Background: There is no pharmacological intervention on the treatment of hypoxemia and respiratory distress in COVID-19 patients. Objective: The objective of the study was to study the effect of the reduced form of methylene blue (MB) on the improvement of oxygen saturation (SpO 2 ) and respiratory rate (RR). Methods: In an academic medical center, 80 hospitalized patients with severe COVID-19 were randomly assigned to receive either oral MB along with standard of care (SOC) (MB group, n = 40) or SOC only (SOC group, n=40). The primary outcomes were SpO 2 and RR on the 3 rd and 5 th days. The secondary outcomes were hospital stay and mortality within 28 days. Results: In the MB group, a significant improvement in SpO 2 and RR was observed on the 3 rd day (for both, p < 0.0001) and also the 5 th day (for both, p < 0.0001). In the SOC group, there was no significant improvement in SpO 2 (p = 0.24) and RR (p = 0.20) on the 3 rd day, although there was a significant improvement of SpO 2 (p = 0.002) and RR (p = 0.01) on the 5 th day. In the MB group in comparison to the SOC group, the rate ratio of increased SpO 2 was 13.5 and 2.1 times on the 3 rd and 5 th days, respectively. In the MB group compared with the SOC group, the rate ratio of RR improvement was 10.1 and 3.7 times on the 3 rd and 5 th days, respectively. The hospital stay was significantly shortened in the MB group (p = 0.004), and the mortality was 12.5% and 22.5% in the MB and SOC groups, respectively. Conclusions:The addition of MB to the treatment protocols significantly improved SpO 2 and respiratory distress in COVID-19 patients, which resulted in decreased hospital stay and mortality. ClinicalTrials.gov: NCT04370288 (REV INVEST CLIN. 2021;73(3):XX-XX)
Background: Influenza is a contagious and acute viral disease caused by influenza viruses involving upper and lower respiratory tract system, especially in the cold seasons. Children aged less than 5 years old, elderly people, immunocompromised patients, pregnant women, and people with certain health conditions are at a higher risk for the disease and severe complications. Objectives: Due to the serious complications of influenza in certain groups, it is important to know which group of people are more at risk and need prevention strategies. This study aimed to investigate the patients with confirmed influenza, identify the people who are at a higher risk for infection, and assess the clinical outcomes of disease among patients. Methods: In this cross-sectional and descriptive study, we studied the files of all patients with confirmed influenza referred to the health centers in Mashhad, Iran, during autumn and winter of 2019 when influenza virus was prevalent. The disease was confirmed by reverse transcription polymerase chain reaction (RT-PCR) method. We studied all registered data related to the flu, including gender, age, residency, history of vaccination, risk factors, complications, and clinical outcomes. Results: In this study, 2977 patients (3% outpatients vs. 97% hospitalized) with flu like syndrome were tested by RT-PCR for influenza. Out of 84 outpatients, only two cases were positive for influenza. Among hospitalized patients, 80 cases (51% male vs. 49% female; age range: 1 - 87 years) had a positive RT-PCR test, and influenza type A was seen in 95% of cases. Pneumonia was the most common complication. Death happened in 29 (35.36%) patients and three (33.33%) cases with risk factors. The highest number of influenza patients (31 [37.8%]) had been reported from district No. 3 of Mashhad municipality, which is a crowded place and near the holy shrine. Conclusions: The results showed a high prevalence of complication and death among hospitalized patients, especially among those who did not have a risk factor for influenza viruses. Comprehensive vaccination programs and promotion of knowledge about transmission routes are two important measures for disease prevention and lower death rates.
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