Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), has led to huge concern worldwide. Some SARS-CoV-2 infected patients may experience post–COVID-19 complications such as multisystem inflammatory syndrome, defined by symptoms including fever and elevated inflammatory markers (such as elevation of C reactive protein (CRP), erythrocyte sedimentation rate, fibrinogen, procalcitonin test, D-dimer, ferritin, lactate dehydrogenase or IL-6, presence of neutrophilia, lymphopenia, decreased albumin, and multiple organ dysfunction). Post–COVID-19 complications may also manifest as autoimmune diseases such as Guillain-Barré syndrome and systemic lupus erythematosus. Signaling disorders, increased inflammatory cytokines secretion, corticosteroid use to treat COVID-19 patients, or impaired immune responses are suggested causes of autoimmune diseases in these patients. In this review, we discuss the molecular and pathophysiological mechanisms and therapeutic opportunities for multisystem inflammatory syndrome and autoimmune diseases following SARS-CoV-2 infection with the aim to provide a clear view for health care providers and researchers.

Background: The outbreak of COVID-19 in China in late 2019 was an unprecedented catastrophe that also involved many other countries, including Iran. Concerning the danger of disease contagion, it is necessary to detect asymptomatic or mild cases, especially in hospital staff who are highly exposed to the disease. Objectives: In this serosurvey study, we aimed to estimate IgG seroprevalence among hospital staff in two public hospitals to determine local transmission and infection risk factors, as well as protective immunity among high-risk populations. Methods: Screening was offered to the hospital staff of two public hospitals in Shiraz, Iran. Screening involved the measurement of IgG antibodies against SARS-CoV-2. Besides, a checklist that consisted of questions about sociodemographic, occupational, and epidemiological characteristics was completed by the participants. Results: Among 494 participants in this study, 29 (5.8%) had anti-SARS-CoV-2 IgG in their blood. Besides, 320 (64.8%) had at least one of the clinical symptoms within six months before this survey. Among participants with positive PCR, nine (21.4%) had anti-SARS-CoV-2 IgG, while this figure was seven (33.3%) for individuals with positive CT scans. Non-proper disposal of used protective equipment or infectious wastes (OR = 26.5), rotational daily work shifts (OR = 7.5), being anxious about getting COVID-19 (OR = 3.8), and age (OR = 1.06) were the significant determinants of having anti-SARS-CoV-2 IgG in the hospital staff. Conclusions: It is essential to continue training and giving technical consultations about COVID-19, especially the proper disposal of used protective equipment or infectious wastes in rotational daily shift workers.

: Diabetes mellitus and Alzheimer’s disease are considered the most prevalent diseases in older ages worldwide. The main pathology of Alzheimer’s disease is highly related with accumulation of misfolded proteins that lead to neuronal dysfunction in the brain. On the other hand, diabetes mellitus is associated with alteration of insulin signaling, which could cause the reduction of glu-cose uptake, metabolic prohibition of energy consuming cells, as well as suppression of glucose to fat conversion in the liver. In spite of having seemingly different pathological features, both dis-eases share common underlying biological mechanisms. Besides, the epidemiological and envi-ronmental links between these two diseases should not be overlooked. In this study, we aim to review shared pathological mechanisms of Alzheimer’s disease and diabetes mellitus, including impaired glucose metabolism, increased Amyloid-Beta (Aβ) production, impaired lipid metabo-lism, mitochondrial dysfunction, increased inflammation and elevated oxidative stress. Further-more, we discuss epidemiological/environmental association between these two diseases and also review animal investigations, which have evaluated the potential links between the two diseases.

Background Inflammatory bowel disease (IBD) is a chronic inflammatory condition involving individuals across all age groups. Recent data suggests the increase in the prevalence of IBD and the surge in applying the biologic drugs in which both change the cost of IBD in recent years. Comprehensive assessment of direct and indirect cost profiles associated with IBD in our area is scarce. This study aimed to determine the economic burden of IBD in Iran from a societal perspective, using cost diaries. Methods Patients available on clinic registry and hospital information system (HIS), who were diagnosed with IBD, were invited to take part in this study. Demographic and clinical data, the healthcare resource utilization or cost items, absenteeism for the patients and their caregivers were obtained. The cost of the used resources were derived from national tariffs. The data regarding premature mortality in IBD patients was extracted from HIS. Productivity loss was estimated based on the human capital method. Then, cost date were calculated as mean annual costs per patient. Results The cost diaries were obtained from 240 subjects (Ulcerative colitis: n = 168, Crohn’s disease, n = 72). The mean annual costs per patient were 1077 US$ (95% CI 900–1253), and 1608 (95% CI 1256, 1960) for the patients with ulcerative colitis and Crohn’s disease, respectively. Of the total costs, 58% and 63% were in terms of the indirect costs for the patients with ulcerative colitis and Crohn’s disease, respectively. The cost of illness for country was found to be 22,331,079 US$ and 15,183,678 US$ for patients with ulcerative colitis and Crohn’s disease, respectively. Highest nationwide economic burden of IBD was found for patients older than 40 years were estimated to be 8,198,519 US$ and 7,120,891 US$, for ulcerative colitis and Crohn’s disease, respectively. Conclusion The medication was found to be the greatest contributor of direct medical costs. Productivity loss in terms of long-term disability and premature mortality were major components of IBD’s economic burden in Iran.

Background: Diabetes mellitus and depression are both considered the most prevalent diseases of the recent century. On the other hand, it is estimated that the rate of depression is nearly doubled in diabetic patients compared with the general population.Method: A total of 89 patients, who were admitted to the hospital because of the complications of the disease, were voluntarily and conveniently participated in the study. The participants were given the questionnaires of Beck Depression Inventory-2nd-edition and Beck Scale for Suicide Ideation. They were divided into two age groups: 18-50 years old and 50-75 years old. Control group, consisting of 89 individuals without any underlying disease, were randomly selected from the patients’ visitors, matched with the participants according to the age group and gender. Statistical analysis was performed between the two groups based on scores obtained. Results: Beck Depression Inventory Scale score was significantly higher, regardless of age, in the patient group compared to the control group. However, there was no significant difference between the scores of Beck Scale for Suicide Ideation between the patient group and the control group. In the patient group, it was found that among the variables, female gender, and diabetic foot were associated with higher severity of depression symptoms. Conclusion: It is vitally essential for diabetic patients to undergo periodic psychiatric evaluation. Early diagnosis of depression could help them to better cope with their mental health issue, and as a result, it will decrease risk of suicidal ideation and other consequences.