Background: COVID-19, which began in December 2019 in China, can have a broader impact on individuals' mental dimensions. Meanwhile, the medical staff battling this epidemic are more at risk of mental and emotional problems.  This study aimed to examine the level of stress, anxiety, and depression and their relationship with the level of knowledge of medical staff battling in COVID-19 pandemic treatment. Methods: This descriptive-analytical study was conducted on 641 medical staff using an online platform to design the questionnaire, and its link was placed in different groups of social networks all over the country  in which the medical staff battling COVID 19 were members. Statistical analysis was performed by SPSS 25 and Kolmogorov-Smirnov test, independent samples t-test, independent one-way analysis of variance, and chi-square. Results: Higher knowledge about COVID-19 was associated with younger age, clinicians, and nurses. Moreover, females were more knowledgeable in terms of support; while males were more reliable in washing hands and disinfecting wet places. Based on the categorical version of psychological factors, the majority of cases had severe stress ( 39.80 % ), normal depression ( 48.50 % ), and normal anxiety ( 57.30 % ). Finally, it was found that married participants had more knowledge about COVID-19, but knew less about its fatality. Conclusion: Studies have shown negative psychological experiences caused by COVID-19 in nurses, including negative emotions, such as fatigue, discomfort, helplessness due to high-intensity work, anxiety, and worry about family members.

This study investigated the bacterial causes of superinfections and their antibiotic resistance pattern in severe coronavirus disease 2019 (COVID‐19) patients admitted to the intensive care unit (ICU) of Razi Hospital in Ahvaz, southwest Iran. In this cross‐sectional study, endotracheal tube (ETT) secretion samples of 77 intubated COVID‐19 patients, confirmed by reverse transcription‐quantitative polymerase chain reaction, were investigated by standard microbiology test and analytical profile index kit. Antibiotic susceptibility testing was performed by disc diffusion. The presence of Haemophilus influenzae and Mycoplasma pneumoniae was investigated by the polymerase chain reaction (PCR). Using culture and PCR methods, 56 (72.7%) of the 77 COVID‐19 patients (mean age of 55 years, 29 male and 27 female) had superinfections. Using culture, 67 isolates including 29 (43.2%) Gram‐positive and 38 (56.7%) Gram‐negative bacteria (GNB) were identified from 49 COVID‐19 patients. The GNB were more predominant than the Gram‐positive pathogens. Klebsiella pneumoniae (28.4%, n = 19/67) was the most common isolate followed by Staphylococcus aureus (22.4%, n = 15/67). Using PCR, 10.4% (8/77) and 11.7% (9/77) of ETT secretion specimens had H. influenzae and M. pneumoniae amplicons, respectively. Gram‐positive and Gram‐negative isolates showed high resistance rates (>70.0%) to majority of the tested antibiotics including fluoroquinolone, carbapenems, and cephalosporins and 68.7% (46/67) of isolates were multidrug‐resistant (MDR). This study showed a high frequency rate of superinfections by MDR bacteria among COVID‐19 patients in southwest Iran. The prevention of long‐term consequences caused by COVID‐19, demands continuous antibiotic surveillance particularly in management of bacterial superinfections.

Background: Patients with COVID-19 have shown a wide variety of symptoms and mortality rates in different communities. Objectives: This study aimed to compare the epidemiological, clinical, and paraclinical features of patients with COVID-19 who have overcome the disease with patients who died. Methods: All hospitalized patients admitted to Special Corona Hospital who had a positive real-time PCR test for SARS-CoV-2 from January to March 2020 were included in the study. Clinical characteristics, date of disease onset, hospital admission date, and the severity of COVID-19 were obtained from each patient's medical records. Independent sample t-test was used to compare continuous variables between the groups of the discharged and expired patients. The independence between categorical variables and the outcome was assessed by Chi-square or Fisher's exact tests. Results: The order of essential variables for admission as the starting time are pH, WBC count, loss of consciousness, neutrophil count, base excess (BE), HCO3, age, BUN, O2 saturation, and lymphocyte count. Conclusions: In the current study, the mortality rate of COVID-19 was 30% and was significantly associated with critical disease intensity, fever, chills, loss of consciousness, ischemic heart disease (IHD) history, Parkinson's disease, invasive O2 therapy, and troponin level.

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Aims: The pandemic of coronavirus disease 2019 (COVID-19), has emerged as a dire health problem, causing a massive crisis for global health. Background: Most commonly reported clinical manifestations are fever, fatigue and dry cough. Interestingly, a small percentage of patients experience GI symptoms with the most common being anorexia, diarrhea, nausea and vomiting. We aimed to investigate a comparable study of COVID-19 patients with or without gastrointestinal patients (GI). Methods: Collective data of clinical manifestations and laboratory reports of patients admitted in Razi Hospital, Ahvaz, Khuzestan, Iran, during two weeks were analyzed. Results: Our results showed that GI symptoms are not statistically significant criteria to be predictive or prognostic factors in the COVID-19 patients despite they are probably related to acute or non-acute phase of the disease. Moreover, non-specific GI symptoms seem to be as a result of cytokine storm occurred during the disease. Conclusion: Therefore, our results did not support GI tract involvement as a common route of COVID-19 infection. Maybe future research will shed light on why and how the gastrointestinal system became infected by COVID-19.