Coronavirus disease 2019 (COVID-19) vaccines had a great impact on world health and well-being. However, various adverse events have been observed following COVID-19 vaccination. Cutaneous reactions have been prevalent following many vaccines, including COVID-19 vaccines. Here, we present a case of new-onset lichen planus in a COVID-19 patient.

BackgroundHydroxychloroquine with or without azithromycin was one of the common therapies at the beginning of the COVID-19 pandemic. They can prolong QT interval, cause Torsade de pointes, and lead to sudden cardiac death. We aimed to assess QT interval prolongation and its risk factors in patients who received hydroxychloroquine with or without azithromycin.MethodsThis was a retrospective cohort study. 172 patients with COVID-19 included, hospitalized at hospitals of Babol University of Medical Sciences between March 5, 2020, and April 3, 2020. Patients were divided into two groups: hydroxychloroquine alone and hydroxychloroquine with azithromycin. Electrocardiograms were used for outcome assessment.Results83.1% of patients received hydroxychloroquine plus azithromycin vs 16.9% of patients who received only hydroxychloroquine. The mean age of patients was 59.2 ± 15.4. The mean of post-treatment QTc interval in the monotherapy group was shorter than the mean of post-treatment QTc interval in the combination therapy group but it had no significant statistical difference (462.5 ± 43.1 milliseconds vs 464.3 ± 59.1 milliseconds; P = 0.488). Generally, 22.1% of patients had a prolonged QTc interval after treatment. Male gender, or baseline QTc ≥ 450 milliseconds, or high-risk Tisdale score increased the likelihood of prolonged QTc interval. Due to QTc prolongation, 14 patients did not continue therapy after 4 days.ConclusionHospitalized patients treated with hydroxychloroquine with or without azithromycin, had no significant difference in prolongation of QT interval and outcome. But the number of patients with prolonged QT intervals in this study emphasizes careful cardiac monitoring during therapy; especially in high-risk patients.

Seasonal Influenza can cause cardiovascular complications. Therefore, this study aimed to investigate recent influenza-like illnesses (ILI) in acute myocardial infarction (AMI) patients compared to other hospitalized patients as the control group during the cold season in the north of Iran. This retrospective case-control study included 300 patients (150 AMI patients and 150 controls) aged > 50 years hospitalized for acute myocardial infarction (AMI) or other conditions between September 22, 2019, and March 15, 2020. Patients in each group were frequency-matched for gender and age range. The primary exposure was a recent ILI (fever > 37.8 C, cough, and sore throat) in the past month. The patients' mean age was 64.42 +- 9.47 years, with a range of 50-94 years. Forty-five (15%) patients had diseases that met the ILI criteria. The AMI group patients significantly reported more ILI than controls (adjusted OR: 3.04, 95% CI: 1.02 to 9.09, p < 0.001). On the other hand, patients who received the influenza vaccine were significantly less likely to have an acute myocardial infarction than those who did not receive the vaccine (adjusted OR: 0.02, 95% CI: 0.001 to 0.38, p = 0.006). In conclusion, the present study demonstrates that ILI can significantly increase the risk of AMI. Also, it was confirmed that Influenza vaccination could significantly reduce the risk of AMI.

Background: Hepatitis A (HAV) and Hepatitis E viruses (HEV) are endemic in Iran and are known major causes of acute viral hepatitis. Also, during pregnancy, they are associated with severe outcomes. Therefore, it is vital to evaluate the antibody levels against HAV and HEV in pregnant women to avoid severe outcomes incidence. Study design and methods: A total of 247 pregnant women were enrolled in this prospective cross-sectional study. In addition to completing the questionnaire and interviewing all participants, the serum samples were tested for anti-HAV and anti-HEV IgG using the enzyme-linked immunosorbent assay (ELISA). The association between anti-HAV and anti-HEV antibodies status and risk factors was evaluated. Results: The mean age of patients was 28.06 +- 5.29 years. Anti-HAV antibody was found in 111 patients (44.9%), while anti-HEV antibody was detected in only two pregnant women (0.8%). The seroprevalence of HAV was inversely related to the level of education. There was no significant correlation between HAV antibody levels and age, marital status, residence location, and pregnancy trimesters. Conclusion: Considering many complications of these diseases in pregnancy, the detection of enteroviral hepatitis, especially HAV in pregnant women, is necessary, and therefore, proactive measures, such as promoting education, improving people awareness, and vaccination, are recommended.

A 28-year-old female with a chief complaint of right lower limb claudication for two weeks was admitted into the infectious disease ward. Because of the unreversible damage to the head of her right femur, a total hip replacement surgery was suggested for this patient.