auditory system. In the current study, a review of the studies conducted in the fields of etiopathology, clinical manifestations, research, and treatment of hearing loss caused byCOVID-19 was conducted, which can be used as a baseline for future studies. Methods We utilized the research approach suggested by Arksey and O'Malley to carry out this scoping review. Search was conducted in Farsi and English with a focus on the onset of hearing loss in patients with COVID-19 through Medline and PubMed, and Google Scholar search engine. Studies included were those involving adult patients diagnosed with COVID-19 who experienced hearing loss, ear pain, ear discharge, and otitis media. Studies were eligible for inclusion if there was a description of the otologic dysfunction, specifically onset, duration, or clinical outcomes. Results Among 90 studies identified, 35 studies were included in the review process. Our findings suggest several possible mechanisms for sudden sensorineural hearing loss (SSNHL) in COVID-19 patients, and COVID-19 infection could have deleterious effects on the inner ear, specifically on the hair cells of the cochlea despite patients being asymptomatic and early identification of SSNHL in COVID-19patients can save the hearing and also patient. Conclusion Hearing loss in COVID-19 infection has not received much attention by health care professionals. Sensorineural hearing loss (SNHL), tinnitus, and/or vertigo have been shown to occur during and following COVID-19 infection. Due to lack of research studies, and the inconsistency and even contradictory of the findings, it remains questionable whether COVID-19 contributes to the high incidence of hearing loss. The proper understanding of the mechanisms behind hearing loss in COVID-19 infections needs further research. However, it seems likely that SNHL could be included among the manifestations of those-called "long COVID" syndrome.
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Affiliation(s)
- Samin Shibafar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Audiology, School of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Jafarlou
- Department of Audiology, School of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Yin ZJ, Xiao H, McDonald S, Brusic V, Qiu TY. Dynamically adjustable SVEIR(MH) model of multiwave epidemics: Estimating the effects of public health measures against COVID-19. J Med Virol 2023; 95:e29301. [PMID: 38087460 DOI: 10.1002/jmv.29301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/16/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023]
Abstract
The COVID-19 pandemic was characterized by multiple subsequent, overlapping outbreaks, as well as extremely rapid changes in viral genomes. The information about local epidemics spread and the epidemic control measures was shared on a daily basis (number of cases and deaths) via centralized repositories. The vaccines were developed within the first year of the pandemic. New modes of monitoring and sharing of epidemic data were implemented using Internet resources. We modified the basic SEIR compartmental model to include public health measures, multiwave scenarios, and the variation of viral infectivity and transmissibility reflected by the basic reproduction number R0 of emerging viral variants. SVEIR(MH) model considers the capacity of the medical system, lockdowns, vaccination, and changes in viral reproduction rate on the epidemic spread. The developed model uses daily infection reports for assessing the epidemic dynamics, and daily changes of mobility data from mobile phone networks to assess the lockdown effectiveness. This model was deployed to six European regions Baden-Württemberg (Germany), Belgium, Czechia, Lombardy (Italy), Sweden, and Switzerland for the first 2 years of the pandemic. The correlation coefficients between observed and reported infection data showed good concordance for both years of the pandemic (ρ = 0.84-0.94 for the raw data and ρ = 0.91-0.98 for smoothed 7-day averages). The results show stability across the regions and the different epidemic waves. Optimal control of epidemic waves can be achieved by dynamically adjusting epidemic control measures in real-time. SVEIR(MH) model can simulate different scenarios and inform adjustments to the public health policies to achieve the target outcomes. Because this model is highly representative of actual epidemic situations, it can be used to assess both the public health and socioeconomic effects of the public health measures within the first 7 days of the outbreak.
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Affiliation(s)
- Zuo-Jing Yin
- Institute of Clinical Science, Zhongshan Hospital; Shanghai Institute of Infectious Disease and Biosecurity; Intelligent Medicine Institute, Fudan University, Shanghai, China
| | - Han Xiao
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Stuart McDonald
- Smart Medicine Laboratory, School of Economics, University of Nottingham Ningbo China, Ningbo, China
| | - Vladimir Brusic
- Smart Medicine Laboratory, School of Economics, University of Nottingham Ningbo China, Ningbo, China
| | - Tian-Yi Qiu
- Institute of Clinical Science, Zhongshan Hospital; Shanghai Institute of Infectious Disease and Biosecurity; Intelligent Medicine Institute, Fudan University, Shanghai, China
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Khaddage-Soboh N, Tawil S. Navigating the crisis: A review of COVID-19 research and the importance of academic publications - The case of a private university in Lebanon. Heliyon 2023; 9:e22917. [PMID: 38282919 PMCID: PMC10812900 DOI: 10.1016/j.heliyon.2023.e22917] [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: 09/13/2022] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 01/30/2024] Open
Abstract
Objectives The threat of the Corona virus has had a profound global impact, prompting extensive discussions among academicians and medical researchers seeking to understand its implications across various fields. Consequently this review aims to explore the COVID-19 research approaches adopted at the Lebanese American University (LAU) between 2019 and 2022 and, to eventually shed light on the importance of the academic publications during this crisis period in the context of Lebanon. Design Data sources Eligibility criteria Studies related to "Coronavirus", "SARS-CoV-2," or "COVID-19″ were extracted from the SciVal database spanning the period 2019 to 2022. The identified studies, totaling 97 publications, were indexed in Scopus and Web of Science and underwent narrative analysis along with an evaluation using a predefined scale to determine their eligibility. The majority of the studies were literature reviews, followed by observational studies, modeling studies, systematic reviews, and meta-analyses. Results The majority of the identified studies (31 %) were focused on the medical field, primarily the impact of SARS-CoV-2 infection. Additionally, 22 % of studies discussed updates related to global finance and economic markets, while 18 % addressed the psychological burden of the pandemic. Other areas covered in the literature included the impact on performance, nutrition, tourism, politics, and telecommunication. Conclusion This study marks a pioneering endeavor that sparks a crucial dialogue regarding peer-reviewed scientific literature during a period of immense need for accurate information. The prevalence of literature reviews can be attributed to the demand for swift dissemination of preliminary findings and the increased call for COVID-19-related research. However, despite the abundance of publications in this specific domain, it is imperative for future research to shift its focus towards the development of novel therapies, preventive measures, psychological insights, and strategies to address the socioeconomic and financial burdens stemming from the pandemic. This study has the potential to establish a standardized framework for addressing similar crises across diverse fields and at various levels. Limitations The review readily acknowledges certain limitations. By solely relying on specific databases like Scopus and WoS, there is a possibility of inadvertently overlooking relevant studies. Although the study provides insights into the impact of COVID-19 across different fields and their respective publications, it is important to recognize that the continuous updates to databases and potential exclusions of related studies may have imposed constraints on the findings. Moreover, the urgency for expeditious peer-review during the pandemic may have heightened the chances of errors and diminished transparency. This urgency has unfortunately increased the risk of fraudulent activities and misconduct.
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Affiliation(s)
- Nada Khaddage-Soboh
- Adnan Kassar School of Business, Lebanese American University (LAU), Beirut, Lebanon
| | - Samah Tawil
- School of Medicine, Lebanese American University (LAU), Beirut, Lebanon
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Albakri K, Abdelwahab OA, Gabra MD, Nafady MH, Alabdallat YJ, Soliman A, Cadri S, Hanaqtah B, Albazee E. Characteristics of sudden hearing loss after different COVID-19 vaccinations: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:5167-5176. [PMID: 37594544 DOI: 10.1007/s00405-023-08172-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/31/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION COVID-19 vaccines are essential to prevent complications and reduce the burden of SARS-CoV-2. However, these vaccines showed side effects such as fatigue, pain, fever, and rarely hearing loss. In this review, we aim to summarize studies investigating hearing loss following COVID-19 vaccination and try to find the possible association and risk factors for this hazardous complication. METHODS We performed a comprehensive search of five electronic databases (PubMed, Scopus, Web of Science, google scholar, Cochrane) from inception until 9 October 2022. We finally included 16 studies after the first and second scans. We used SPSS to analyze the extracted data. RESULTS A total of 630 patients were identified, with a mean age of 57.3. Of the patients, 328 out of 609 vaccinated patients took the Pfizer-BioNTech BNT162b2 vaccine, while 242 (40%) took the Moderna COVID-19 vaccine. The mean time from vaccination to hearing impairment was 6.2, ranging from a few hours to one month after the last dose. The results found a significant difference between vaccine types in terms of incidence and prognosis of the condition, while they showed that the number of doses prior to the onset had no significance. CONCLUSION SNHL has been reported in a small number of people who have received the COVID-19 vaccine, but it is unclear at this time whether the vaccine is directly causing this condition. However, the COVID-19 vaccine has been demonstrated to be safe and effective in preventing illness, and the benefits of vaccination are significant compared to any potential risks. PROTOCOL REGISTRATION The protocol of this study was registered on Prospero CRD42022367180.
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Affiliation(s)
- Khaled Albakri
- Faculty of Medicine, The Hashemite University, Zarqa, Jordan
- Medical Research Group of Egypt, Cairo, Egypt
| | - Omar Ahmed Abdelwahab
- Medical Research Group of Egypt, Cairo, Egypt
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Diaa Gabra
- Medical Research Group of Egypt, Cairo, Egypt
- Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mohamed H Nafady
- Medical Research Group of Egypt, Cairo, Egypt
- Faculty of Applied Health Science Technology, Misr University for Science and Technology, El Giza, Egypt
- Radiation Science Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Yasmeen Jamal Alabdallat
- Faculty of Medicine, The Hashemite University, Zarqa, Jordan
- Medical Research Group of Egypt, Cairo, Egypt
| | - Ahmed Soliman
- Medical Research Group of Egypt, Cairo, Egypt.
- Faculty of Medicine, Mansoura University, 6 Al Ashqar St., Off El Gomhouria St., Mansoura, 35511, Dakahlia, Egypt.
- Research Department, Mansoura Research Team, Mansoura, Egypt.
| | - Shirin Cadri
- Medical Research Group of Egypt, Cairo, Egypt
- Grigore T. Popa University of Medicine and Pharmacy, Iași, Romania
| | - Balqees Hanaqtah
- Faculty of Medicine, The Hashemite University, Zarqa, Jordan
- Medical Research Group of Egypt, Cairo, Egypt
| | - Ebraheem Albazee
- Medical Research Group of Egypt, Cairo, Egypt
- Kuwait Institute for Medical Specializations, Kuwait City, Kuwait
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10
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SeyedAlinaghi S, Afsahi AM, Shahidi R, Afzalian A, Mirzapour P, Eslami M, Ahmadi S, Matini P, Yarmohammadi S, Saeed Tamehri Zadeh S, Asili P, Paranjkhoo P, Ramezani M, Nooralioghli Parikhani S, Sanaati F, Amiri Fard I, Emamgholizade Baboli E, Mansouri S, Pashaei A, Mehraeen E, Hackett D. Social stigma during COVID-19: A systematic review. SAGE Open Med 2023; 11:20503121231208273. [PMID: 38020797 PMCID: PMC10640804 DOI: 10.1177/20503121231208273] [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: 04/28/2023] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Stigmatization was reported throughout the COVID pandemic for COVID-19 patients and close contacts. The aim of this systematic review was to comprehensively examine the prevalence and impact of stigmatization during COVID-19 pandemic. Methods English articles were searched using online databases that included PubMed, Scopus, Embase, and Web of Science up to 24 August 2022. A two-step screening and selection process was followed utilizing an inclusion and exclusion criteria and then data was extracted from eligible articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed, and the risk of bias was assessed using the Newcastle-Ottawa Scale. Results Seventy-six studies were eligible for inclusion. Twenty-two studies reported the prevalence of social stigma due to COVID-19 infection with social isolation being the most commonly reported stigma. There were 20 studies that reported the majority of participants experienced stigma due to COVID-19 infection, which was as high as 100% of participants in two studies. Participants in 16 studies reported blaming from others as the second most common type of stigma, with various other types reported such as psychological pressure, verbal violence, avoidance, and labeling. The most common effect of the stigma was anxiety followed by depression, and then reduction of socialization. Conclusion Findings from the present review have identified that COVID-19-related stigma studies have generally focused on its prevalence, type, and outcome. Greater awareness of this topic may assist with improving public education during pandemics such as COVID-19 as well as access to support services for individuals impacted by stigmatization.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego, CA, USA
| | - Ramin Shahidi
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Arian Afzalian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Eslami
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepide Ahmadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Matini
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Seyed Saeed Tamehri Zadeh
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Pooria Asili
- Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Parinaz Paranjkhoo
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Maryam Ramezani
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Foziye Sanaati
- School of Nursing and Allied Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Iman Amiri Fard
- Department of Community Health Nursing and Geriatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Emamgholizade Baboli
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Somaye Mansouri
- Department of Management, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran
| | - Ava Pashaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Daniel Hackett
- Faculty of Medicine and Health, Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
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11
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Castro S, Pedrero S, Ruiz LA, Serrano L, Zalacain R, Pérez‐Fernández S, Iriberri M, Cabriada V. High-flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS-CoV-2 pneumonia out of ICU. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:905-914. [PMID: 37537998 PMCID: PMC10500315 DOI: 10.1111/crj.13679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/17/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION AND OBJECTIVES High-flow nasal cannula oxygen therapy (HFNC) has been successfully used for the treatment of acute hypoxaemic respiratory failure (AHRF) secondary to SARS-CoV-2 pneumonia and being effective in reducing progression to invasive mechanical ventilation. The objective of this study was to assess the usefulness of HFNC on a hospital ward for the treatment of AHRF secondary to SARS-CoV-2 pneumonia and its impact on the need for intensive care unit (ICU) admission and endotracheal intubation. Other objectives include identifying potential physiological parameters and/or biomarkers for predicting treatment failure and assessing the clinical course and survival. METHODS Observational study based on data collected prospectively between March 2020 and February 2021 in a single hospital on patients diagnosed with AHRF secondary to SARS-CoV-2 pneumonia who received HFNC outside an ICU. RESULTS One hundred and seventy-one patients out of 1090 patients hospitalised for SARS-CoV-2 infection. HFNC was set as the ceiling of treatment in 44 cases; 12 survived (27.3%). Among the other 127 patients, intubation was performed in 25.9% of cases with a mortality of 11.8%. Higher creatinine levels (OR 1.942, 95% CI 1.04; 3.732; p = 0.036) and Comorbidity-Age-Lymphocyte-LDH (CALL) score (OR 1.273, 95% CI 1.033; 1.617; p = 0.033) were associated with a higher risk of intubation. High platelet count at HFNC initiation was predictive of good treatment response (OR 0.935, 95% CI 0.884; 0.983; p = 0.012). CONCLUSIONS HFNC outside an ICU is a treatment with high success rate in patients with AHRF secondary to SARS-CoV-2 pneumonia, including in patients in whom this therapy was deemed to be the ceiling of treatment.
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Affiliation(s)
- Sonia Castro
- Pneumology ServiceHospital Universitario de CrucesBarakaldoBizkaiaSpain
- Department of Medicine and Surgery, Facultad de Medicina y EnfermeríaUniversidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHULeioaBizkaiaSpain
| | - Sandra Pedrero
- Pneumology ServiceHospital Universitario de CrucesBarakaldoBizkaiaSpain
- Department of Medicine and Surgery, Facultad de Medicina y EnfermeríaUniversidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHULeioaBizkaiaSpain
| | - Luis Alberto Ruiz
- Pneumology ServiceHospital Universitario de CrucesBarakaldoBizkaiaSpain
- Department of Immunology, Microbiology and Parasitology, Facultad de Medicina y EnfermeríaUniversidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHULeioaBizkaiaSpain
| | - Leyre Serrano
- Pneumology ServiceHospital Universitario de CrucesBarakaldoBizkaiaSpain
- Department of Immunology, Microbiology and Parasitology, Facultad de Medicina y EnfermeríaUniversidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHULeioaBizkaiaSpain
| | - Rafael Zalacain
- Pneumology ServiceHospital Universitario de CrucesBarakaldoBizkaiaSpain
| | - Silvia Pérez‐Fernández
- Scientific Coordination FacilityBiocruces Bizkaia Health Research InstituteBarakaldoSpain
| | - Milagros Iriberri
- Pneumology ServiceHospital Universitario de CrucesBarakaldoBizkaiaSpain
| | - Valentín Cabriada
- Pneumology ServiceHospital Universitario de CrucesBarakaldoBizkaiaSpain
- Department of Medicine and Surgery, Facultad de Medicina y EnfermeríaUniversidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHULeioaBizkaiaSpain
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12
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Crum RJ, Huckestien BR, Dwyer G, Mathews L, Nascari DG, Hussey GS, Turnquist HR, Alcorn JF, Badylak SF. Mitigation of influenza-mediated inflammation by immunomodulatory matrix-bound nanovesicles. SCIENCE ADVANCES 2023; 9:eadf9016. [PMID: 37205761 PMCID: PMC10198633 DOI: 10.1126/sciadv.adf9016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/14/2023] [Indexed: 05/21/2023]
Abstract
Cytokine storm describes a life-threatening, systemic inflammatory syndrome characterized by elevated levels of proinflammatory cytokines and immune cell hyperactivation associated with multi-organ dysfunction. Matrix-bound nanovesicles (MBV) are a subclass of extracellular vesicle shown to down-regulate proinflammatory immune responses. The objective of this study was to assess the efficacy of MBV in mediating influenza-induced acute respiratory distress syndrome and cytokine storm in a murine model. Intravenous administration of MBV decreased influenza-mediated total lung inflammatory cell density, proinflammatory macrophage frequencies, and proinflammatory cytokines at 7 and 21 days following viral inoculation. MBV decreased long-lasting alveolitis and the proportion of lung undergoing inflammatory tissue repair at day 21. MBV increased the proportion of activated anti-viral CD4+ and CD8+ T cells at day 7 and memory-like CD62L+ CD44+, CD4+, and CD8+ T cells at day 21. These results show immunomodulatory properties of MBV that may benefit the treatment of viral-mediated pulmonary inflammation with applicability to other viral diseases such as SARS-CoV-2.
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Affiliation(s)
- Raphael J. Crum
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brydie R. Huckestien
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gaelen Dwyer
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lisa Mathews
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - David G. Nascari
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - George S. Hussey
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Heth R. Turnquist
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - John F. Alcorn
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen F. Badylak
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
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13
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SeyedAlinaghi S, Afsahi AM, Shahidi R, Kianzad S, Pashaei Z, Mirahmad M, Asili P, Mojdeganlou H, Razi A, Mojdeganlou P, Fard IA, Mahdiabadi S, Afzalian A, Dashti M, Ghasemzadeh A, Parmoon Z, Badri H, Mehraeen E, Hackett D. Effects of Smoking on COVID-19 Management and Mortality: An Umbrella Review. J Smok Cessat 2023; 2023:7656135. [PMID: 37214631 PMCID: PMC10199802 DOI: 10.1155/2023/7656135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/22/2023] [Accepted: 04/04/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Smoking status appears to lead to a poor prognosis in COVID-19 patients. However, findings from the studies conducted on this topic have not been consistent, and further exploration is required. Methods The objective of this umbrella review was to examine the effects of smoking on COVID-19 management and mortality. Online databases that included PubMed, Embase, Scopus, and Web of Science were searched using relevant keywords up to July 27, 2022. Articles were restricted to the English language, and the PRISMA protocol was followed. Results A total of 27 systematic reviews, published from 2020 to 2022, were included. Individual studies included in the systematic reviews ranged from 8 to 186, with various population sizes. The consensus from the majority of systematic reviews was that COVID-19 smoker patients experience greater disease severity, disease progression, hospitalization rate, hospital admission duration, mechanical ventilation, ICU admission, and mortality rate. Conclusions COVID-19 patients with a history of smoking (current and former) are vulnerable to adverse hospital outcomes and worse COVID-19 progression. Effective preventive and supportive approaches are required to decrease the risk of COVID-19 morbidity and mortality in patients with a history of smoking.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), CA, USA
| | - Ramin Shahidi
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Zahra Pashaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Mirahmad
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pooria Asili
- Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Hengameh Mojdeganlou
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Armin Razi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Iman Amiri Fard
- Department of Community Health Nursing and Geriatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Mahdiabadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arian Afzalian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Dashti
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Afsaneh Ghasemzadeh
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohal Parmoon
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Hajar Badri
- School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Daniel Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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14
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Shareef J, Sridhar SB, Bhupathyraaj M, Shariff A, Thomas S, Salim Karattuthodi M. Assessment of the scope, completeness, and consistency of various drug information resources related to COVID-19 medications in pregnancy and lactation. BMC Pregnancy Childbirth 2023; 23:296. [PMID: 37106456 PMCID: PMC10134615 DOI: 10.1186/s12884-023-05609-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Drug use in pregnancy and lactation is challenging. It becomes more challenging in pregnant and lactating women with certain critical clinical conditions such as COVID-19, because of inconsistent drug safety data. Therefore, we aimed to evaluate the various drug information resources for the scope, completeness, and consistency of the information related to COVID-19 medications in pregnancy and lactation. METHODS Data related to COVID-19 medications from various drug information resources such as text references, subscription databases, and free online tools were used for the comparison. The congregated data were analyzed for scope, completeness, and consistency. RESULTS Scope scores were highest for Portable Electronic Physician Information Database (PEPID), Up-to-date, and drugs.com compared to other resources. The overall completeness scores were higher for Micromedex and drugs.com (p < 0.05 compared to all other resources). The inter-reliability analysis for overall components by Fleiss kappa among all the resources was found to be 'slight' (k < 0.20, p < 0.0001). The information related to the older drugs in most of the resources, provides in-depth details on various components such as pregnancy safety, clinical data related to lactation, the effect of the drug distribution into breast milk, reproductive potential/infertility risk and the pregnancy category/recommendations. However, the information related to these components for newer drugs was superficial and incomplete, with insufficient data and inconclusive evidence, which is a statistically significant observation. The strength of observer agreement for the various COVID-19 medications ranged from poor to fair and moderate for the various recommendation categories studied. CONCLUSION This study reports discrepancies in the information related to pregnancy, lactation, drug level, reproductive risk, and pregnancy recommendations among the resources directing to refer to more than one resource for information about the safe and quality use of medications in this special population.The present study also emphasizes the need for development of comprehensive, evidence-based, and precise information guide that can promote safe and effective drug use in this special population.
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Affiliation(s)
- Javedh Shareef
- Department of Clinical Pharmacy & Pharmacology, RAK College of Pharmacy, RAK Medical & Health Sciences University, Ras Al Khaimah, United Arab Emirates.
| | - Sathvik Belagodu Sridhar
- Department of Clinical Pharmacy & Pharmacology, RAK College of Pharmacy, RAK Medical & Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | | | - Atiqulla Shariff
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Sabin Thomas
- School of Pharmacy, College of Health Sciences, University of Nizwa, Nizwa, 616, Oman
| | - Mohammed Salim Karattuthodi
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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15
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Mehraeen E, Afzalian A, Afsahi AM, Shahidi R, Fakhfouri A, Karimi K, Varshochi S, Habibi MA, Molla A, Dadjou A, Tajabadi Z, Nasiri K, Seyed Alinaghi SA, Hackett D. Hearing loss and COVID-19: an umbrella review. Eur Arch Otorhinolaryngol 2023:10.1007/s00405-023-07982-2. [PMID: 37093291 PMCID: PMC10123565 DOI: 10.1007/s00405-023-07982-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/11/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION COVID-19 can result in an extensive range of extrapulmonary, and neurological signs and symptoms such as olfactory and/or taste dysfunction, and otologic symptoms. The aim of this study was to investigate the hearing loss manifestation from COVID-19. METHODS The goal of this umbrella review was to examine hearing loss associated with COVID-19 disease. English literature published until October 15, 2022 in online databases including PubMed, Scopus, Web of Science, and Embase was considered for this purpose. Eligibility of the articles for subsequent data extraction was evaluated in a two-step selection process with consideration to an inclusion/exclusion criterion. This review followed the PRISMA protocol and the Amstar-2 checklist for quality assessment. RESULTS A total of four treatment strategies were used by different studies which included oral corticosteroids, intratympanic corticosteroids, combined oral and intratympanic corticosteroids, and hyperbaric oxygen therapy. Five studies investigated corticosteroid use in the forms of oral or intratympanic injection; four studies reported (complete or partial) hearing improvements after steroid treatment, while one study stated no significant improvement in hearing function. One study reported that oral corticosteroid monotherapy alone was not effective, while vestibular symptoms were ameliorated by a combination of oral prednisone, intratympanic dexamethasone injection, and hydroxychloroquine. CONCLUSION The findings suggest that despite being one of the rare complications of COVID-19, hearing loss can impact a patient's quality of life. The most common type reported was sensorineural hearing loss, which can be diagnosed with variable techniques.
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Affiliation(s)
- Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Arian Afzalian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), San Diego, CA, USA
| | - Ramin Shahidi
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Kiana Karimi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Varshochi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Habibi
- Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Ayoob Molla
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ali Dadjou
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Zohreh Tajabadi
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Nasiri
- Department of Nursing, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Seyed Ahmad Seyed Alinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
| | - Daniel Hackett
- Department of Nursing, Khalkhal University of Medical Sciences, Khalkhal, Iran
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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16
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Haghighian-Roudsari A, Khoshnazar TAK, Ajami M, Pourmoradian S. A qualitative study of Covid-19 effects on nutrition associated problems in recovered patients. BMC Nutr 2023; 9:29. [PMID: 36782270 PMCID: PMC9924848 DOI: 10.1186/s40795-023-00686-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND World is currently challenging with Covid-19 pandemic. Nutritional status is a determinant factor in the treatment process and recovery for patients with Covid-19. Although a limited data is available about the effects of nutrition on this disease. Therefore, the aim of this study was to identify nutritional problems in patients recovering from Covid-19 before, during and after the disease. METHODS This qualitative descriptive study was carried out based on the specified inclusion criteria through targeted sampling of 45 patients recovered from Covid-19, 2021-2022. In-depth semi-structured individual interviews were used to collect data. Interviews were recorded, transcribed and analyzed using qualitative content analysis method and MAXQDA Software. RESULTS Based on the participants' description of this stage, it can be reported that most of the individuals who were infected had no specific symptoms. Nutrition-linked problems in the main stage of the disease included troubles in tolerating foods and nutrition (e.g., fatty and solid foods), highly consumed foods in the main stage of the disease (e.g., beverages), individuals' approaches to improve nutritional challenges (e.g., consumption of herbal teas and soft texture foods) and using supplements. The patients stated fewer nutritional problems after recovering from the disease. The most significant change included their desire to eat solid foods such as rice, bread, pasta and fast foods. CONCLUSION appropriate nutrition with medication can help accelerate the recovery process of the patients, especially hospitalized patients with further severe degrees of the illness.
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Affiliation(s)
- Arezoo Haghighian-Roudsari
- grid.411600.2Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tahereh Alsadat Khoubbin Khoshnazar
- grid.411746.10000 0004 4911 7066Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Marjan Ajami
- grid.411600.2Food and Nutrition Policy and Planning Research Department, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samira Pourmoradian
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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17
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Fajloun Z, Legros C, Sabatier JM. COVID-19 and Ehlers-Danlos Syndrome: The Dangers of the Spike Protein of SARS-CoV-2. Infect Disord Drug Targets 2023; 23:e040123212375. [PMID: 36600622 DOI: 10.2174/1871526523666230104145108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Ziad Fajloun
- Department of Biology, Faculty of Sciences 3, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli 1352, Lebanon
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon
| | - Christian Legros
- College of Life Sciences, University of Angers, INSERM, CNRS, MITOVASC, Team 2 CarMe, SFR ICAT, Angers 49000, France
| | - Jean-Marc Sabatier
- College of Life Sciences, Aix-Marseille University, CNRS, INP, Inst Neurophysiopathol, Marseille 13385, France
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18
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Fajloun Z, Abi Khattar Z, Kovacic H, Legros C, Sabatier JM. Why do Athletes Develop Very Severe or Fatal Forms of COVID after Intense Exercise Following SARS-CoV-2 Infection or Anti-COVID Vaccination? Infect Disord Drug Targets 2023; 23:e110123212563. [PMID: 36631923 DOI: 10.2174/1871526523666230111104355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Ziad Fajloun
- Department of Biology, Faculty of Sciences 3, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli 1352, Lebanon
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon
| | - Ziad Abi Khattar
- Laboratory of Georesources, Geosciences, and Environment (L2GE), Microbiology/Tox-Ecotoxicology Team, Faculty of Sciences 2, Lebanese University, Campus Fanar, Jdeidet El-Matn, Beirut, P.O. Box 90656, Lebanon
- CNRS, INP, Inst Neurophysiopathol, Aix- Marseille Univ, Marseille 13385, France
| | - Hervé Kovacic
- Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, 13385 Marseille, France
| | - Christian Legros
- INSERM, CNRS, MITOVASC, Univ Angers, Team 2 CarMe, SFR ICAT, Angers 49000, France
| | - Jean-Marc Sabatier
- CNRS, INP, Inst Neurophysiopathol, Aix- Marseille Univ, Marseille 13385, France
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19
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Fajloun Z, Abi Khattar Z, Kovacic H, Legros C, Sabatier JM. Understanding and Relieving of Neuropathic Disorders in the Long COVID. Infect Disord Drug Targets 2023; 23:e270223214061. [PMID: 36843369 DOI: 10.2174/1871526523666230227113205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/28/2023]
Affiliation(s)
- Ziad Fajloun
- Department of Biology, Faculty of Sciences 3, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli 1352, Lebanon
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon
| | - Ziad Abi Khattar
- Laboratory of Georesources, Geosciences and Environment (L2GE), Microbiology/Tox-Ecotoxicology Team, Faculty of Sciences 2, Lebanese University, Campus Fanar, Jdeidet El-Matn, Beirut, P.O. Box 90656, Lebanon
| | - Hervé Kovacic
- CNRS, INP, Inst Neurophysiopathol, Aix- Marseille Univ, Marseille 13385, France
| | - Christian Legros
- Univ Angers, INSERM, CNRS, MITOVASC, Team 2 CarMe, SFR ICAT, Angers 49000, France
| | - Jean-Marc Sabatier
- CNRS, INP, Inst Neurophysiopathol, Aix- Marseille Univ, Marseille 13385, France
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20
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Charitou T, Kontou PI, Tamposis IA, Pavlopoulos GA, Braliou GG, Bagos PG. Drug genetic associations with COVID-19 manifestations: a data mining and network biology approach. THE PHARMACOGENOMICS JOURNAL 2022; 22:294-302. [PMID: 36171417 PMCID: PMC9517961 DOI: 10.1038/s41397-022-00289-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/16/2022] [Accepted: 09/08/2022] [Indexed: 01/08/2023]
Abstract
Available drugs have been used as an urgent attempt through clinical trials to minimize severe cases of hospitalizations with Coronavirus disease (COVID-19), however, there are limited data on common pharmacogenomics affecting concomitant medications response in patients with comorbidities. To identify the genomic determinants that influence COVID-19 susceptibility, we use a computational, statistical, and network biology approach to analyze relationships of ineffective concomitant medication with an adverse effect on patients. We statistically construct a pharmacogenetic/biomarker network with significant drug-gene interactions originating from gene-disease associations. Investigation of the predicted pharmacogenes encompassing the gene-disease-gene pharmacogenomics (PGx) network suggests that these genes could play a significant role in COVID-19 clinical manifestation due to their association with autoimmune, metabolic, neurological, cardiovascular, and degenerative disorders, some of which have been reported to be crucial comorbidities in a COVID-19 patient.
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21
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Mehraeen E, Mehrtak M, SeyedAlinaghi S, Nazeri Z, Afsahi AM, Behnezhad F, Vahedi F, Barzegary A, Karimi A, Mehrabi N, Dadras O, Jahanfar S. Technology in the Era of COVID-19: A Systematic Review of Current Evidence. Infect Disord Drug Targets 2022; 22:e240322202551. [PMID: 35331123 DOI: 10.2174/1871526522666220324090245] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/13/2021] [Accepted: 11/01/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, the use of technology-based services has been incremental by the care providers for patients scheduling, regulatory considerations, resource allocation, thus enabling virus exposure prevention while maintaining effective patient care. This study aims to review the currently available evidence to identify available technology solutions in the era of COVID-19. METHODS A systematic review in July 2020 using the PubMed, Scopus, Embase, Science Direct, and Web of Science databases has been carried out. After evaluating the title and abstract to select the most relevant studies based on inclusion and exclusion criteria, the selected articles underwent quality assessment. The full text of selected articles was then thoroughly evaluated to extract the essential findings. RESULTS In this study, 20 technology-based approaches have been identified for provision of healthcare services to patients with COVID-19. These methods included telemedicine, virtual visits, e-consult, tele-consulting, video conference, virtual healthcare, mobile-based self-care, social media, tele ICU, 3D printing technology, telemonitoring, teleradiology, telesurgical, and cloud-based service. CONCLUSION Due to the rapid spread of the coronavirus, the use of technology-based methods for the provision of remote healthcare services can help control the disease. The effectiveness of each of these approaches can be investigated in future research.
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Affiliation(s)
- Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Mohammad Mehrtak
- School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Nazeri
- Department of Medical Informatics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology,School of Medicine,University of California, San Diego (UCSD), California, USA
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Vahedi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Mehrabi
- Department of Health Information Technology, Aja University of Medical Sciences, Tehran, Iran
| | - Omid Dadras
- School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts University School of Medicine, USA
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22
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Oliaei S, SeyedAlinaghi S, Mehrtak M, Karimi A, Noori T, Mirzapour P, Shojaei A, MohsseniPour M, Mirghaderi SP, Alilou S, Shobeiri P, Azadi Cheshmekabodi H, Mehraeen E, Dadras O. The effects of hyperbaric oxygen therapy (HBOT) on coronavirus disease-2019 (COVID-19): a systematic review. Eur J Med Res 2021; 26:96. [PMID: 34412709 PMCID: PMC8374420 DOI: 10.1186/s40001-021-00570-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/10/2021] [Indexed: 02/08/2023] Open
Abstract
Background Oxygenation serves as a cornerstone in the treatment of COVID-19, and several methods have been extensively studied so far. Herein, we aimed to systematically review the studies discussing hyperbaric oxygen therapy (HBOT) to examine its reported efficacy and adverse events in patients with COVID-19. Methods We systematically searched and retrieved the relevant articles using keywords on the online databases, including PubMed, Scopus, Embase, Web of Science, and Cochrane databases up to April 11th, 2021. The retrieved records underwent a two-step title/abstract and full-text screening process, and the eligible papers were identified. National Institutes of health (NIH) quality assessment tool was used for this study. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42021269821. Results Eight articles from three countries were included. All the included studies had good and fair quality scores, with no poor studies included in this systematic review (Good: n = 5, Fair: n = 3). Studies were divided into clinical trials and case reports/series. Most of the studies used HBOT less than 1.5–2 absolute atmospheres (ATA) for 90 min sessions and thereafter sessions were decreased to 60 min. Trials demonstrated most of the patients recovered after receiving HBOT, and blood oxygen saturation increased after several sessions of HBOT. Conclusion Overall, HBOT seems to be a safe and effective oxygenation method in patients with COVID-19. However, there is limited knowledge and evidence regarding the effects and mechanism of HBOT in COVID-19 treatment, and further evaluations require extensive well-designed studies.
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Affiliation(s)
- Shahram Oliaei
- HBOT Research Center, Golestan Hospital, Islamic Republic of Iran, Navy and AJA Medical University, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehrtak
- Healthcare Services Management, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Noori
- Department of Health Information Technology, Zabol University of Medical Sciences, Zabol, Iran
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shojaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sanam Alilou
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadiseh Azadi Cheshmekabodi
- Health Information Technology, School of Health Information Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- AMAD Research Institute, Supreme National Defense University, Tehran, Iran. .,Department of Health Information Technology, Khalkhal University of Medical Sciences, 1419733141, Khalkhal, Iran.
| | - Omid Dadras
- Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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