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Coronavirus disease 2019 (COVID-19) is an acute respiratory illness caused by novel coronavirus SARS-CoV-2. The clinical manifestations of this infection have a range and typically include impairment of smell, taste disturbance, cough, fever, and shortness of breath. Gastrointestinal manifestations have been reported in anywhere from 3% to 50% of patients with concomitant SARS-CoV-2 pulmonary infection. Abnormalities in coagulation markers have been reported in patients hospitalized with COVID-19. During this article, we will introduce a patient with COVID 19 but with the most manifestation of abdominal pain due to intestinal ischemia and mesenteric vascular thrombosis.

Coronavirus disease 2019 (COVID-19) pandemic has caused an urgent need for investigating potential treatments. Traditional medicine offers many potential remedies that have been historically used and have the advantage of bypassing the cultural obstacles in the practice of medicine. We aimed to investigate the efficacy of Zufa syrup in the treatment of suspected patients with mild to moderate symptoms of COVID-19. This triple-blind randomized controlled trial recruited patients with evidence of COVID-19 on chest computed tomography without an indication of hospital admission from March 2020 until April 2020. Participants were assessed by a physician and completed a pre-specified form to assess the duration and severity of symptoms. Patients were randomized to receive Zufa syrup (a combination of herbal medicines: Nepetabracteata, Ziziphus jujube, Glycyrrhizaglabra, Ficuscarica, Cordia myxa, Papaver somniferum, Fennel, Adiantumcapillusveneris, Viola, Viper‘s-buglosses, Lavender, Iris, and sugar) or identical-looking placebo syrup at a dose of 7.5 mL (one tablespoon) every 4 hours for 10 days. After applying the eligibility criteria, 116 patients (49.1% male) were randomized to trial arms with a mean age of 44.3. During the follow-up, Cough, dyspnea, headache, myalgia, anorexia, anxiety, and insomnia improved gradually in both groups, and showed no difference between Zufa syrup and placebo. Oxygen saturation and pulse rate had stable trends throughout the follow-up and were similar between study arms. No patient required hospital admission or supplemental oxygen therapy during the study period. To conclude, in patients with mild to moderate symptoms of COVID-19, Zufa syrup did not show any difference in symptomatology over a 10 days’ period when compared with placebo. Due to potential effects of medicinal plants in the treatment of respiratory infections, further studies are warranted to clarify their role in COVID-19. The study was approved by the Ethics Committee of the Qom University of Medical Science (Ethics committee reference number IR.MUQ.REC.1398.165) on March 10, 2020 and was registered in Iranian Clinical Trial Center (approval ID: IRCT20200404046934N1) on April 13, 2020.

Background: Increasing the number of COVID-19 patients raises concerns about the capacity of the health care system. This issue emphasizes reducing the admission rate and expediting patient discharge. Objective: This study aimed to develop a discharge protocol for COVID-19 patients based on the existing capacity of the healthcare system and to assess its post-discharge outcomes. Methods: This is a multicenter cohort study. All COVID-19 patients referred to selected medical centers in Qom, Iran, from Feb. 19 to Apr. 19, 2020, were target populations. Eligible patients were classified into a] the criterion group and b] the non-criterion group. Patients were followed up daily for 14 days after discharge by phone, and required data was gathered and recorded in follow-up form. Univariate [chi-square and t-tests] and multivariate multiple [multivariate probit regression] analysis were used. Results: Results: Totally, 2775 patients were included in the study [1440 people in the criterion group and 1335 people in the non-criterion group]. Based on multivariate probit regression, death was statistically associated with discharged outside our criteria [p<0.001], rising age [p<0.001], and being male [p=0.019], and readmission were associated with discharge outside our criteria [p<0.001], rising age [p=0.009], and having the history of underlying diseases [p=0.003]. Furthermore, remission had statistically significant associations with discharged based on our criteria [p<0.001], decreasing age [p=0.001], and lack of a history of underlying diseases [p<0.001]. Conclusion: Conclusion: Mortality and readmission were significantly lower according to our discharge criteria. Our designed criteria apply to less developed and developing countries due to the limited capacity and resources available in the health care system.