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Ashraf MA, Shokouhi N, Shirali E, Davari-Tanha F, Shirani K, Memar O, Kamalipour A, Azarnoush A, Mabadi A, Ossareh A, Sanginabadi M, Azad TM, Aghaghazvini L, Ghaderkhani S, Poordast T, Pourdast A, Nazemi P. COVID-19, An early investigation from exposure to treatment outcomes in Tehran, Iran. J Res Med Sci 2022; 26:114. [PMID: 35126577 PMCID: PMC8765513 DOI: 10.4103/jrms.jrms_1088_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/30/2020] [Accepted: 05/31/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is a growing need for information regarding the recent coronavirus disease of 2019 (COVID-19). We present a comprehensive report of COVID-19 patients in Iran. MATERIALS AND METHODS One hundred hospitalized patients with COVID-19 were studied. Data on potential source of exposure, demographic, clinical, and paraclinical features, therapy outcome, and postdischarge follow-up were analyzed. RESULTS The median age of the patients was 58 years, and the majority of the patients (72.7%) were above 50 years of age. Fever was present in 45.2% of the patients on admission. The most common clinical symptoms were shortness of breath (74%) and cough (68%). Most patients had elevated C-reactive protein (92.3%), elevated erythrocyte sedimentation rate (82.9%), and lymphocytopenia (74.2%) on admission. Lower lobes of the lung were most commonly involved, and ground-glass opacity (81.8%) was the most frequent finding in computed tomography scans. The administration of hydroxychloroquine improved the clinical outcome of the patients. Lopinavir/ritonavir was efficacious at younger ages. Of the 70 discharged patients, 40% had symptom aggravation, 8.6% were readmitted to the hospital, and three patients (4.3%) died. CONCLUSION This report demonstrates a heterogeneous nature of clinical manifestations in patients affected with COVID19. The most common presenting symptoms are nonspecific, so attention should be made on broader testing, especially in age groups with the greatest risk and younger individuals who can serve as carriers of the disease. Hydroxychloroquine and lopinavir/ritonavir (in younger age group) can be potential treatment options. Finally, patients discharged from the hospital should be followed up because of potential symptom aggravation.
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Affiliation(s)
- Mohammad Ali Ashraf
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasim Shokouhi
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shirali
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Davari-Tanha
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiana Shirani
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omeed Memar
- Academic Dermatology and Skin Cancer Institute, Chicago, IL, USA
| | - Alireza Kamalipour
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, CA, USA.,MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ayein Azarnoush
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Avin Mabadi
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Adele Ossareh
- Department of Statistics, Shahid Beheshti University, Tehran, Iran
| | - Milad Sanginabadi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Talat Mokhtari Azad
- The National Influenza Centre, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ghaderkhani
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alieh Pourdast
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Research Center for HIV/AIDS (IRCHA), Tehran, Iran
| | - Pershang Nazemi
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Moradi B, Ghanaati H, Kazemi MA, Gity M, Hashemi H, Davari-Tanha F, Chavoshi M, Rouzrokh P, Kolahdouzan K. Implications of Sex Difference in CT Scan Findings and Outcome of Patients with COVID-19 Pneumonia. Radiol Cardiothorac Imaging 2020; 2:e200248. [PMID: 33778607 PMCID: PMC7370352 DOI: 10.1148/ryct.2020200248] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/13/2020] [Accepted: 07/07/2020] [Indexed: 01/07/2023]
Abstract
Purpose The novel coronavirus pandemic has caused significant morbidity and mortality since December 2019. Although the role of chest CT for diagnosing coronavirus disease 2019 (COVID-19) pneumonia is still debatable, the modality has been used in scenarios of constrained reverse-transcription polymerase chain reaction (RT-PCR) testing. The epidemiologic reports indicate an unexplored difference between men and women in disease severity. We aimed to study the role of sex on disease severity and its correlation with CT findings. Materials and Methods Authors retrospectively studied all confirmed cases of COVID-19 with thoracic CT scans obtained at three hospitals from February 25, 2020, to March 15, 2020, in Tehran, Iran. CT involvement patterns of COVID-19 were analyzed based on sex and age of patients. Results One hundred fifteen patients (64.3% [74/115] men) were enrolled, with a median age of 57 years (age range, 21-89). Thirty patients were admitted to the intensive care unit, and 30 patients died during the hospital stay. Seventy-seven percent (37/48) of patients with unfavorable prognosis were male. Peripheral distribution of opacities was more common in men than women. When grouped by an age cut-off of 60 years, the women in the elder group had a peribronchovascular distribution pattern, and younger men showed an anterior distribution of opacities. Women younger than 60 years had significantly lower severity scores (CT-scores) (7.5 ± 6.8). Receiver operating characteristic (ROC) curve analysis demonstrated a CT-score cut-off of 14.5 to have 100% sensitivity and 91.9% specificity for predicting poor prognosis in women younger than 60 years. Conclusion Opacity patterns on chest CT scans in COVID-19 are different based on sex and age, and men are at higher risk of disease severity and death.© RSNA, 2020.
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Affiliation(s)
- Behnaz Moradi
- Department of Radiology, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran (B.M.); Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center (B.M., H.G., M.A.K., M.G., H.H., P.R.) and Cancer Institute, Department of Radiation Oncology (K.K.), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 1416753955, Iran; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.A.K.); Department of Obstetrics & Gynecology & Reproductive Endocrinology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran (F.D.T.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.C.)
| | - Hossein Ghanaati
- Department of Radiology, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran (B.M.); Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center (B.M., H.G., M.A.K., M.G., H.H., P.R.) and Cancer Institute, Department of Radiation Oncology (K.K.), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 1416753955, Iran; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.A.K.); Department of Obstetrics & Gynecology & Reproductive Endocrinology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran (F.D.T.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.C.)
| | - Mohammad Ali Kazemi
- Department of Radiology, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran (B.M.); Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center (B.M., H.G., M.A.K., M.G., H.H., P.R.) and Cancer Institute, Department of Radiation Oncology (K.K.), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 1416753955, Iran; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.A.K.); Department of Obstetrics & Gynecology & Reproductive Endocrinology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran (F.D.T.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.C.)
| | - Masoumeh Gity
- Department of Radiology, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran (B.M.); Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center (B.M., H.G., M.A.K., M.G., H.H., P.R.) and Cancer Institute, Department of Radiation Oncology (K.K.), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 1416753955, Iran; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.A.K.); Department of Obstetrics & Gynecology & Reproductive Endocrinology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran (F.D.T.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.C.)
| | - Hassan Hashemi
- Department of Radiology, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran (B.M.); Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center (B.M., H.G., M.A.K., M.G., H.H., P.R.) and Cancer Institute, Department of Radiation Oncology (K.K.), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 1416753955, Iran; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.A.K.); Department of Obstetrics & Gynecology & Reproductive Endocrinology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran (F.D.T.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.C.)
| | - Fateme Davari-Tanha
- Department of Radiology, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran (B.M.); Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center (B.M., H.G., M.A.K., M.G., H.H., P.R.) and Cancer Institute, Department of Radiation Oncology (K.K.), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 1416753955, Iran; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.A.K.); Department of Obstetrics & Gynecology & Reproductive Endocrinology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran (F.D.T.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.C.)
| | - Mohammadreza Chavoshi
- Department of Radiology, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran (B.M.); Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center (B.M., H.G., M.A.K., M.G., H.H., P.R.) and Cancer Institute, Department of Radiation Oncology (K.K.), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 1416753955, Iran; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.A.K.); Department of Obstetrics & Gynecology & Reproductive Endocrinology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran (F.D.T.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.C.)
| | - Pouria Rouzrokh
- Department of Radiology, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran (B.M.); Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center (B.M., H.G., M.A.K., M.G., H.H., P.R.) and Cancer Institute, Department of Radiation Oncology (K.K.), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 1416753955, Iran; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.A.K.); Department of Obstetrics & Gynecology & Reproductive Endocrinology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran (F.D.T.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.C.)
| | - Kasra Kolahdouzan
- Department of Radiology, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran (B.M.); Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center (B.M., H.G., M.A.K., M.G., H.H., P.R.) and Cancer Institute, Department of Radiation Oncology (K.K.), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 1416753955, Iran; Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.A.K.); Department of Obstetrics & Gynecology & Reproductive Endocrinology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran (F.D.T.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (M.C.)
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