Predictors of care burden among caregivers of patients with COVID-19

AIM

To explore predictors of care burden among the caregivers of patients with COVID-19.

DESIGN

The findings of this cross-sectional study were presented in accordance with the guidelines outlined in the Strengthening the Reporting of Observational Studies in Epidemiology statement.

METHODS

The samples included 172 caregivers in Imam Reza and Farabi Hospitals, located in Kermanshah, Iran, who were enrolled in the study using convenience sampling. A demographic information form and the Caregiver Burden Inventory were administered. The data were collected between 13 May 202 and 20 August 2021.

RESULTS

Of the caregivers, 62.8% (n = 108) were male and 71.5% (n = 123) were over 40 years old. Furthermore, 66.3% (n = 114) of caregivers had severe and very severe care burden, with a mean care burden of 78.9 ± 20.4 out of 120. A statistically significant difference was found between care burden and the variables of monthly income, health status, number of patients under care and residence status (p < 0.05).

CONCLUSION

The caregivers experienced a high care burden, which can have harmful effects on them. Therefore, it is necessary to provide them with various forms of economic, psychological and social support.

Prevalence and reasons for self-medication for prevention of COVID-19 among the adult population in Kermanshah-Iran

AIM

To determine the prevalence of self-medication and reasons for self-medication (SM) for the prevention/treatment of COVID-19 among the adult population.

DESIGN

Cross-sectional study.

METHODS

This study was performed on 147 adults in Kermanshah, Iran. Data were collected by a researcher-made questionnaire and analysed by SPSS-18 software using descriptive and inferential statistics.

RESULTS

The prevalence of SM in the participants was 69.4%. Vitamin D and vitamin B complex were the most commonly used drugs. The most common symptoms leading to SM were fatigue and rhinitis. Strengthening the immune system and prevention of COVID-19 (48%) were the main reasons for SM. Factors related to SM included marital status [OR = 8.04, 95% CI = (3.62, 17.83)], education [OR = 0.16, 95%CI = (0.08, 0.35)] and monthly income [OR = 0.09, 95%CI = (0.03, 0.26)].

PATIENT OR PUBLIC CONTRIBUTION

Yes.

Red Cell Distribution Width as a Prognostic Indicator for Mortality and ICU Admission in Patients with COVID-19

BACKGROUND

COVID-19 disease caused by the SARS-CoV-2 virus can lead to an acute respiratory illness with a high hospitalization and mortality risk. Therefore, prognostic indicators are essential for early interventions. As a component of complete blood counts, the coefficient of variation (CV) of red blood cell distribution width (RDW) reflects cellular volume variations. It has been shown that RDW is associated with increased mortality risk in a wide range of diseases. This study aimed to determine the relationship between RDW and mortality risk in COVID-19 patients.

METHODS

This retrospective study was performed on 592 patients admitted to hospital between February 2020 and December 2020. Patients were divided into low and high RDW groups and the relationship between RDW and mortality, intubation, admission to intensive care unit (ICU), and need for oxygen therapy was investigated.

RESULTS

The mortality rate in the low RDW group was 9.4%, while that in the high group was 20% (p < 0.001). Also, ICU admission in the low group was 8%, whereas this was 10% in the high RDW group (p = 0.040). The results of the Kaplan-Meyer curve showed that the survival rate was higher in the low group compared to the high RDW group. Cox results in the crude model showed that higher RDW values were directly related to increased mortality, although this was not significant after adjustment for other covariates.

CONCLUSION

The results of our study reveal that high RDW is associated with increased hospitalization and risk of death and that RDW may be a reliable indicator of COVID-19 prognosis.

Impacts of subway development on air pollution and vegetation in Tabriz and Shiraz, Iran

Introduction: Presently, air pollution is viewed as a critical environmental challenge that has deleterious effects on human health and ecosystems. The subway system is extensively developed in numerous countries with the objective of minimizing traffic congestion and pollutant emissions. The aim of the present study is to explore the impact of metro activities on air pollution and, subsequently, urban vegetation inside the two metropolises of Tabriz and Shiraz in comparison to prior years. Materials and methods: To assess air quality before and after the establishment of the metro, we collected average data for Particulate Matters less than 2.5 µm (PM2.5), Particulate Matters less than 10 µm (PM10), SO2, NO2, O3, and CO, as well as the Air Quality Index (AQI), retrieved from monitoring stations in Tabriz and Shiraz between 2014 and 2019. We used the average of the Normalized Difference Vegetation Index (NDVI) calculated by the Landsat 8 satellite in the second phase in order to numerically determine the status of urban vegetation across two timeframes. Results: Preliminary evidence revealed that the average concentration of pollutants in Tabriz, excluding NO2, fell after the launch of the metro system in 2016. Simultaneously, several pollutants, including O3, NO2, and PM2.5, and consequently the AQI, increased following the subway's establishment in Shiraz in 2017. Moreover, it was observed that decreasing emissions in Tabriz amplified vegetation, whereas reducing air quality in Shiraz lowered the NDVI values. Conclusion: Although it appears that the metro's operation improved environmental conditions in Tabriz, a similar outcome was not evident in Shiraz. Therefore, it is suggested that future studies consider meteorological variables whenever addressing the metro's efficiency.

Statin Use in COVID-19 Hospitalized Patients and Outcomes: A Retrospective Study

Background

Coronavirus disease 2019 (COVID-19) might affect everyone, but people with comorbidities such as hypertension and cardiovascular disease (CVD) may often have more severe complications and worse outcomes. Although vaccinations are being performed worldwide, it will take a long time until the entire population of the world is vaccinated. On the other hand, we are witnessing the emergence of new variants of this virus. Therefore, effective therapeutic approaches still need to be considered. Statins are well-known lipid-lowering drugs, but they have also anti-inflammatory and immunomodulatory effects. This study aimed to investigate the effects of statins on the survival of COVID-19 hospitalized patients.

Methods

This retrospective study was performed on 583 patients admitted to a highly referenced hospital in Tabas, Iran, between February 2020 and December 2020. One hundred sixty-two patients were treated with statins and 421 patients were not. Demographic information, clinical signs, and the results of laboratory, and comorbidities were extracted from patients' medical records and mortality and survival rates were assessed in these two groups.

Results

The results of the Cox crude regression model showed that statins reduced mortality in COVID-19 patients (HR = 0.56, 95% CI: 0.32, 0.97; p = 0.040), although this reduction was not significant in the adjusted model (HRs=0.51, 95%CI: 0.22, 1.17; p = 0.114). Using a composite outcome comprising intubation, ICU admission, and mortality, both crude (HR = 0.43; 95% CI: 0.26, 0.73; p = 0.002) and adjusted (HR = 0.57; 95% CI: 0.33, 0.99; p = 0.048) models suggested a significant protective effect of statin therapy.

Conclusion

Due to anti-inflammatory properties of statins, these drugs can be effective as an adjunct therapy in the treatment of COVID-19 patients.

The relationship of dietary total antioxidant capacity with sarcopenia and cardiometabolic biomarkers in type 2 diabetes patients

Background

The aim of this study was to investigate the relationship of dietary total antioxidant capacity (DTAC) with sarcopenia and metabolic biomarkers in people with type 2 diabetes in the Kurdish race.

Methods

In this cross‐sectional study, data of 189 type 2 diabetic patients (35–65 years old) from RaNCD cohort study were evaluated. DTAC, fasting blood sugar, lipid profile, body composition, muscle strength, and sarcopenia were assessed. t and χ² tests to compare the variables between sarcopenic and non‐sarcopenic patients and one‐way analysis of variance to compare the variables in DTAC tertiles were used. The relationship between DTAC and different variables was evaluated using multiple logistic regression model.

Results

The mean age and body mass index were 49.7 ± 8.7 years and 27.1 ± 3.9 kg/m². Body mass index, waist circumference, and hip circumference were significantly different between diabetic patients with and without sarcopenia (p < 0.05). In crude (p = 0.010) and adjusted (p = 0.035) models, there was a significant relationship between DTAC and fasting blood sugar. Also, the relationship between DTAC with waist (p = 0.019) and hip (β = −4.25, p = 0.026) circumference was significant. Sarcopenia was significantly lower in the third tertile in comparison with the first tertile of DTAC (p = 0.016). 

Conclusion

Diet with higher DTAC can be associated with lower fasting blood sugar, abdominal obesity and sarcopenia in type 2 diabetic patients. However, further studies are required to confirm these relationships.

Examining Lifestyle Components in Hospitalized COVID-19 Patients, Iran 2021

Background

COVID-19 pandemic is a serious health threating element throughout the world. One of the key elements to strengthen the body’s immune system is to follow a healthy lifestyle to deal with health threating. The aim of this study was to evaluate the lifestyle components in COVID-19 patients.

Methods

This descriptive-analytical study carried on hospitalized COVID-19 patients from October 22, 2020 to January 19, 2021. Demographic characteristics, physical activity, nutritional status, stress and anxiety, and substance abuse were assessed. A simple model and multiple logistic regression model were used.

Results

About 32% were hospitalized in the intensive care unit (ICU). Healthy lifestyle was observed only in 28%. About 82% had insufficient physical activity, and 67.3% was reported to be unfavorable in nutritional status. Severe stress and anxiety were observed in 30.4% of people. There were significant relationships between age (AOR = 2.11, p = 0.036), education (AOR = 0.35, p = 0.002) and a healthy lifestyle. A significant correlation was observed between ICU admission and unhealthy lifestyle (AOR = 0.40, p = 0.015).

Conclusion

Unhealthy lifestyle behaviors were seen in the most COVID-19 patients. Considering the significance of lifestyle changes could prove effective in reducing the risk of transmissible viral infections.

Analyzing relationships between air pollutants and Covid-19 cases during lockdowns in Iran using Sentinel-5 data

Introduction: Air quality improvement was an unparalleled environmental consequence of the Covid-19 global crisis in many regions. Numerous researches have been conducted on the influence of national quarantines on air pollution and the relationship between the abundance of infected cases and mortality caused by this pandemic with air pollutants; however, these investigations are limited in Iran. The present study aims to investigate the correlation between Covid-19 cases and air pollution from a statistical viewpoint in order to evaluate the performance of multiple national lockdowns from February 2020 to August 2021 through measuring changes in air pollutants in the 31 provinces of Iran. Materials and methods: We applied a remote sensing method by employing Sentinel-5P satellite data to analyze changes in PM2.5, CO, and O3 during the three public quarantine periods and their two months earlier. Results: We recognized a considerable positive correlation between PM2.5 and the infected cases (r=0.63, p=0.001) and victims (r=0.41, p=0.001). Moreover, we compared the efficiency of lockdowns and supposed lockdown 2 (November-December 2020) as an only effective quarantine due to a dramatic reduction in PM2.5 (21.2%), CO (0.8%), the infected cases (48.7%), and victims (66.9%) in comparison to the average of its next two months. Conclusion: Governments should handle the outbreak of Covid-19 by implementing efficient quarantines, as well as environmental conservation strategies.