This global level ecological study aimed to investigate the correlation between environmental factors and the COVID-19 indices. This survey is an ecological study, so all studied variables are aggregate variables. To collect the variables in the study, a data set was provided, which includes the information of each country based on the cumulative deaths, case fatality rate, recovery rate, and the number of performed COVID-19 tests. Scatter plots of environmental factors for the studied countries were drawn based on cumulative incidence rate of cases, cumulative incidence rate of death, tests, recovery rate, and case fatality rate of COVID-19. Furthermore, Spearman correlation coefficient was also used to verify the correlation between environmental factors and indicators related to COVID-19. The results of this ecological study showed that among all countries surveyed, Montenegro (60,310.56 per million) and Luxembourg (54,807.89 per million) had the highest cumulative incidence rates of COVID-19 cases, when Tanzania (8.42 per million) and Vietnam (13.78 per million) had the lowest cumulative incidence rates of COVID-19. In addition, in this study, it was shown that the cumulative incidence rate of cases, the cumulative incidence rate of deaths, and performed COVID-19 tests had significant direct correlations with the access to drinking water and the access to sanitation services (p < 0.001). The findings of the present study showed an inverse correlation between the mortality rate due to unhealthy water consumption, poor health status, and a positive correlation between access to drinking water and health services with the cumulative incidence and mortality rates of COVID-19. The differences between our findings and many other studies could be due to the ecological nature of the study. Nevertheless, our findings will help health policymakers to develop timely strategies to reduce the mortality and incidence rate of COVID-19.
Background: Public trust in the healthcare system is a critical necessity of management in public health crises such as the COVID-19 pandemic. To rapidly assess the public trust in the healthcare system during the COVID-19 epidemic and its correlates in Iran.Methods: A cross-sectional rapid assessment was conducted in Iran during the COVID-19 epidemic in the country. A probability proportional to size multistage random sampling was applied. Sampling was done in 15 provinces. We collected data on public perceived fear, public trust in health system and socio-demographics. Ordinary least square regression modeling was applied to identify correlates of public trust.Results: A total of 5250 adults (response rate: 76%) were participated in the study. Mean of reported trust scores was 50.3±22.8, and of fear scores was 72.0±17.8. Being male (p=0.006), higher levels of education (p<0.001) and socio-economic status (p<0.001), and higher fear scores (p<0.001) were independently correlated with trust in healthcare system. Conclusion: At the time of the COVID-19 epidemic in Iran, public trust in healthcare system is low. A dynamic public epidemic communication with appropriate strategies to communicate with higher social classes is urgent in Iran. Rapid assessments to identify appropriate strategies are needed. These results might be generalizable to the other similar countries during the COVID-19 pandemic.
The article's abstract is not available.
Background and aims: Public health policies and programs should be adapted to the level of public trust in the healthcare system, as an indicator of the public support level. Accordingly, the data about public trust level in the healthcare system is considered as a critical requirement for managing public health crises. This study aimed to rapidly assess the public trust in the healthcare system during the COVID-19 epidemic in Iran, as well as to evaluate the effect of socioeconomic status (SES) on this trust. Methods: This cross-sectional and web-based study which was conducted in Iran during the COVID-19 epidemic included adults aged 18-60 years. A probability proportional to size multistage random sampling was applied and performed in 15 provinces of the country. Data on the main sources of information about COVID-19, trust in healthcare system, fear level of COVID-19, and demographics were collected via an electronic questionnaire. Multiple linear regression was applied, and adjusted regression coefficients and 95% confidence intervals (CIs) were estimated. Results: A total of 5250 adults (response rate: 76%) were included in the study. The mean of reported trust scores was 50.3±22.8, and that of fear scores was 72.0±17.8. The highest (65%) and lowest (28%) levels of trust were observed among participants from the lowest and highest SES, respectively. Gender (male) (P=0.006), higher levels of education (P<0.001), higher socio-economic status (P<0.001), and higher fear scores (P<0.001) were independently correlated with the lower level of ⦰ trust in healthcare system. Conclusion: It was found that the public trust in Iran’s healthcare system was not high enough at the time of the COVID-19 epidemic in the country, especially among higher social class population.
One year after the prevalence of the novel coronavirus pandemic, some aspects of the physiopathology, treatment and progression of coronavirus 2019 disease (COVID-19) have remained unknown. Since no comprehensive study on the use of urological medications in patients with COVID-19 has been carried out, this narrative review aimed to focus on clinically important issues about the treatment of COVID-19 and urologic medications regarding efficacy, modifications, side effects and interactions in different urologic diseases. In this review, we provide information about the pharmacotherapeutic approach toward urologic medications in patients with COVID-19 infection. This study provides an overview of medications in benign prostatic hyperplasia, prostate cancer, impotence and sexual dysfunction, urolithiasis, kidney transplantation and hypertension as the most frequent diseases in which the patients are on long-term medications. Also, the effect of urologic drugs on the efficacy of vaccination is briefly discussed.
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