Abstract Introduction A vaccine's ability to protect against disease acquisition is considered one of its most important aspects of effectiveness. The study aimed to determine the effectiveness of COVID-19 vaccines among healthcare workers (HCWs). Materials and methods This was a prospective cohort study conducted with HCWs from April 2021 to May 2022. Vaccination data and PCR-confirmed infections were extracted from the Comprehensive COVID-19 Information System. Vaccine effectiveness for AZD1222 (ChAdOx1 nCoV-19), Sinopharm (BBIBP-CorV), and Sputnik V was evaluated using incidence rates per 100,000 person-days and multivariable time-dependent Cox regression models adjusted for age, sex, and occupational characteristics. Result Among the 3365 participants, all individuals received at least one dose, 95.3% received at least two doses, and 36.7% received a three doses of the COVID-19 vaccine. During follow-up, 517 SARS-CoV-2 infections were identified, with an overall incidence rate of 42.65 per 100,000 person-days (95% CI: 39.12–46.49). Vaccine effectiveness increased with successive doses.The overall effectiveness after three doses was estimated at 92% (95% CI: 81–97). By vaccine type, effectiveness after three doses was highest for AZD1222 (98%; 95% CI: 96–97), followed by Sinopharm (93%; 95% CI: 42–99) and Sputnik V (83%; 95% CI: 13–97). Higher infection rates were observed among females and certain occupational groups with greater exposure risk. Conclusion Completion of the COVID-19 vaccination schedule, including booster doses, markedly reduces SARS-CoV-2 infection risk among healthcare workers. Vaccine effectiveness increased with successive doses, peaking after the third dose. AZD1222 demonstrated the highest effectiveness, while all vaccines provided substantial protection.

Prostate cancer ranks second among cancers affecting men and is the fifth leading cause of cancer-related deaths in men worldwide. Currently, there is no updated information about the incidence of prostate cancer in Iran since 2017. This study aims to investigate the incidence rate and secular trend of prostate cancer in Shahroud and Meyami, northeast Iran. Data for this population-based registry study were extracted from the national population-based cancer registration system between 2010 and 2022. Age-standardized incidence rates (ASIR) were calculated using World Health Organization (WHO) reference populations. The annual percent change (APC) was calculated using Joinpoint regression. During 2010 to 2022, an average of 130,641 males comprised the target population. Over this 13-year period, 220 men (aged 43–93 years) were diagnosed with prostate cancer. The ASIR was 14.18 (95% CI: 12.26–16.09) based on the WHO standard population and 11.67 (95% CI: 10.02–13.31) based on the Segi standard population. The secular trend showed no statistically significant change, with an APC of 0.05% (95% CI: -5.43 to 5.89) based on WHO standard and 0.89% (95% CI: -4.98 to 7.26) based on Segi standard. Crude incidence increased from age 40–44 years to 80–84 years, then declined in those aged ≥ 85 years. Age-period-cohort analysis confirmed a log-linear age effect but found no significant net drift or period/cohort effects. In conclusion between 2010 and 2022, prostate cancer incidence in Shahroud and Meyami showed no statistically significant change (ASIR: 14.18/100,000), lower than global estimates. However, this absence of evidence for a trend should not be interpreted as evidence of epidemiological stability given the limited statistical power (220 cases) and the absence of systematic PSA screening in Iran. Alternative explanations including under-detection and registry maturation should be considered. Future studies with larger sample sizes are needed.

This study aimed to investigate the cumulative incidence of adverse events of special interest (AESI) among Iranians who were vaccinated with COVID-19 vaccines, including Sinopharm, Sputnik V, AZD1222, and COVIran Barekat. Using World Health Organization guidelines, this cohort event monitoring (CEM) study was conducted to assess the adverse events of COVID-19 vaccines, in seven cities in Iran. A total of 89783 participants (31690 Sinopharm, 20195 Sputnik V, 23780 AZD1222, and 14118 CoVIran Barekat) who were 18 or older were followed up for 17 weeks (25 weeks for AZD1222) after receiving the first dose of vaccine by weekly phone contacts or self-reporting in a web application. Furthermore, all hospitalized cases were investigated for causes of admission by classification committees. A total of 11 cases (cumulative incidence: 12.3 per 100,000) of AESIs were recorded. All of the AESI cases were observed among 2080 hospitalized cases. The AESIs included five cases of coagulation disorders (three after AZD1222 and two after Sinopharm vaccination), and three cases of generalized seizure (one after Sputnik V, and two cases after AZD1222). In addition, two cases of Guillain–Barre syndrome, and Sub-acute Thyroiditis were detected after receiving Sputnik V, and one individual developed pericarditis after receiving COVIran Barekat. We found around one AESI among every 8,000 vaccinated Iranian people. The incidence of AESIs after COVID-19 vaccines was relatively rare and the studied vaccines can be considered safe. AZD1222 had a higher incidence of AESIs. Coagulation disorders, and generalized seizure were the main and most common AESIs.

COVID-19 infection during pregnancy might be associated with maternal complications. This study aimed to investigate the impact of COVID-19 vaccination on the risk of miscarriage. This cohort study included 26,701 women of reproductive age (15-49) who were vaccinated with different vaccines (Sinopharm, Sputnik V, AZD1222 and CoVIran Barekat) between April 2021 and August 2022 in seven cities in Iran. Among them 459 women were pregnant and included in this analysis. All pregnant women were followed up until the end of their pregnancy. The mean age (standard deviation) of pregnant women was 31.7 (6.8) years. Among them, 50 miscarriage cases occurred. The cumulative incidence of miscarriage was 10.9%; 95% confidence intervals [CI] 8.0-13.8) in total, and 11.0% (5.9-16.1), 9.7% (4.4-14.9), 12.0% (5.9-18.2), and 11.1% (4.2-18.0) for AZD1222, Sputnik V, Sinopharm and Barekat vaccines respectively. Cumulative incidence rates by vaccine brands were not statistically significant (P value = 0.962). The mean (SD) time interval between conception and vaccination was 3.5 (3.8) weeks and it was 7.5 (2.7) weeks for the age of the fetus at miscarriage. In general, the miscarriage rate in women of reproductive age was 4.8 (95% CI 4.1-5.7) per 1000 women. The estimated incidence rates were not higher than expected; therefore, it can be argued that COVID - 19 vaccination with Sputnik V, Sinopharm, Barekat and AZD1222 does not increase the probability of miscarriage and the vaccines are therefore safe in this respect.

Background and Objectives: Colorectal cancer is considered as one of the most common cancers in the world and Iran. Epidemiological studies are necessary to evaluate the trend of this disease in society. This study aimed to describe the incidence and trend of colorectal cancer in 13 years in Shahroud and Meyami districts, Iran. Methods: The data were obtained from the population-based cancer registry system at Shahroud University of Medical Sciences, including patients in Shahroud and Meyami districts. The standardized incidence rate (ASR) was calculated based on age and gender, and the 13-year trend from 2010 to 2022 was calculated using joinpoint regression along with the percentage of annual changes. Results: In general, 543 cases of colorectal cancer were recorded from 2010 to 2022, including 280 (51.6%) males and 263 (48.4%) females. The most recorded cases of this cancer were in 2021 with 54 cases. The Age-standardized mean incidence rate of colorectal cancer in this period was 17.6 per 100,000 people. The ASR of colorectal cancer in males and females was 18.4 (95%CI: 16.2 - 20.6) and 16.8 (95% CI: 14.8 - 18.9), respectively. The annual percent change of ASR during the study period was 2.33% (95% CI: 0.13 – 4.87), indicating an increasing trend. Conclusion: In the Shahroud and Meyami districts, the incidence rate of colorectal cancer was 17.6 per 100,000 people and has increased relatively over the 13-year study period.

Although the safety of the BBIBP-CorV (Sinopharm) vaccine has been confirmed in both adults and children, safety data remain limited for individuals under 18 years of age. This longitudinal study in Iran aimed to investigate reactogenicity, breakthrough infections, and serious adverse events following Sinopharm vaccination in this population. In this cohort event monitoring study, children and adolescents aged 5 to 18 Years in the eight cities around the country were invited to participate after receiving the first dose of the vaccine. The assessment of local and systemic reactogenicities was conducted through daily telephone calls for up to seven days following the first and second doses of the vaccine. Severe adverse events, adverse events of special interest (AESI), and COVID-19 infections were monitored with weekly follow-ups. Follow-up lasted for 13 weeks for those who received one dose of the vaccine and 17 weeks for those who received two doses. Adverse events were reported as percentages along with 95

Background; This study investigated the relationship between sleep quality and circadian rhythm chronotype with uncontrolled hypertension.Methods: This cross-sectional study was conducted on 170 patients. Sleep quality is classified into two groups: good sleep quality and poor sleep quality. Circadian rhythm has three chronotypes: morning, intermediate, and evening.Results: Of a total of 170 patients, 84 (49.4%) patients were male. The total mean age was 62.8 (+/- 12). The Uncontrolled hypertension odds ratio in patients with poor sleep quality was 18.47 (CI= (5.1, 67); P-value = 0.001). Patients with intermediate rhythms were more likely to have uncontrolled hypertension (OR:4.18, CI= (1.7, 10.5); P-value = 0.002). In the multiple logistic regression model, male gender increased the odds of uncontrolled hypertension in patients with poor sleep quality or intermediate circadian rhythm (OR: 17, CI;(3.7, 78.9); OR:6.83, CI:(2.3, 20.3) respectively). Conclusion: Poor sleep quality and intermedia circadian rhythm were related to uncontrolled hypertension..

Abstract Background This study aimed to evaluate the reactogenicity effects of COVID-19 vaccines, used in Iran. Methods At least 1000 people were followed up with phone calls or self-report in a mobile application within 7 days after vaccination. Local and systemic reactogenicities were reported overall and by subgroups. Results The presence of one or more local and systemic adverse effects after the first dose of vaccines was 58.9% [(95% Confidence Intervals): 57.5–60.3)] and 60.5% (59.1–61.9), respectively. These rates were reduced to 53.8% (51.2–55.0) and 50.8% (48.8–52.7) for the second dose. The most common local adverse effect reported for all vaccines was pain in the injection site. During the first week after the first dose of vaccines, the frequency of the pain for Sinopharm, AZD1222, Sputnik V, and Barekat was 35.5%, 86.0%, 77.6%, and 30.9%, respectively. The same rates after the second dose were 27.3%, 66.5%, 63.9%, and 49.0%. The most common systemic adverse effect was fatigue. In the first dose, it was 30.3% for Sinopharm, 67.4% for AZD1222, 47.6% for Sputnik V, and 17.1% for Barekat. These rates were reduced to 24.6%, 37.1%, 36.5%, and 19.5%, in the second dose of vaccines. AZD1222 had the highest local and systemic adverse effects rates. The odds ratio of local adverse effects of the AZD1222 vaccine compared to the Sinopharm vaccine were 8.73 (95% CI 6.93–10.99) in the first dose and 4.14 (95% CI 3.32–5.17) in the second dose. Barekat and Sinopharm had the lowest frequency of local and systemic adverse effects. Compared to Sinopharm, systemic adverse effects were lower after the first dose of Barekat (OR = 0.56; 95% CI 0.46–0.67). Reactogenicity events were higher in women and younger people. Prior COVID-19 infection increased the odds of adverse effects only after the first dose of vaccines. Conclusions Pain and fatigue were the most common reactogenicities of COVID-19 vaccination. Reactogenicities were less common after the second dose of the vaccines. The adverse effects of AZD1222 were greater than those of other vaccines.

Objectives:Identifying the trend of diseases and its changes over time can be highly important in evaluating the extent and method of achieving strategies for controlling them, developing health indicators, and health planning. This study aimed to investigate the incidence of tuberculosis. Methods:As a repeated cross-sectional study in which the population under study was a census, this study involved all tuberculosis cases registered in 21 cities of Southwest of Iran, from 2010 to 2019. Data were obtained from the National System of Notification of Tuberculosis and included variables related to age, sex and Disease consequence. Segmented regression models were used to analyze the trend of tuberculosis changes. Also, data analysis software- Join Point Regression version 5.0.2 was used for data analysis. Results:The results of evaluating the trend of tuberculosis from 2010 to 2019 showed no change in the general trend of tuberculosis and an annual 0.84% (95% CI: -5.17 to 6.82) increase in incidence rate is observed in the trend. Also, the findings of join point regression analysis show that between 2010 and 2013, an annual 18.10% (95% CI: 8.78 to 34.89) increase in the incidence of tuberculosis, and between 2013 and 2019, annual -5.42% (95% CI: -10.04 to -2.22) decrease in the incidence of tuberculosis was observed. From 2010 to 2012, a 33.10% (95% CI: 15.77 to 48.06) annual increase in the incidence of tuberculosis in males and - 9.47% (95%CI: -14.02 to -6.33) annual decrease in the incidence of tuberculosis in females was observed. Conclusions:The results of this study showed that the incidence of tuberculosis had an upward trend from 2010 to 2013 and a downward trend from 2013 onwards.

Background New vaccines that are initially approved in clinical trials are not completely free of risks. Systematic vaccine safety surveillance is required for ensuring safety of vaccines. This study aimed to provide a protocol for safety monitoring of COVID-19 vaccines, including Sputnik V, Sinopharm (BBIBP-CorV), COVIran Barekat, and AZD1222. Methods This is a prospective cohort study in accordance with a template provided by the World Health Organization. The target population includes citizens of seven cities in Iran who have received one of the available COVID-19 vaccines according to the national instruction on vaccination. The participants are followed for three months after they receive the second dose of the vaccine. For each type of vaccine, 30,000 people will be enrolled in the study of whom the first 1,000 participants are in the reactogenicity subgroup. The reactogenicity outcomes will be followed seven days after vaccination. Any hospitalization, COVID-19 disease, or other minor outcomes will be investigated in weekly follow-ups. The data are gathered through self-reporting of participants in a mobile application or phone calls to them. The study outcomes may be investigated for the third and fourth doses of vaccines. Other long-term outcomes may also be investigated after the expansion of the follow-up period. We have planned to complete data collection for the current objectives by the end 2022. Discussion The results of this study will be published in different articles. A live dashboard is also available for managers and policymakers. All data will be available on reasonable requests from the corresponding author.The use of the good and comprehensive guidelines provided by WHO, along with the accurate implementation of the protocol and continuous monitoring of the staff performance are the main strengths of this study which may be very useful for policymaking about COVID-19 vaccination.

Background & Objective: COVID-19 is a serious disease with different symptoms and risk factors infecting and killing many people around the world.This study was performed to investigate the demographic and clinical characteristics of COVID-19 suspects referred to the hospitals and coronavirus treatment centers of Shahroud, Iran.Materials & Methods: Upon the outbreak of the COVID-19 epidemic in Shahroud, Shahroud University of Medical Sciences launched a project to systematically record the demographic, clinical, and medical data of all suspects referred to the Corona Center.In this study, the data of 3945 suspected people collected during 5 months were analyzed.The RT-PCR test was used as the criterion for diagnosing the disease.Results: Among 3945 suspected cases, 24.4% had positive RT-PCR test.The mean age of confirmed cases was 52.16 years.Dry cough and fever in addition to anorexia were reported as the most common symptoms.The results of logistic regression analysis showed that people over 60 years with heart disease reduce the risk, while people over 60 years, diabetics, and obese people increase the risk of infection. Conclusion:These results necessitate further lines of research into different symptoms and risk factors to help identify COVID-19 cases earlier and start faster treatment.

BACKGROUND: The urgency of uncomplicated blood pressure (BP) is known as a sudden rise in BP. The aim of this study was to evaluate the intravascular administration of midazolam as an emergency care to control BP against captopril in patients with uncomplicated hypertension (HTN).METHODS: The present study was a double-blind parallel randomized clinical trial (RCT) study that was performed on patients with urgent HTN referred to Imam Hossein Hospital in Shahroud, Iran, in 2018. Patients with BP higher than 180/110 mmHg and with healthy vital organs were selected randomly and allocated into three groups of 43 participants. All patients' BP in both arms, and after a period of 10 minutes in the left arm, was checked and after administering the medication was checked again for 4 times of 15 minutes till 1 hour complete.RESULTS: There were significant differences between systolic (P = 0.024), diastolic (P = 0.001), and mean BP (P = 0.009) in the midazolam group before and after treatment. The group of midazolam and captopril showed the greatest reduction of BP before, in the middle, and after carrying out the treatment methods. As such, systolic, diastolic, and mean BP showed 23.5% (P = 0.047), 17.4% (P = 0.021), and 20.5% (P = 0.031) reduction, respectively.CONCLUSION: Midazolam can be used as an effective and low-risk drug for lowering BP. Midazolam also has a faster effect on lowering BP.

Objective To investigate the incidence of coronavirus disease 2019 (COVID-19) cases, hospitalizations and deaths in Iranians vaccinated Methods We enrolled individuals 18 years or older receiving their first COVID-19 vaccine dose between April 2021 and January 2022 in seven Iranian cities. Participants completed weekly follow-up surveys for 17 weeks (25 weeks for AZD1222) to report their COVID-19 status and hospitalization. We used Cox regression models to assess risk factors for contracting COVID-19, hospitalization and death. Findings Of 89 783 participants enrolled, incidence rates per 1 000 000 person-days were: 528.2 (95% confidence interval, CI: 514.0???542.7) for contracting COVID-19; 55.8 (95% CI: 51.4???60.5) for hospitalization; and 4.1 (95% CI: 3.0???5.5) for death. Compared with SARS-CoV-2 Vaccine (Vero Cell), hazard ratios (HR) for contracting COVID-19 were: 0.70 (95% CI: 0.61???0.80) with AZD1222; 0.73 (95% CI: 0.62???0.86) with Sputnik V; and 0.73 (95% CI: 0.63???0.86) with CovIran??. For hospitalization and death, all vaccines provided similar protection 14 days after the second dose. History of COVID-19 protected against contracting COVID-19 again (HR: 0.76; 95% CI: 0.69???0.84). Diabetes and respiratory, cardiac and renal disease were associated with higher risks of contracting COVID-19 after vaccination. Conclusion The rates of contracting COVID-19 after vaccination were relatively high. SARS-CoV-2 Vaccine (Vero Cell) provided lower protection against COVID-19 than other vaccines. People with comorbidities had higher risks of contracting COVID-19 and hospitalization and should be prioritized for preventive interventions.

In the present study we report 10 hospitalized patients with COVID-19 infection with gastrointestinal bleeding. The PCR result was 4 positive and the others had negative PCR, but hadevidence of COVID-19 and had symptoms of gastrointestinal bleeding. Bleeding of 7 people was controlled.

BACKGROUND:Colorectal cancer is one of the most common cancers in the world. This study aimed to determine the relationship between risk factors and the incidence of colorectal cancer in Urbanization levels in Iran. METHODS:This was a population-based study. Urbanization levels were determined using the census data of the Statistical Center in 2012. Data on risk factors for colorectal cancer were obtained from the information provided by the Iranian Non-Communicable Disease Control Center and the incidence of colorectal cancer from the data from the National Cancer Registry System. Negative binomial regression analysis was used to determine the relationship between colorectal cancer risk factors and urbanization levels with colorectal cancer incidence. For statistical analysis, SPSS and Stata software were used. A significant level of P≤0.05 was considered. RESULTS:The relationship between urbanization levels and risk factors with the incidence of colorectal cancer, nutrition Status, tobacco use, and body mass index were not significant. There was a significant relationship between physical activity and incidence at different levels and between levels of urbanization and incidence rate, indicating a lower incidence rate of colorectal cancer at lower levels of urbanization. CONCLUSION:Colorectal cancer incidence is higher at higher levels of urbanization than lower levels. The difference between regions in terms of urbanization can have in flounce on access to facilities, health service, and counseling opportunities to modify the risk factors and access to proper screening and follow-up care.

The present study investigated an 18-days-old neonate who was referred to the hospital with suspected respiratory symptoms of COVID-19. Results of CT-Scan and blood tests were highly suspicious, but result of the first RT-PCR test was negative on March 1. The second RT-PCR test reported positive on March 12. The neonate's medical history indicated no close contact except with family members and hospital treatment staffs, but the RT-PCR test results of all family members were also negative.

Background: Both Gestational diabetes and hypertension almost affect 10.5% of the pregnancies. This study was conducted to investigate and compare the pregnancy outcomes in women with gestational diabetes or high blood pressure with outcomes belonging to healthy mothers. Methods: This population-based case-control study was conducted in 8 provinces and two cities of Iran on women referred to the public health centers during 2015 to 2018. Descriptive statistics for variables presented by percentages and frequencies and logistic regression analysis was used to analyze data at a significance level of less than 0.05. Results: Some variables such as ethnicity, maternal education and age, gestational diabetes, high blood pressure and previous pregnancy outcome were significantly associated with stillbirth. Maternal age greater than 35 yr (OR=1.78, CI: 1.29-2.48), maternal illiteracy (OR=3.67, CI: 2.25-5.98), a previous stillbirth (OR=9.92, CI: 4.98-19.78), gestational diabetes among women who had never had a screening test (OR=3.91, CI: 2.96-5.18) and high blood pressure (OR=1.95, CI: 1.38-2.77) were important factors associated with stillbirth. Maternal and paternal occupation, paternal education and age, place of residence, smoking and maternal BMI were significantly associated with stillbirth. Conclusion: Gestational diabetes, hypertension, a previous miscarriage, stillbirth, first pregnancy, low education level, advanced maternal age and ethnicity were associated with an increased risk of stillbirth. It is necessary to provide high-quality healthcare services before and during pregnancy particularly for those at heightened risk and improve knowledge of mothers on the side effects of each of the mentioned risk factors in order to control these factors more effectively and thus reducing the risk of stillbirth.

Introduction: Hypertensive crisis defines as a sudden rise in blood pressure that can adversely affect the vital organs. As such, it is recommended to take midazolam to lower the blood pressure in patients of hypertensive crisis. This study aims to investigate the midazolam efficacy as an emergency care to control the blood pressure in patients diagnosed with hypertensive crisis. Methods The current paper represents a double-blinded clinical trial study that examines the patients of the hypertensive crisis who referred to Imam Hossein Hospital of Shahroud, 2018. Patients with systolic/diastolic blood pressure greater than 180/110 mm Hg and with healthy vital organs were selected randomly and divided into three groups of 43 participants. All patients’ blood pressure in both arms, and after a period of 10 minutes in the left arm, was checked and was checked again after administering the medication for 4 times of 15 minutes till 1 hour complete. IBM SPSS Amos 23 was implemented. One-way ANOVA, Chi-Square and Repeated measure tests were performed to carry out statistical analysis. The level of significance of 0.05 was considered. Results in the group of midazolam, it was observed a reduction of 20.6% (P = 0.024), 17.4% (P = 0.001), and 19.1% (P = 0.009) for the systolic blood pressure, diastolic blood pressure, and blood pressure average, respectively. In such case, it was also indicated to be a significant difference of the reduction before and after the treatment. The group of captopril showed a decrease of 19.9% (P = 0.001), 13.5% (P = 0.008), and 16.7% (P = 0.001) for the systolic blood pressure, diastolic blood pressure, and blood pressure average, respectively. It was also observed to be a significant difference in reducing the blood pressure before and after the treatment. The group of midazolam and captopril showed the greatest reduction of blood pressure before, in the middle, and after carrying out the treatment methods. As such, systolic blood pressure, diastolic blood pressure, and the blood pressure average changed to the reduction of 23.5% (P = 0.047), 17.4% (P = 0.021), and 20.5% (P = 0.031), respectively. No significant difference was observed among these three groups (P = 0.239).

Introduction : In addition to educational conditions and facilities, the presence of a good and capable teacher is an effective factor in improving teaching and learning processes. The present study aimed to determine the characteristics of a capable teacher from students' perspective at Shahroud University of Medical Sciences. Materials : The present cross-sectional study was conducted on 289 students at Shahroud University of Medical Sciences during the academic year of 2017-2018 using a multi-stage random sampling method. Data were collected by a questionnaire containing demographic characteristics and factors affecting the evaluation of capable teachers, including six domains, namely personal characteristics (10 questions), teaching method (14 questions), evaluation and personal communication skills (10 questions), teacher's scholarship (4 questions), and educational rules (5 questions). The data were then analyzed using SPSS. Results : The maximum and minimum mean scores were related to teaching methods (61.9± 6.5) and teacher's scholarship (16± 3.1) respectively. There were significant relationships between evaluation skills and students' residences, the field of study, and six domains of teacher evaluation and academic level, and six domains of academic satisfaction, evaluation skills, and scholarship. Conclusion : From the learners' perspective, the most important characteristics of a capable teacher included the teaching method, personal communication, and personal characteristics respectively. Awareness of learners' perspectives on education can help teachers to provide informed teaching planning. According to the results of the present study, the criteria of a capable teacher can be evaluated for achieving effective teaching. Keywords : Capable teacher; Teaching; Student; Shahroud.

Abstract Background: The highest incidence rate of covid-19 in Iran was reported from Shahroud County. This study was conducted by geographic information systems (GIS) to determine the geographical distribution of Covid-19 in 60 days. Study design: A cross-sectional study Methods: This study was conducted in counties covered by Shahroud University of Medical Sciences, namely Shahroud and Mayami, from February 20, 2020 to April 18, 2020. The GIS can better show the spread of epidemics. This software indicates geographical distribution of disease spread and is very helpful in controlling the epidemics. Therefore, maps of spatial distribution and risk of infection to COVID-19 were prepared in different regions of Shahroud county using Arc-GIS software to better implement health policies. Results: During this sixty-day period, 529 confirmed cases were detected, of which 51% were men and the average age was 55 years. The maps showed high-risk to risk-free regions. Shahroud and Bastam cities were known as the coronavirus hot spots. The eastern region of Shahroud has the highest number of cases but some high risk areas are spread throughout the Shahroud city due to high infectivity of virus. Risk-based time maps indicated a reduction in the risk of infection at the end of the research period due to some mitigation and suppression strategies. Conclusions: Shahroud and Bastam are the most dangerous cities that, the number of patients and dissemination has decreased over time because of tracking definite patients and people in contact with them and implementation of preventive care.