Background: The tyrosinase enzyme catalysis monophenols to melanin pigments through the melanogenesis process. For this reason, various inhibitors have been studied for enzyme regulations in melanogenesis abnormalities in both the food and cosmetics industries. In this study, the effect of humic acid (Hu) and fulvic acid (Fu) on the structure, activity, and stability of mushroom tyrosinase (MT) was investigated. Methods: These two organic acids are the main components of soil humus. Assessment of the thermodynamic and structural stability of enzymes was obtained through thechemical and thermal denaturations and (8-anilino-naphthalene sulfonic acid) ANS fluorescence analysis. The Hu and Fu impact on A375 melanoma cancer cell viability was achieved by MTT assay. Findings: The results of enzyme half denaturation concentration (Cm), melting points (Tm), ΔG0 values and external fluorescence emissions in the presence of Hu and FA proved the reduction of the thermodynamic and structural stability of MT by these compounds. The anti-proliferation effects of the compounds were confirmed by the inhibitory concentrations of 50% (IC50) of 31.5 and 42.7 µM and 12.5 and µM at time points of 24 and 48 hours treatments of the A375 melanoma cell line by Hu and Fu, respectively. Conclusion: Humic and fulvic acids can be expected to contribute to advancing skin disorder science play a crucial role in tyrosinase related disorders and anti-cancer effects, and good candidates for medical applications.
Background:Acute lymphoblastic leukemia (ALL) is the most prevalent childhood cancer. ALL is a heterogeneous type of malignancy and treatment protocols vary based on the immunological classification of ALL. The critical step for treating ALL is to identify immunological subgroups by flow cytometry findings. Objective: In this study, immunophenotypic information was evaluated for the first time in children with ALL in Qazvin City, Iran. Methods: This cross-sectional study reviewed the clinical and laboratory data of children with ALL during 2019-2020. Next, children with ALL were immunophenotyped by flow cytometry applying a panel of the specific monoclonal antibodies for some clusters of differentiation (CD) molecules, including CD20, CD21, CD10, CD34, CD38, and terminal deoxynucleotidyl transferase (TdT). The data were separately analyzed using SPSS software, version 24. Findings: Of 52 children with ALL in the age range of 6 months to 15 years, 23 children (44.23%) had B-ALL-ProB (pro-B) cell immunotyping features, 26 (50%) had B-ALL-PreB (pre-B) cell immunotyping features, and 3 (5.7%) had T-cell immunotyping features. The ages of T-cell group children were higher than those of B-cell group children. The most common clinical and laboratory findings were fever (26 cases, 55.31%). In 55% of children, periodic acid-schiff (PAS) staining was positive. The presence of the terminal deoxynucleotidyl transferase (TdT) enzyme was higher in B-cell patients than in T-cell cases. Children with CD34+ were higher in the pro-B group than in the pre-B group. Conclusion: our study shows that the immunophenotypic characteristics of children with ALL are more similar to previous reports and can be used for monitoring and prognosis of children with ALL in Qazvin City
Background: People with chronic kidney disease (CKD) experience chronic systemic inflammation. Although a relationship exists between inflammation and renal injury, the association between inflammatory markers and renal disease has not been well-studied. As inflammation may be a trigger or a result of chronic disease, the kidney needs to be investigated to determine whether it is a clearer target for the devastating effects of persistent inflammation. Here, we report the relation of C-reactive protein and mean platelet volume levels with renal functions in chronic kidney disease patients. Methods: This study was an observational retrospective single-center study conducted on the record of CKD patients to detect the outcomes over a median follow-up time of three years. Demographic, clinical, laboratory, medication, and outcome data were obtained from the electronic data records of the hospital. We investigated the multivariable association of plasma levels of C-reactive protein and mean platelet volume with the progression of CKD in the study participants. Findings: Elevated plasma levels of C-reactive protein (r=0.13, P<0.001) and mean platelet volume (r=0.23, P<0.001) were associated with a greater loss of kidney function over time. The presence of diabetes mellitus was detected to be a risk factor for CKD progression (P=0.04). An inverse relationship was detected between sodium and creatinine (P<0.001). In addition, a weak association was detected between uric acid and creatinine (P<0.001). Conclusion: Elevated plasma levels of C-reactive protein and mean platelet volume were associated with a decline in the estimated glomerular filtration rate in patients with CKD.
Background: For severe cases of acute respiratory syndrome type 2 (SARS-CoV-2) infection (COVID-19), Remdesivir (RDV) is introduced as an anti-viral drug with side effects. Hepatotoxicity from prolonged exposure to RDV is associated with increased inflammatory factors. In this study, we evaluated the effect of RDV on the secretion of inflammatory markers by chicken liver cells. Methods: In this in vitro study, 20 stage X embryonated chicken eggs were incubated for 10 days at 37.5°C and 60–65% humidity Hamburger–Hamilton stages (stage HH35). Liver cells were grown in a medium containing DMEM/F12+10% fetal bovine serum (FBS). After three days, the culture media was supplemented with four doses of RDV (1.00, 2.00, 3.00, and 4.00 μM). After 24 and 48hs, the viability of the hepatocytes, gene expression of Sox17, CXC motif chemokine receptor 4 (CXCR4), Interleukin-1 (IL-1), Interleukin-6 (IL-6), and TNF-α, and hepatocellular functions (albumin and urea secretion) were assessed. Findings: Each hepatocyte had a prominent nucleus and a nucleolus with a hexagonal shape. The pink tint of the periodic acid Schiff (PAS) positive cells in the PAS staining verified the hepatocytes’ glycogen content. Up to 50% of the cells lose viability after 48 hours in the presence of 3 and 4 μM RDV (P<0.001). In the presence of 3 μM RDV, the production and secretion of both albumin (P<0.001) and urea (P<0.05) decreased. Besides, the expression of IL-1, IL-6, and TNF-α significantly increased after treatment with 3 μM RDV (P<0.001). Conclusion: We concluded that RDV therapy altered the expression and function of hepatocyte inflammatory factors.
Background: One of the best tests for the assessment of a fetus is the biophysical profile test which has a significant effect on the fetus’s health and the outcome of pregnancy. The present study was designed to determine the relationship between the full biophysical profile (FBP) and the rapid biophysical profile (RBP) tests in antepartum fetal surveillance. Methods: In this prospective study, Singleton pregnancies (n=209) with more than 34 weeks of gestational age were chosen. Both FBP and RBP tests were performed for all the patients. The main outcome is the Apgar score and neonatal intensive care unit admission analyzed by SPSS software, version 24. The sensitivity, specificity, positive predictive value, and negative predictive value of RBP were calculated. Findings: Out of 209 people who entered the study, 48 women (23.0%) had gestational diabetes, 84 women (40.2%) had hypertension pregnancy (preeclampsia), 45 people (21.5%) had intrauterine growth restriction, and 45 women (21.5%) had post-date pregnancy. For predicting adverse fetal outcomes of pregnancy, the sensitivity, specificity, positive predictive value, and negative predictive value of RBP were 95%, 73%, 52%, and 98%, respectively. Conclusion: According to the statistically significant positive correlation between RBP and FBP and its simple and rapid application, RBP might be an acceptable alternative method for primary antepartum fetal screening tests in overcrowded obstetrics centers.
A major cause of male infertility, which includes 50 causes of infertility, is oxidative stress. Aerobic respiration in the sperm cell is associated with the production of reactive oxygen species (ROS). Some reactions, such as sperm capacitation and acrosome reactions require moderate levels of ROS. However, when the amount of ROS production surpasses the natural antioxidant defense of the cell, it causes a harmful effect called oxidative stress. This results in the oxidation of lipids, proteins, carbohydrates, and nucleotides. The production of ROS is increased by various factors, including the presence of leukocytes, sperms with abnormal and immature morphology, centrifugation of samples, and changes in oxygen concentration, pH, and temperature. Sperm freezing is a method widely used in assisted reproductive technology (ART) as well as infertility treatment. The process of freezing also contributes to increased oxidative stress because it alters the fluidity of the mitochondrial membrane, leading to increased production and release of ROS. Sperm have defense mechanisms against oxidative stress caused by increased ROS production, which includes the presence of enzymatic and non-enzymatic antioxidants in semen. The utilization of supplementary antioxidants in the freezing environment is a strategy to combat oxidative stress. This review aims to summarize the current evidence on the effect of antioxidants on sperm freezing.
Background: Influenza is a respiratory infection that causes a wide range of symptoms, from mild symptoms to a significantly impaired disease. Objective: This study aims to examine demographic characteristics, clinical features, and underlying medical conditions in children and adults hospitalized with laboratory-confirmed influenza. Methods: This was a retrospective comparative study on 333 adults and 102 children hospitalized with symptoms of acute respiratory tract infection and seasonal influenza confirmed by reverse transcription polymerase chain reaction (RT-PCR) in three university hospitals, in Qazvin City, Iran, during two influenza seasons (March 2017 and February 2019). Findings: Most clinical manifestations of influenza were similar among adults. A significant difference was observed among the two groups in terms of 1) a greater proportion of male patients in children (66.7%) and female patients in adults (58.6%); 2) adults were more exposed to risk factors than children (median 1 vs. 0); 3) a greater proportion of children presenting influenza-related encephalopathy (38.2% vs. 26.7%) and upper respiratory signs compared to adults; 4) a greater proportion of adults presenting lower respiratory signs and symptoms compared to children. The most common underlying conditions were asthma and diabetes mellitus (DM) in adults and diabetes mellitus (DM) and cancer in children. The duration of hospitalization had a significant relationship with the number of risk factors (r=0.219, P<0.001). Conclusion: In summary, influenza-related encephalopathy and upper respiratory signs are more prevalent in children, and in contrast, adults are more likely to have underlying medical conditions than children with seasonal influenza.
Background: Coronavirus disease 2019 (COVID-19) has rapidly become a pandemic since it was first reported in late December 2019. Serological reports are of great value to medical specialists in developing health policies. The detection of Immunoglobulin G (IgG) level in COVID-19 patients can specify a preclinical infection or previous exposure to the virus. Objective: This study aims to assess the IgG rate in patients with COVID-19. Methods: This is a cross-sectional study on 172 patients with confirmed COVID-19 (having positive PCR test) in Qazvin, Iran in 2020, including 86 inpatients and 86 outpatients. In order to measure the IgG levels, the serum samples were collected 3-5 weeks after onset of their clinical symptoms. Data were statistically analyzed in SPSS software v. 20, considering the significance level of P<0.05. Results: Of 172 patients, 81(94.2%) inpatients and 74(86%) outpatients tested positive for IgG, while 5(5.8%) inpatients and 10(11.6%) outpatients tested negative for IgG. The mean IgG level in inpatients was significantly higher than in outpatients (P<0.001) 3-5 weeks after a positive PCR test. Conclusion: The amounts of IgG in the sera of COVID-19 patients 3-5 weeks after the onset of symptoms can help health care authorities develop policies and control strategies by determining the burden of disease, monitoring the spread of disease, and estimating the epidemiological factors.
Background: Metabolic syndrome (MetS) comprises a group of conditions that happen together and increase the risk of heart disorders. MetS has known characteristic diagnostic criteria and is diagnosed through physical examination and blood tests. This syndrome is extremely prevalent in patients with acute myocardial infarction. We aimed to determine the prevalence of MetS and its relationship with myocardial infarction and response to treatment in patients suffering from acute myocardial infarction under fibrinolytic treatment. Methods: In this cross-sectional study, 145 patients with acute ST-elevation myocardial infarction (STEMI) were enrolled. They were referred to Bu-Ali Sina Hospital in Qazvin, Iran, between January 2018 and January 2019 and were candidates for thrombolytic therapy. The patients were divided into two groups with and without MetS according to the NCEP ATP III definition (the National Cholesterol Education Program-Adult Treatment Panel III). In each group, the ST resolution of more than 50% in electrocardiogram was evaluated 90 minutes after thrombolytic administration. In addition, angiographic information and left ventricular ejection fraction (LVEF) were compared between the two groups. Results: Overall, the prevalence of MetS was 57.2% in the study population. After treatment, ST-segment resolution of more than 50%, the number of involved coronary vessels, the thrombolysis in myocardial infarction flow grade, mean LVEF, and type of myocardial infarction were similar in both study groups. Conclusion: Our study indicates that MetS does not affect the response rate to thrombolytic treatment.
Background: The initial reports of an outbreak of SARS-CoV-2 pneumonia suggest that COVID-19 is a severe disease. Objective: We aimed to investigate the clinical parameters and mortality of patients with SARS-CoV-2 pneumonia admitted to the intensive care unit (ICU) of Velayat Hospital in Qazvin, Iran. Methods: In this single-centered, cross-sectional, and retrospective study, we enrolled all adult patients with COVID-19 admitted to the intensive care unit (ICU) of Velayat Hospital from March 20 to April 30, 2020. Sociodemographic data, laboratory values, and disease outcomes of the patients were collected. Then, the obtained data were compared between survivors and non-survivors. Results: Of 1100 patients with SARS-CoV-2 pneumonia, 74 adult patients were included in this study. The Mean±SD age of the 52 patients was 60.1±16.46 years. All patients had underlying diseases. The Mean±SD time from admission to discharge from the ICU was 12.39±6.48 days. The logistic regression test indicated that the amount of blood urea nitrogen (BUN) during hospitalization in the ICU was associated with increased mortality risk (OR=1.081, 95% CI=1.024-1.141; P=0.005). Moreover, the same test showed that platelet count (OR: 0.991, 95% CI: 0.985-0.997; P=0.002) and hemoglobin concentration (OR: 0.691, 95% CI: 0.502-0.951; P=0.023) were associated with a decreased mortality risk in ICU patients; this means that patients with higher hemoglobin concentration and platelet counts had a lower mortality risk in ICU. Conclusion: The mortality rate of patients with SARS-CoV-2 pneumonia is high. The BUN level was a predictor of mortality in patients with COVID-19. Therefore, it is recommended that BUN be measured during initial referral, and based on that, timely and appropriate corrective actions be conducted.
Background: Several supplementary approaches have been used to increase the patient’s comfort during phacoemulsification under topical anesthesia. Objective: This study aimed to compare the effects of lidocaine/paracetamol (LP) and midazolam/fentanyl (MF) administration on pain intensity and hemodynamic changes in patients undergoing cataract surgery using phacoemulsification. Methods: This study was designed and implemented as a pilot randomized double-blinded clinical trial. A total number of 80 patients with cataracts scheduled for phacoemulsification were randomly assigned to two groups (40 subjects in each group) to receive lidocaine at a dose of 1.5 mg/kg and then infused with 1 g of paracetamol in 100 cc of normal saline (LP group) or midazolam 0.2 mg/kg and fentanyl 1.5 µg/kg (MF group). Hemodynamic parameters and sedation scores were measured before, 5, and 15 minutes after surgery, and then during recovery. Furthermore, pain (VAS), patient-surgeon satisfaction, propofol, and opioid consumption were all assessed. Findings: The sedation scores during recovery in the LP group were significantly lower (P= 0.04) than those in the MF group. Respiratory depression was also significantly lower (P<0.001) in the LP group compared to that infused by MF. According to other findings, no significant difference was observed between both study groups. Conclusion: The use of lidocaine-paracetamol as a supplementary approach for patients undergoing cataract surgery under topical anesthesia can cause better sedation scores with lower respiratory depression compared to the use of midazolam-fentanyl.
Background: Health promotion among health workers requires appropriate evidence of relevant determinants. Objective: This study was conducted to investigate the relationship between mental health and its measured covariates with self-rated health (SRH) among health workers during the COVID-19 pandemic in northwest Iran. Methods: In this cross-sectional study, we recruited 569 health workers from three educational hospitals of Qazvin University of Medical Sciences, Iran. From July 1 to September 5 (2020), participants were asked to provide demographic and clinical information and to complete the symptom checklist 90 (SCL-90) questionnaire. The relationship between suboptimal SRH with each of the SCL-90 domains and measured covariates were analyzed using logistic regression models. Findings: The Mean±SD age of participants was 34.73(7.95) years. A total of 148 health workers (26%) reported their suboptimal SRH, which was higher in women (odds ratio [OR]: 1.98; 95% confidence interval [CI]: 1.21, 3.24), as well as among participants without physical activity (OR: 2.14; 95% CI: 1.35, 3.39). Depression (OR: 2.13; 95% CI: 1.64, 2.77) and anxiety (OR: 3.76; 95% CI: 2.78, 5.09) showed significantly higher odds of suboptimal SRH. Also, other SCL-90 domains indicated a positive association with suboptimal SRH during the COVID-19 pandemic. Conclusion: Mental health, gender, and physical activity were significant variables related to SRH. The current findings suggest that we should pay attention to mental health problems and other important covariates during the COVID-19 epidemic. Hence, policymakers should consider this issue in health promotion programs for health workers.
Background: No evidence exists for the lowest effective dose of magnesium on menstrual pain. Objective: To determine and compare the effects of two different doses of magnesium on pain intensity and menstrual blood loss in students with primary dysmenorrhea. Methods: Sixty dysmenorrhea patients were randomly assigned to one of two therapeutic groups and one placebo group (receiving one tablet a day of 300 or 150 mg magnesium sulphate or placebo from the 15th cycle day until no pain existed on the following cycle). Visual analogue scale (VAS) and Hjgham collected data for two cycles before and two cycles after the intervention. The data were analyzed using one-way ANOVA and ANCOVA tests. Findings: No significant difference was observed between the groups in terms of baseline characteristics. Both intervention groups outperformed the placebo group in terms of pain intensity (adjusted differences of -2.9, 95% confidence intervals of -3.3 to -2.4 and -1.9, -2.4 to -1.5, respectively) and menstrual bleeding (-20.0, -26.0 to -14.0, and -13.0, -19.0 to -7.0, respectively), as well as the secondary outcome, i.e. rest duration and ibuprofen consumption. In terms of pain alleviation and menstrual bleeding, participants in the 300 mg magnesium group outperformed those in the 150 mg magnesium group. No significant difference was observed between intervention groups regarding secondary outcomes. Conclusion: Both magnesium levels are useful in alleviating pain and reducing menstrual bleeding, although 300 mg of magnesium was more effective.
Health risks from asbestos exposures have been evaluated, considering past professional histories when exposures at workplaces were higher than today. A linear no-threshold (LNT) model has been applied, although its relevance is unproven. Fibers are often found in the lungs and pleura of deceased people. Fiber findings do not prove that a disease is caused by asbestos. It is reasonable to assume that a targeted search for mesothelioma and other asbestos-related conditions in asbestos workers resulted in an increased detection rate. Histological and immunohistochemical characteristics of malignant mesothelioma partly overlap with other cancers, which may contribute to the overdiagnosis in exposed populations. The etiology and differential diagnosis of malignant pleural mesothelioma as well as differences in carcinogenicity between different asbestos types are briefly discussed here. In the author’s opinion, current regulations applied in some countries are excessive and should be reconsidered based on independent research. The most promising way to obtain reliable information would be through lifelong bioassays. It can be reasonably assumed that the non-use of asbestos-containing brakes, fireproofing, insulation, etc. increases the harm caused by fires, traffic accidents, and armed conflicts.
Background: Adverse effects of high parathormone hormone (PTH) in critical illness have been described in some studies. Objective: The relationship between high PTH levels with mortality in hospitalized patients with COVID-19 was evaluated in the present study. Methods: A total of 123 patients were included in the study. The patients were evaluated in phase 1 (on admission) and phase 2 (days 4-6 of hospitalization). The patients were categorized into four groups based on the PTH status in both phases: normal PTH1/normal PTH2 (group 1), high PTH1/normal PTH2 (group 2), high PTH1/high PTH2 (group 3), and normal PTH1/high PTH2 (group 4). The multiple logistic regression analysis was performed to examine the independent association of late hyperparathyroidism with mortality. After excluding ineligible participants, 115 patients in phase 1 and 96 patients in phase 2 (days 4-6 of hospitalization) were evaluated. Findings: The level of phase 2 PTH in non-survivors was significantly higher than in survivors (57.5±40.9 pg/mL vs. 27.6±16.2 pg/mL, P=0.001). The mortality rate was significantly higher in high-PTH groups in phase 2 compared to normal-PTH groups in this phase (50% and 42.9% in groups 3 and 4 vs. 6.6% and 18.2% in PTH groups 1 and 2, respectively, P=0.007). Late hyperparathyroidism was associated with 11.4 times higher mortality risk (95% CI: 2.3-56.1, P=0.003). Conclusion: Late hyperparathyroidism remained a significant predictor of mortality after adjusting for the main PTH secretion modulators and disease severity. Late hyperparathyroidism is an independent and strong risk factor for mortality in COVID-19. Further studies are necessary to clarify the mechanisms involved.
Background: Statins may be protective against viral infection and have been suggested for the treatment of coronavirus disease 2019 (COVID-19). Objective: In this study, we aimed to evaluate the effect of atorvastatin on COVID-19 patients. Methods: Our study is a randomized double-blind controlled clinical trial that constitutes a population of COVID-19 patients admitted to Bu-Ali Sina Hospital in Qazvin, Iran, from May to August 2021. For the intervention and control groups, in addition to the national standard treatment, atorvastatin 40 mg tablet and placebo were daily administered for 7 days, respectively. A questionnaire including demographic characteristics, history of underlying diseases, vital signs, laboratory and imaging results, and outcome (alive, died) was completed on the first, third, and fifth days of hospitalization. Finally, the obtained data were analyzed by SPSS software, version 25. Findings: One hundred five patients with COVID-19 (62 females and 43 males, mean age 69 years) were studied. On days 3 and 5 after the intervention, no significant difference was observed between the groups in terms of vital signs, laboratory findings, hospitalization time, and need for intensive care unit hospitalization. However, 5.7% of patients in the atorvastatin group and 0% of patients in the control group died (P=0.243). Among the studied variables, C-reactive protein (P=0.227 vs P=0.002), blood urea nitrogen (P=0.055 vs P<0.001), and creatinine (P=0.598 vs P=0.013) decreased significantly in the statin group (no control group during days 0-5). Conclusion: There was no evidence about the harm and benefits of statin treatment during COVID-19 hospitalization.
Background: The lateral hypothalamus (LH), which produces orexin, is vital for body solution homeostasis. Lateral hypothalamus (LH) lesion causes adipsia and its stimulation increases water intake. Objective: This study aimed to investigate the effect of an intracerebroventricular (ICV) injection of orexin-A (OXA) on water-drinking behavior in water-deprived rats. Metods: A total of 32 male Wistar rats (220–250 g) were used and divided into 4 groups, control (no injection), vehicle (Normal saline, 5 µL), OXA (30 µg/rat), SB-334867 (OXA receptor selective antagonist, 30 µg/rat). After the microinjection of drugs or vehicles in the right lateral ventricle, each rat was placed individually into the metabolic cage and the amount of water intake, the delay time for the first water intake, and the referral number for water intake were recorded for 4 h. Findings: This study showed that ICV administration of OXA increased both water intake and the referral number for water intake in water-deprived animals (P<0.05). On the other hand, ICV administration of SB-334867 decreased water intake compared to vehicle and control groups. Conclusion: It can be concluded that OXA has a regulatory role in water drinking behavior in water-depriving states.
The COVID-18 pandemic severely affected people older than 65 years, especially those with age-related comorbidities, causing a disproportionate death burden in this age group. The reasons for this difference from other respiratory virus pandemics have been attributed to the aging-induced changes in the immune system, and their effects on the pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. In this brief review, I summarize some of the recent findings throwing light on the relationship between aging, immunity, and the severity of COVID-19.
Background: The demand for home care services has increased not only due to the increase in the elderly population but also due to consumer preference and technological advances that allow for the provision of sophisticated home care. Home healthcare services aim to help people improve their performance, live a more independent life, improve their well-being, and help them stay at home, and avoid hospitalization. Objective: This study was conducted to compare the quality of life (QoL) of COVID-19 patients under home care at a hospital in Qazvin City, Iran. Methods: his study was a cohort study. The samples included two groups of patients, hospitalized patients due to COVID-19 and patients with COVID-19 who received medical and nursing care at home. Patients were matched for age, underlying disease, and severity of the COVID-19 disease. In this study, a 3-month follow-up on changes in QoL compared to before hospitalization and receiving care at home was performed using a QoL questionnaire (SF-12). Findings: The mean score of QoL in the home care group was 32.36±2.15 and in the hospitalized group, it was 29.70±2.94, which shows a statistically significant difference, and the quality of home care patients reported to be higher than hospitalized patients (P<0.001, t=7.20) Conclusion: Receiving hospital care at home increases the QoL for patients with COVID-19. This finding can be generalized during different epidemics, and home care can be an excellent alternative to hospitalization for some patients.
Background: Coronavirus disease-2019 (COVID-19), an infectious disease, has been known as a worldwide pandemic involving many countries, including Iran. Meantime, the analyses of clinical and demographic features of the fourth surge in COVID-19 patients provide a better overview of disease management and mortality reduction. Objective: This study aimed to identify the effective clinical and demographic hallmarks of the fourth wave of COVID-19 in Ardabil Province, Iran. Methods: We carried out a population-based analytical cross-sectional study using clinical and demographic characteristics of COVID-19 from February 2021 to May 2021 among confirmed COVID-19 patients who were admitted to the hospital during the fourth surge. Predictors of intensive care unit (ICU) admission and death were evaluated by controlling for intervening variables. Findings: We evaluated 500 patients, of whom 54.5% were men, and 45.5% were women. Among them, 35.1% of patients had hypertension as the main comorbidity, followed by diabetes (21.4%), cardiovascular disease (8.4 %), renal diseases (2.4%), and others. The findings indicated that increasing age has increased mortality among patients with COVID-19. Moreover, our results showed that among the analyzed items, age, sex, and cerebral vascular accident (CVA) were indicated as predictors of ICU admission. Conclusion: This evaluation demonstrated that old age and comorbidities are two major risk factors for reducing the probability of recovery and increasing admission to the ICU. Therefore, elderly individuals with at least one co-morbidity are at higher risk of becoming infected.
