Background: Diabetes mellitus (DM) and cardiovascular disease (CVD) are present in a large number of patients with novel Coronavirus disease 2019 (COVID-19). We aimed to determine the risk and predictors of in-hospital mortality from COVID-19 in patients with DM and CVD. Methods: This retrospective cohort study included hospitalized patients aged ≥ 18 years with confirmed COVID-19 in Alborz province, Iran, from 20 February 2020 to 25 March 2020. Data on demographic, clinical and outcome (in-hospital mortality) data were obtained from electronic medical records. Self-reported comorbidities were classified into the following groups: "DM" (having DM with or without other comorbidities), "only DM" (having DM without other comorbidities), "CVD" (having CVD with or without other comorbidities), "only CVD" (having CVD without other comorbidities), and "having any comorbidity". Multivariate logistic regression models were fitted to quantify the risk and predictors of in-hospital mortality from COVID-19 in patients with these comorbidities. Results: Among 2957 patients with COVID-19, 2656 were discharged as cured, and 301 died. In multivariate model, DM (OR: 1.62 (95% CI 1.14-2.30)) and only DM (1.69 (1.05-2.74)) increased the risk of death from COVID-19; but, both CVD and only CVD showed non-significant associations (p > 0.05). Moreover, "having any comorbidities" increased the risk of in-hospital mortality from COVID-19 (OR: 2.66 (95% CI 2.09-3.40)). Significant predictors of mortality from COVID-19 in patients with DM were lymphocyte count, creatinine and C-reactive protein (CRP) level (all P-values < 0.05). Conclusions: Our findings suggest that diabetic patients have an increased risk of in-hospital mortality following COVID-19; also, lymphocyte count, creatinine and CRP concentrations could be considered as significant predictors for the death of COVID-19 in these patients.
Hypertension is a public health issue in iran. the study aimed to estimate the prevalence, awareness, treatment, and control of hypertension, and to explore their determinants among 10,040 Kurdish adults from Ravansar Non-Communicable Disease (RaNCD) cohort study in Iran. Univariate, and multivariate analyses were used for statistical analysis. Prevalence of hypertension was 15.7%. Among hypertensive patients, awareness, treatment, and control of hypertension were 80.7%, 73.2%, and 53.3%, respectively. In multivariate analysis, significant associations were found between awareness and female sex, older age, being married rather than being single, literacy, living in rural areas, having family history, and comorbidities, with a higher probability for those who had both diabetes and dyslipidemia. Being married, living in rural areas, being ex-smokers, having less physical activity and individuals who had diabetes and dyslipidemia had higher odds of receiving treatment. Being female had a statistically significant association with the control of hypertension. The Kurdish population had higher awareness, with a greater proportion of treated, and controlled patients compared to populations included in previous studies for the last 20 years in Iran. With the continuing health promotion programs in iran, it is expected to observe a lower prevalence of hypertension, higher awareness and greater number of treated individuals with controlled hypertension. Hypertension is one of the most common risk factors for cardiovascular disease (CVD) 1. Hypertension and its complications are responsible for approximately 9.4 million deaths worldwide every year 2. It is estimated that the the number of hypertensive patients will raise to 1.56 billion worldwide by 2025 3. According to the report from the global burden of disease, systolic blood pressure (SBP) of at least 110 to 115 mm Hg is responsible for more than half of the global Disability-Adjusted Life Years (DALYs) in countries such as India and Indonesia 4. World Health Organization (WHO) reported that the prevalence of raised blood pressure was 24.1% for males and 23.3% for females aged ≥18 years globally in 2014 5. However, almost all hypertension-related complications are preventable. Lifestyle modification helps decrease blood pressure and prevents hypertension, and antihypertensive medication can effectively reduce the cardiovascular events attributed to hypertension 6. Adherence to medication and improving lifestyle in people with hypertension are known to decrease hospitalization, the cost associated with outpatient care, and cardiovascular
Aims: Chronic diseases may affect sexual health as an important factor for well-being. Mobile health (m-health) interventions have the potential to improve sexual health in patients with chronic conditions. The aim of this systematic review was to summarise the published evidence on mobile interventions for sexual health in adults with chronic diseases. Methods: Five electronic databases were searched for English language peer-reviewed literature from 1 January 2009 to 31 December 2019. Appropriate keywords were identified based on the study's aim. Study selection was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. The full texts of potential studies were reviewed, and final studies were selected. The m-health evidence reporting and assessment (mERA) checklist was used to assess the quality of the selected studies. After data extraction from the studies, data analysis was conducted. Results: Nine studies met the inclusion criteria. All interventions were delivered through websites, and a positive effect on sexual problems was reported. Prostate and breast cancer were considered in most studies. Interventions were delivered for therapy, self-help and consultation purposes. Quality assessment of studies revealed an acceptable quality of reporting and methodological criteria in the selected studies. Replicability, security, cost assessment and conceptual adaptability were the criteria that had not been considered in any of the reviewed studies. Conclusions: Reviewed studies showed a positive effect of mobile interventions on sexual health outcomes in chronic patients. For more effective interventions, researchers should design web-based interventions based on users' needs and consider the m-health essential criteria provided by mERA. Additionally, mobile interventions can be more effective in combination with smartphone apps.
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