Hospital Practices and Research

Abstract Background: Among suggested medications for the treatment of COVID-19, chloroquine derivates and angiotensin-converting–enzyme inhibitors (ACEIs)/angiotensin II type 1 receptor blockers (ARBs) are the two medications with conflicting effects on the development of the disease.
Objectives: The present study aimed to evaluate COVID-19 in patients with rheumatic diseases receiving chloroquine derivate.
Methods: Every patient with proven rheumatologic diseases registered in two referral centers in Tehran and Alborz, Iran was enrolled in the present descriptive cross-sectional study between May and June 2020. At first, the symptoms of COVID-19 were assessed, and if a case had suspicious symptoms, reverse transcription-polymerase chain reaction (RT-PCR) COVID-19 tests were done. Demographic and clinical data are documented for every patient. Then, the patients were grouped once according to their COVID-19 infection status and another time according to their hydroxychloroquine use.
Results: 1159 patients enrolled in the study with a mean age of 49.39 years. Frequency of hypertension was 22.17 %, diabetics (9.49%) and 20 (1.7%) patients were positive for COVID-19 testing. The most common symptoms of the COVID-19 positive cases were cough (5.2%) and fever (4%). There was no significant difference in receiving ACEIs/ARBs or other medications between COVID-19 positive or negative patients. Among the patients receiving hydroxychloroquine, 15 patients (1.7%) had proved COVID-19 versus 5 patients (1.7%) who were not receiving these medications (P>0.999).
Conclusion: The present study demonstrated that receiving ARBs or ACEIs was not different among patients with or without COVID-19. Moreover, receiving chloroquine derivate was not related to the development of COVID-19 in patients with rheumatologic disorders.

Abstract Background: In December 2019, in Wuhan, China; a new coronavirus emerged that had not been previously identified in humans. Hence is crucial to characterize the infection risk among infected health care workers (HCWs), being responsible for secondary transmission to patients, and others.
Objectives: The current study aimed to assess the disease burden among the front-line warriors and efficiently planned the preventive and management strategies for such infections.
Methods: HCWs with clinical suspicion of COVID-19 infection, who reported to Fever Clinic for possible diagnosis by Truenat testing, were enrolled through a self-reporting Risk Assessment form. An oropharyngeal swab was subjected to Truenat testing based on the principle of Real time reverse transcription polymerase chain reaction (RT-PCR).
Results: Doctors comprised 60% of our HCWs. Eighty-three percent of the HCWs under study reported either the presence of BCG scar or gave a history of BCG immunization at birth. The maximum number of HCWs (29.16%) took Hydroxychloroquine prophylaxis for four weeks. Seventy-four percent of the HCWs affirmed the use of personal protective equipment (PPE) at the time of exposure. The most common mode of infection reported was the exposure to COVID-19 patients. Fever was the most common reported symptom. Truenat was positive in 9 of 100 HCWs who were tested, giving an infection rate of 9%.
Conclusion: The study provides insights into the burden of COVID-19 infection among HCWs, and guides us to evaluate and plan our preventive measures and management strategies for such infections.