Background. In December, 2019, China, has experienced an outbreak of novel coronavirus disease 2019 . Coronavirus has now spread to all of the continents. We aimed to consider clinical characteristics, laboratory data of COVID-19 that provided more information for the research of this novel virus. Methods.We performed a retrospective cohort study on the clinical symptoms and laboratory findings of a series of the 100 confirmed patients with COVID-19. These patients were admitted to the hospitals affiliated to Babol University of Medical Sciences (Ayatollah Rohani, ShahidBeheshti and Yahyanejad hospitals) form 25 February 2020 to 12 March 2020. Results.Nineteen patients died during hospitalization and 81 were discharged. Non-survivor patients had a significantly higher C-reactive protein (CRP) (MD: 46.37, 95% CI: 20.84, 71.90; P= 0.001), white blood cells (WBCs) (MD: 3.10, 95% CI: 1.53, 4.67; P< 0.001) and lower lymphocyte (MD: -8.75, 95% CI: -12.62, -4.87; P< 0.001) compared to survivor patients Data analysis showed that comorbid conditions (aRR: 2.99, 95%CI: 1.09, 8.21, P= 0.034), higher CRP levels (aRR: 1.02, 95%CI: 1.01, 1.03, P= 0.044), and lower lymphocyte (aRR: 0.82, 95%CI: 0.73, 0.93, P= 0.003) were associated with increased risk of death. Conclusions.Based on our findings, most non-survivors are elderly with comorbidities. Lymphopenia and increased levels of WBCs along with elevated CRP were associated with increased risk of death. Therefore, it is best to be regularly assessed these markers during treatment of COVID-19 patients.

While some biomolecules have been explored to identify potential biomarkers for the prognosis of COVID-19 patients, there is no reliable prognostic indicator of the disease progression and severity. We aimed to evaluate the ability of the C-reactive protein (CRP) to predict COVID-19 infection outcome. This retrospective study was conducted on 429 patients diagnosed with COVID-19 between March 30, 2020, and April 30, 2020. The study population was divided into severe (n = 175) and nonsevere cases (n = 254). Data on demographic characteristics, clinical features, and laboratory findings on admission were collected. The proportion of patients with increased CRP levels was significantly higher in severe cases than in nonsevere patients. Analysis of the receiver operating characteristic (ROC) curve found that CRP could be used as an independent factor in predicting the severity of COVID-19. Also, patients with CRP >64.75 mg/L were more likely to have severe complications. In conclusion, CRP serum levels can predict the severity and progression of illness in patients with COVID-19.

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There is very little knowledge about the immune responses, particularly cellular immunity to coronavirus disease 2019 . The main objective of this study was to evaluate the frequency of T helper (Th) cell subtypes, including Th1, Th17, and Treg cells, in moderate-to-severe and critical COVID-19 patients compared to healthy controls. Twenty-nine moderate-to-severe and 13 critical patients confirmed for COVID-19, and 15 healthy subjects were included in this study. Interferon-c (IFN-c)-producing Th1 and interleukin-17A-producing Th17 and Treg cells in peripheral blood were measured with flow cytometry. The frequency of Th1 and Th17 was significantly decreased in critical patients compared to healthy subjects (aMD: À2.76 and À 2.34) and moderate-to-severe patients (aMD: À1.89 and À 1.89), respectively (p < 0.05). Differences were not significant between moderate-to-severe patients and healthy subjects for both Th1 (p = 0.358) and Th17 (p = 0.535), respectively. In contrast, significant difference was not observed between study subjects regarding the frequency of Treg cells. Patients with critical COVID-19 had a markedly lower Th1/Treg and Th17/Treg ratios compared with the controls and moderate-to-severe cases. Our study showed a dysregulated balance of Th1 and Th17 cells and its relation to the severity of COVID-19.

S U M M A R YWith the aim to analyze the clinical manifestations and outcomes of influenza, we evaluated the symptoms of proven H1N1 cases and outcomes of patients admitted to hospitals Babol University of Medical Sciences during 2015 -2016.In this descriptive cross-sectional study, we included patients diagnosed with influenza-like illness (ILI) from October 2015 to March 2016 at hospitals affiliated to Babol University of Medical Sciences.To diagnose H1N1 infection, reverse transcription-polymerase chain reaction (RT-PCR) was performed on nasopharyngmeal swabs collected from the patients.In the current study, 123 patients were admitted due to ILI.The RT-PCR result was positive in 47.2% of patients. Symptoms such as productive cough (35.3%), sore throat (51.4%), headache (50%), dyspnea (53.2%) were comparable between PCR + H1N1 confirmed cases and H1N1 negative cases. Among the H1N1 confirmed cases, 48.3% were admitted to the intensive care unit (ICU) because of the disease severity, and 20.7% died even after receiving the therapy for several days. Among the infected cases, 20 women were pregnant, out of which three subjects died. Mortality was mostly observed in the age ˃ 50 (39%) (p = 0.03). Myalgia was significantly less observed in the group with mortality compared to other age groups (6.5% vs. 93.5%) (p = 0.005). The mortality rate of patients who received vancomycin was found to be significantly low (40%) (p = 0.01). In mortality group, the frequency of patients with creatinine levels > 1.5 mg/dL was significantly higher (58.3%) (p = 0.009) than in the group of patients who recovered. The average length of hospitalization in the mortality group was significantly longer than the hospitalization of the recovered group (11.1 days vs. 6.3 days) (p = 0.02).The current study reported a mortality rate that was more than expected in comparison to previous seasons. Our study results suggest that the absence of typical influenza symptoms such as myalgia should not cause a O r i g i n a l a r t i c l e Acta facultatis medicae Naissensis 2019; 36(4):356-364 357 delay in the diagnosis of this infection in cold seasons.