The COVID-19 epidemic has become a major public health challenge around the world. According to the World Health Organization (WHO), as of August 2020 there are more than 833,556 dead and over 24,587,513 people infected around the world. This pandemic has adversely affected many professions around the globe, including dentistry. COVID-19, caused by the Corona virus family, is transmitted mainly by direct contact with an infected person or through the spread of aerosol and droplets. Dentistry by nature is considered to be one of the most vulnerable professions with regards to the high risk of transmission between the dentist, dental team, and patients; therefore, a protocol for infection control and the prevention and spreading of the COVID-19 virus in dental settings is urgently needed. This article reviews essential knowledge about this virus and its transmission and recommends preventive methods based on existing scientific research and recommendations to prevent the spread of this virus in dental offices and clinics.

Background and aims: Novel Coronavirus (COVID-19) first appeared in China in late 2019 which was rapidly spread worldwide. As the COVID-19 pandemic continues to spread, it is crucial to determine the prognostic factors contributing to the development of severe disease and higher mortality. Herein we aimed to evaluate the correlation between the severity and prognosis of patients with COVID 19 with serum 25(OH)D levels. Method: This descriptive retrospective study was performed from March to April 2020 at a referral center for patients with COVID-19, Tehran, Iran. The data collection was performed by a checklist consisting of the demographic features and laboratory assessments consisted of serum 25(OH)D were evaluated and recorded. And investigate the relationship between serum 25(OH)D and clinical outcomes of patients. Result: 205 patients with a mean age of 59.71 years were enrolled. Our findings did not reveal a significant difference in mean levels of vitamin between improved (34.09) and deceased patients (34.54). However, in patients with severe disease, there was a considerable difference in levels of vitamin D in improved and deceased patients (P.value: 0.021). According to our results, the mortality rate was slightly higher in men (odds ratio:2.2). Furthermore, the mean age (64.20 vs. 58.51) and the presence of at least two comorbidities (odds ratio: 2.40) were significantly higher in deceased patients. Conclusion:In this study, we did not reveal a statistical difference in mean levels of vitamin D and the outcome of patients with COVID-19. We concluded that in patients with severe disease, vitamin D deficiency could affect the course of the disease and mortality, especially in comorbidity and older people.

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Combined variable immunodeficiency (CVID) is a primary immunodeficiency, characterized by impairment in immune system function. These patients are susceptible to opportunistic infections, which may mimic COVID-19 manifestations. Also, misdiagnosis or delayed diagnosis of opportunistic infections can lead to perilous consequences. We report a 28-year-old woman with a history of combined variable immunodeficiency disorder (CVID) and ulcerative colitis (UC) complained of fever, cough, and dyspnea. According to the clinical and radiological manifestations and the COVID-19 epidemic, she was admitted with a primary diagnosis of COVID-19 pneumonia. After a week, the patient did not respond to treatment, so she underwent bronchoscopy. Using polymerase chain reaction (PCR) methodology, we detected DNA of Pneumocystis jirovecii, the causative agent of a life-threatening pneumonia (PCP), in respiratory specimens. The patient was hypersensitive to common PCP treatments, so she was treated with high-dose clindamycin. However, the patient's clinical condition aggravated. Besides, we found evidence of pneumothorax, pneumomediastinum, and pneumopericardium in chest CT scan. We inserted a catheter for the patient to evacuate the air inside the mediastinum. Also, we added caspofungin to the treatment. The patient eventually recovered and was discharged from the hospital about a week later. Thus, during the COVID-19 epidemic, in febrile patients with respiratory symptoms, physicians should not think only of COVID-19. They must consider opportunistic infections such as PCP, especially in immunocompromised patients.

Background: Coronavirus disease 2019 (COVID-19) is an infectious illness that causes severe respiratory disease of varying severity. The disease was first reported in Wuhan (China) and caused the first pandemic of the new millennium. Still, a global push is on the way to develop a treatment for COVID-19. Arbidol (Umifenovir) is an orally administered antiviral agent approved for the prophylaxis and treatment of influenza types A and B, SARS, and Lassa viruses in Russia and China. Objectives: The current study aimed to investigate the effectiveness of Arbidol in patients with mild to moderate and severe symptoms suffering from COVID-19. Methods: The first phase of the research was a retrospective study on 47 patients (18 females and 29 males) with mild to moderate symptoms suffering from COVID-19 who were admitted to Labafinejad Hospital in Tehran, Iran, from March to April 2020. Patients were separated into two groups of Hydroxicholoroquine and Kaletra as control (7 subjects) (1a) and intervention. The experiment group who were 20 COVID-19 patients (16 males and 4 females) with mild to moderate symptoms were received Hydroxicholoroquine, Kaletra, and Arbidol (1b). Also, two groups comprised of 17 patients (13 males and 4 females) with severe symptoms of COVID-19 infection who received Hydroxicholoroquine, Kaletra, and Ribavirin as the control group (2a) and 17 patients (13 males and 4 females) with severe symptoms who received Hydroxicholoroquine, Kaletra, Ribavirin, and Arbidol (2b) were compared. Results: The average temperature of patients in groups 1a and 1b (both suffering from mild to moderate illness) on the fifth day of admission was 37.3 and 36.4°C, respectively, which was statistically significant (P value = 0.07). Concerning the respiratory rate, patients in group 1b were significantly different on the fifth day of admission (P value = 0.015). The comparison of neutrophil to lymphocyte (N/L) ratio in the complete blood cell count on the fifth day of admission showed a significant difference (P value = 0.024) between the two groups. Mean O2 saturation on the fifth day of admission in groups 1a and 1b was 91.9% and 94%, respectively, which was significant (P value = 0.04). In groups suffering from severe disease, no significant difference was found regarding the O2 saturation, respiratory rate, and temperature. Also, in laboratory tests, no significant difference was observed in N/L and Plt/L ratios five days after admission. This study demonstrated that Arbidol didn’t cause any significant change in the hospitalization period and mortality rate of COVID-19 patients. Conclusions: In COVID-19 patients with mild to moderate symptoms, treatment with Arbidol could decrease the duration of fever and improved O2 saturation and respiratory rate on the fifth day of admission. The N/L ratio was significantly different in patients with mild to moderate symptoms who received Arbidol, but in patients with severe symptoms, Arbidol couldn’t improve O2 saturation and respiratory rate and was not associated with decreased temperature. Moreover, there was no significant difference concerning the N/L and plt/L ratios and severely of the disease.