Vitamin D and zinc are important components of nutritional immunity. This study compared the serum concentrations of 25-hydroxyvitamin D (25(OH)D) and zinc in COVID-19 outpatients with those of potentially non-infected participants. The association of clinical symptoms with vitamin D and zinc status was also examined. A checklist and laboratory examination were applied to collect data in a cross-sectional study conducted on 53 infected outpatients with COVID-19 and 53 potentially non-infected participants. Serum concentration of 25(OH)D were not significantly lower in patients with moderate illness (19 ± 12 ng/mL) than patients with asymptomatic or mild illness (29 ± 18 ng/mL), with a trend noted for a lower serum concentration of 25(OH)D in moderate than asymptomatic or mild illness patients (p = 0.054). Infected patients (101 ± 18 µg/dL) showed a lower serum concentration of zinc than potentially non-infected participants (114 ± 13 µg/dL) (p = 0.01). Patients with normal (odds ratio (OR), 0.19; p ≤ 0.001) and insufficient (OR, 0.3; p = 0.007) vitamin D status at the second to seventh days of disease had decreased OR of general symptoms compared to patients with vitamin D deficiency. This study revealed the importance of 25(OH)D measurement to predict the progression of general and pulmonary symptoms and showed that infected patients had significantly lower zinc concentrations than potentially non-infected participants.

Since the outbreak of COVID‐19 in China, it has rapidly spread across many other countries. We evaluated antioxidant defense systems and inflammatory status related to the SARS‐CoV2 infection in a population from southwestern Iran. Comorbidities and clinical symptoms of 104 subjects (comprising negative and positive‐PCR COVID‐19 outpatients) were assessed. Serum concentrations of glutathione reductase (GR) and interleukin‐10 (IL‐10) were measured using ELISA. In the positive‐PCR group, follow‐ups on clinical symptoms were carried out for 28 days at 7‐day intervals. In the positive‐PCR group, hypertension, diabetes, liver disease, chronic heart disease, and chronic kidney disease were the most common comorbidities. In the general category of symptoms, we found a significant difference between negative and positive‐PCR groups, except regarding runny noses. In the pulmonary category, there was a significant difference between the two groups except in terms of chest pain. We also determined a significant difference in neurologic symptoms, except for ear pain, between negative and positive‐PCR groups. We also found significantly lower levels of GR but higher levels of IL‐10 in the positive‐PCR group (p = 0.000 for both). In the positive‐PCR group, serum levels of IL‐10 (odds ratio = 0.914, p = 0.012) decreased the chances of neurological symptoms occurring over time. The antioxidant defense systems of positive‐PCR outpatients failed as demonstrated by a reduction in the serum levels of GR. We also indicated a dysregulation in the immune response against COVID‐19, characterized by changes in serum IL‐10 levels.

Abstract Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne, viral disease that may also be transmitted through person-to-person transmission by exposure to infected body fluids. It causes a severe disease in humans with high mortality rates. Here we present two cases of CCHF patients with sudden onset of lethargy, fever, nausea, vomiting, headache, and hemorrhagic manifestation. With one of the patients tick bite was confirmed, then he was treated with ribavirin in isolation and recovered completely. The second patient was in contact with the infected blood of a sheep and, unfortunately, despite the treatment, he passed away. Public health measures should focus on preventing this infection by raising the awareness of CCHF symptoms and route of its transmission, and also by adopting practices to decrease the chances of spreading infections in hospitals.

RAAS could play a substantial role in the pathophysiology of COVID-19. Also, the dynamics of the HPA axis may have changed in COVID-19. So, we aimed to assess RAAS and the HPA axis in COVID-19 suspicious outpatients referred to 16-hour comprehensive health centers in Abadan. Demographic and clinical data were collected. Serum cortisol and aldosterone measurements and blood grouping were done. Clinical symptoms of the positive PCR group were followed up on for four weeks. SPO2 was significantly lower in the positive PCR group, but the respiratory rate was significantly higher (P= 0.03 and P=0.001, respectively). Outpatients with the O blood group showed higher levels of cortisol in comparison to those with A and AB blood groups (P= 0.003 and P= 0.03 respectively) in the positive PCR group. Negative PCR individuals with the AB blood type had significantly higher levels of cortisol compared with those who had A (P= 0.02) and O (P=0.03) blood types. We saw significantly higher levels of aldosterone in males of the negative PCR group in comparison with females (P= 0.05). Cortisol (OR= 0.937, P= 0.033) and aldosterone (OR= 1.005, P= 0.020) levels had a decreasing and increasing effect on the chances of respiratory symptoms occurring over time, respectively. Also, over time, women were twice as likely as men to develop neurologic symptoms (OR= 0.530, P= 0.015). Cortisol and aldosterone are associated with the chance of respiratory symptoms occurring over time. However, the levels of these two markers do not seem to be related to the lower grades of COVID-19.

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