Background Apart from infecting a large number of people around the world and causing the death of many people, the COVID-19 pandemic seems to have changed the healthcare processes of other diseases by changing the allocation of health resources and changing people’s access or intention to healthcare systems. Objective To compare the incidence of endpoints marking delayed healthcare seeking in medical emergencies, before and during the pandemic. Methods Based on a PICO model, medical emergency conditions that need timely intervention was selected to be evaluated as separate panels. In a systematic literature review, PubMed was quarried for each panel for studies comparing the incidence of various medical emergencies before and during the COVID-19 pandemic. Markers of failure/disruption of treatment due to delayed referral were included in the meta-analysis for each panel. Result There was a statistically significant increased pooled median time of symptom onset to admission of the acute coronary syndrome (ACS) patients; an increased rate of vasospasm of aneurismal subarachnoid hemorrhage; and perforation rate in acute appendicitis; diabetic ketoacidosis presentation rate among Type 1 Diabetes Mellitus patients; and rate of orchiectomy among testicular torsion patients in comparison of pre-COVID-19 with COVID-19 cohorts; while there were no significant changes in the event rate of ruptured ectopic pregnancy and median time of symptom onset to admission in the cerebrovascular accident (CVA) patients. Conclusions COVID-19 has largely disrupted the referral of patients for emergency medical care and patient-related delayed care should be addressed as a major health threat.

Background Given the observed olfactory and gustatory dysfunctions in patients with COVID-19 and recent findings on taste receptors possible important activities in the immune system, we elected to estimate the correlation between COVID-19 mortality and polymorphism of a particular type of bitter taste receptor gene called TAS2R38, in a worldwide epidemiological point of view. Methods Pooled rate of each of the rs713598, rs1726866, rs10246939, and PAV/AVI polymorphisms of the TAS2R38 gene was obtained in different countries using a systematic review methodology and its relationship with the mortality of COVID-19. Data were analyzed by the comprehensive meta-analysis software and SPSS. Results There was only a significant reverse Pearson correlation in death counts and PAV/AVI ratio, p = 0.047, r = −0.503. Also, a significant reverse correlation of PAV/AVI ratio and death rate was seen, r = −0.572 p = 0.021. rs10246939 ratio had a significant positive correlation with death rate, r = 0.851 p = 0.031. Further analysis was not significant. Our results showed that the higher presence of PAV allele than AVI, and a higher rate of G allele than A in rs10246939 polymorphism in a country, could be associated with lower COVID-19 mortality. While assessing all three polymorphisms showed a huge diversity worldwide. Conclusion Due to extraoral activities of bitter taste receptor genes, especially in mucosal immunity, this gene seems to be a good candidate for future studies on COVID-19 pathophysiology. Also, the high worldwide diversity of TAS2R38 genes polymorphism and its possible assassination with mortality raises concerns about the efficiency of vaccine projects in different ethnicities.

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Objective: Acute poisoning is a major health problem and one of the most common causes of emergency visits worldwide. Since most poisoning subjects present with a decreased level of consciousness and due to unreliable disease history, recognizing the etiological cause of the poisoning represents a critical part in arranging the treatment strategy. This study aimed at examining the prevalence of etiological causes of poisoning in Iran in a systematic review and meta-analysis. Method: This systematic review and meta-analysis investigated the cross-sectional studies published from 1990 to 2020, reporting specific poisoning agents among acute poisoning cases in Iran. Persian and English articles on this subject were collected by searching the Scientific Information Database (SID), ScienceDirect, PubMed, Medlib, IranMedex, Scopus, Magiran, and Google Scholar databases. The heterogeneity of the studies was investigated using the I2 index and the probability of bias in the publication was assessed by the Begg and Mazumdar test with a significance level of 0.1. Data analysis was performed by Comprehensive Meta-analysis software version 3 (Biostat, Englewood, NJ, USA). Results: In our review, 19 studies appraising 143,251 cases of poisoning were included. The ranking of the OR of each agent was done; Opium poisoning was the most prevalent poisoning case followed by benzodiazepine, acetaminophen, antipsychotic medications, organophosphates, aluminum phosphide, amphetamine, pesticide, tricyclic antidepressant (TCA), alcohol, chemicals, carbon monoxide (CO), nonsteroidal anti-inflammatory drugs (NSAIDs), and selective serotonin reuptake inhibitors (SSRIs). Conclusion: While proper judgment on the cause of poisoning and selection of suitable treatment manners could be followed by a very good prognosis in patients with acute poisoning; this demands an epidemiological perception of the prevalence of the etiological poisoning agents. Our study ranked the most likely agents leading to the poisoning, to be at the top of the list of differential diagnoses of physicians.