Statins can help COVID-19 patients’ treatment because of their involvement in angiotensin-converting enzyme-2. The main objective of this study is to evaluate the impact of statins on COVID-19 severity for people who have been taking statins before COVID-19 infection. The examined research patients include people that had taken three types of statins consisting of Atorvastatin, Simvastatin, and Rosuvastatin. The case study includes 561 patients admitted to the Razi Hospital in Ghaemshahr, Iran, during February and March 2020. The illness severity was encoded based on the respiratory rate, oxygen saturation, systolic pressure, and diastolic pressure in five categories: mild, medium, severe, critical, and death. Since 69.23% of participants were in mild severity condition, the results showed the positive effect of Simvastatin on COVID-19 severity for people that take Simvastatin before being infected by the COVID-19 virus. Also, systolic pressure for this case study is 137.31, which is higher than that of the total patients. Another result of this study is that Simvastatin takers have an average of 95.77 mmHg O2Sat; however, the O2Sat is 92.42, which is medium severity for evaluating the entire case study. In the rest of this paper, we used machine learning approaches to diagnose COVID-19 patients’ severity based on clinical features. Results indicated that the decision tree method could predict patients’ illness severity with 87.9% accuracy. Other methods, including the K -nearest neighbors (KNN) algorithm, support vector machine (SVM), Naïve Bayes classifier, and discriminant analysis, showed accuracy levels of 80%, 68.8%, 61.1%, and 85.1%, respectively.

Background A protective effect of vitamin D against COVID-19 infection is under investigation. We aimed to analyze the effect of vitamin D sufficiency on the clinical outcomes of patients infected with COVID-19. Methods In this cross-sectional study we analyzed the vitamin D levels of COVID-19 patients who were admitted to Razi Hospital (an infectious disease referral center in Mazandaran province in northern Iran) from February to March 2020. Overall, a cutoff point of 30 ng/mL was used for the definition of vitamin D sufficiency. Results One hundred fifty-three patients were analyzed in this study who had laboratory documentation of a 25(OH) D level at the time of hospitalization. The vitamin D levels of the patients were 27.19 ± 20.17 ng/mL. In total, 62.7% (n = 96) of the patients had a 25(OH) D level of less than 30 ng/mL and 37.25% (n = 57) had a 25(OH) D level of more than 30 ng/mL. In total, 49% (n = 75) of the patients suffered from at least one underlying disease. The univariate and multivariable regression showed that vitamin D sufficiency was not associated with a statistically significant lower risk of adverse clinical outcomes of COVID-19 such as duration of hospitalization and severity of infection (P > 0.05). Conclusions Sufficient vitamin D levels were not found to be protective against adverse clinical outcomes in patients infected with COVID-19. Chronic disorders in COVID-19 patients were found to have greater relevance than vitamin D levels in determining the adverse outcomes of the infection. Further studies are needed to determine the role of vitamin D level in predicting the outcomes of COVID-19 infection.

Background and Aim: One of the most common complications of brucellosis is its skeletal manifestations. This study was performed to identify the different types of skeletal manifestations in the patients with brucellosis. Materials and Methods:We reviewed records of the patients with skeletal complications of brucellosis who had been admitted to the infectious diseases ward of Razi Hospital in Qaemshahr from 2011 to 2017. Using SPSS 21 software, data were analyzed by t-test and chisquare (p≥0.001). Results: In 300 patients with brucellosis, the most frequent cause of referring to the hospital was fever (82.33%). The most, common skeletal complication was lumbar spondylosis. The mean value for hemoglobin was 11.50±1.57 gr/dl in women and 12.34± 1.54 gr/dl in men. Elevated alkaline phosphatase (97%) was the most common laboratory finding. This disease was more common in men than in women which showed a statistically significant difference (p≥0.001). The mean erythrocyte sedimentation rate was 52.78±29.15 millimeters per hour in the women (p≥0.001). Conclusion: Fever and back pain were the most common causes of referring to the hospital. The most common articular bone complication was spondylosis, which was more common in the middle-aged patients. Therefore, brucellosis should be considered as a differential diagnosis in the patients with long-standing fever and also in those with low back pain and arthralgia.

Background: This study evaluates the real-world safety and discontinuation rate of Zadiva® (generic product of dimethyl fumarate (DMF)) in Iranian patients with relapsing–remitting multiple sclerosis (RRMS), supplementing existing clinical evidence from randomized controlled trials. Methods: This retrospective observational study evaluated the real-world safety and discontinuation rate of DMF in RRMS patients from Amir A’lam referral hospital’s neurology clinic. Data on safety, discontinuation rate, and clinical disease activity were collected retrospectively. The study aimed to assess the discontinuation rate, safety, and reasons for discontinuation, as well as the number of patients experiencing a relapse, MRI activity, and EDSS scores. Results: In total, 142 RRMS patients receiving DMF were included in the study, with 15 discontinuing treatment due to adverse events, lack of efficacy, or pregnancy. Notably, a significant reduction in relapse rates was observed, with 90.8% of patients remaining relapse-free throughout the study period. After 1 year of treatment with Zadiva®, only 17.6% of patients experienced MRI activity, whereas the EDSS score remained stable. Conclusions: This study provides important real-world data on the safety and tolerability of Zadiva® in RRMS patients. The results indicate that Zadiva® is generally well tolerated and safe, with a low discontinuation rate due to adverse events or lack of efficacy. These findings suggest that Zadiva® is an effective and safe treatment option for RRMS patients in real-world practice.