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B ackground: According to the World Health Organization, preventive measures are the o nly non-pharmacological method to combat the COVID-19 epidemic. This study aimed t o investigate the relationship between perceived social support and preventive behaviors mediated by the variables of life expectancy and mental wellbeing. Materials and Methods: This study is applied in terms of purpose and was conducted by survey method. The statistical population included women living in Tehran City, Iran, with a sample size of 428. The study data were collected using the preventive behavior scale, mental wellbeing scale, Snyder hope scale, and multidimensional perceived social support scale. The obtained data were analyzed using SPSS 25 and AMOS 23 software. Results: The study results showed a positive and significant relationship between perceived social support and mental wellbeing, between perceived social support and life expectancy, and between mental wellbeing and life expectancy. Also, life expectancy and mental wellbeing variables mediate between perceived social support and preventive behaviors. Conclusion: Considering the critical role of women in family management and preventive measures during the COVID-19 epidemic, strengthening social support networks, hope, and mental wellbeing should be considered. [ABSTRACT FROM AUTHOR]

The COVID-19 has placed pandemic modeling at the forefront of the whole world's public policymaking. Nonetheless, forecasting and modeling the COVID-19 medical waste with a detoxification center of the COVID-19 medical wastes remains a challenge. This work presents a Fuzzy Inference System to forecast the COVID-19 medical wastes. Then, people are divided into five categories are divided according to the symptoms of the disease into healthy people, suspicious, suspected of mild COVID-19, and suspicious of intense COVID-19. In this regard, a new fuzzy sustainable model for COVID-19 medical waste supply chain network for location and allocation decisions considering waste management is developed for the first time. The main purpose of this paper is to minimize supply chain costs, the environmental impact of medical waste, and to establish detoxification centers and control the social responsibility centers in the COVID-19 outbreak. To show the performance of the suggested model, sensitivity analysis is performed on important parameters. A real case study in Iran/Tehran is suggested to validate the proposed model. Classifying people into different groups, considering sustainability in COVID 19 medical waste supply chain network and examining new artificial intelligence methods based on TS and GOA algorithms are among the contributions of this paper. Results show that the decision-makers should use an FIS to forecast COVID-19 medical waste and employ a detoxification center of the COVID-19 medical wastes to reduce outbreaks of this pandemic. [ABSTRACT FROM AUTHOR]

The main purpose of this paper is to investigate the effects of COVID-19 regarding the efficiency of industries based on data in the Tehran stock market. A hybrid model of Data Envelopment Analysis (DEA) and data mining techniques is used to analyze the investment behavior in Tehran stock market. Particularly during the COVID-19 pandemic, many companies face financial crises. That is why companies with inferior performance must be benchmarked with efficient companies. First, the financial data of investments on selective companies are analyzed using data mining approaches to recognize the behavioral patterns of investors and securities. Second, customers are clustered into 3 selling and 4 buying groups using data mining techniques. Then, the efficiency of active companies in stock exchange is evaluated using input-oriented DEA. The results indicate that, among 23 industries listed on the stock market in Iran, solely nine were efficient in 2019. Moreover, in 2020, the number of efficient industries further decreased to six industries. Comparing the obtained results with those of another study which was conducted in 2018 by other researchers revealed that COVID-19 strongly affects the performance of an industry and some industries which were efficient in the past such as the bank industry became inefficient in the following year. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic posed significant risks to children worldwide. This study aimed to assess the COVID-19 protection status of children and explored the relationship between household socio-economic status and COVID-19 morbidity and preventive measures, including vaccination and mask-wearing, in two cities in Iran. Method: A population-based cross-sectional study was conducted from July to October 2022 among 7 to 18-year-old children and their families in Tehran and Karaj. A total of 3,022 samples were selected using stratified multistage cluster sampling. Data were collected through interviews with children and adults, using questionnaires and was analyzed with Stata software version 14. Results: The analysis focused on 2,878 children with a median age of 12. Over half (54%) reported that the pandemic negatively affected their family's financial status, with 45% describing its impact on children's needs as negative or very negative. Just under 50% of respondents consistently wore masks during the study period, and around 54% had received at least one dose of the COVID-19 vaccine. Reasons for not getting vaccinated included concerns about side effects, ineligibility for the target age group, and overcrowding at vaccination sites. The odds of not getting vaccinated were significantly lower for children aged 15–18, with boys more likely to refuse vaccination than girls. Conclusion: The financial impact of the pandemic in Iran affected families' ability to meet their children's needs. Moreover, low vaccination acceptance rates increased children's vulnerability to health problems and contributed to COVID-19 infections. Efforts should be made to increase vaccination acceptance, particularly among immigrant populations. [ABSTRACT FROM AUTHOR]

Background: Perceived social support (PSS) plays a considerable role in mental health. The Multidimensional Scale of Perceived Social Support (MSPSS) is one of the most widely used scales, leading to much research evidence. The present study investigated its measurement model, equivalence across gender (male and female) and age groups (older patients= above 60 and non-older patients= below 60), and concurrent validity. Methods: A cross-sectional survey was conducted between March and October 2020, on patients hospitalized due to COVID-19 in Tehran, Iran. The scales were administered to 328 COVID-19 patients (54.6% male, aged 21 to 92) from two general hospitals; participants completed MSPSS (including friends, family, and significant others subscales), Pittsburgh Sleep Quality Index (PSQI, include sleep latency, subjective sleep quality, habitual sleep efficiency, sleep duration, use of sleep medication, daytime dysfunction, and sleep disturbances subscales), and the Perceived Stress Scale-10 (PSS-10, to assess patients' appraisal of stressful conditions). Results: The MSPSS three-factor structure was confirmed among COVID-19 patients by Confirmatory Factor Analysis (CFA). The results support the MSPSS internal consistency and configural, metric, and scalar invariance across gender and age groups. Nevertheless, small but significant differences were found across ages based on the latent factor mean of the MSPSS from friends, with a lower mean level in older patients. The coefficients of Cronbach's alpha (ranging from.92 to.96), the ordinal theta (ranging from.95 to.98), and Omega (ranging from.93 to.97) suggested high internal consistency of MSPSS. The concurrent validity of MSPSS was evidenced by its significant negative correlation with PSS-10 (Γb = -.13, p <.01) and also subjective sleep quality (Γb = -.22, p <.01), sleep disturbances (Γb = -.26, p <.001), and daytime dysfunction (Γb = -.26, p <.001). Conclusions: The MSPSS was valid and reliable for measuring individuals' perception of social support between males and females and older and non-older COVID-19 patients. [ABSTRACT FROM AUTHOR]

The present study was done to evaluate the prevalence of intestinal parasitic infections (IPIs) in patients with COVID-19 in health care centers (Imam Reza and Golestan hospitals), Tehran, capital of Iran. By designing a matched case-control study, 200 fecal samples were collected for each of the COVID-19 patients and healthy individuals. Nasopharyngeal/oropharyngeal swab samples were collected from all participants for the diagnosis of COVID-19. RNA extraction was performed, and then real time reverse-transcription polymerase chain reaction (rRT-PCR) assay was applied to detect viral RNA. Considering the lung complications, 25%> lung complications was detected in 49 patients, 25–49% in 42 patients, and 50%≤ in 109 patients. Fecal samples were examined using different parasitological techniques. After nested-PCR, sequencing was applied to identify Cryptosporidium spp. and microsporidia spp. A relatively lower prevalence of IPIs was detected among control group (7.5%), than in COVID-19 patients (13%), though not significant P = 0.13 . The most prevalent parasite among patients was Blastocystis sp. (6%). Also, 13.76% of IPIs were detected in inpatients with more than 50% lung complication. As well, a remarkably significant difference in IPIs was observed among diarrheic COVID-19 patients, in comparison with nondiarrheic patients P < 0.00001 . Moreover, the isolated sequences in the present study belonged to C. parvum subtype IIa and Enterocytozoon bieneusi genotypes D and Peru 8. In conclusion, more epidemiological and clinical research studies are needed to better understand the status and interaction of IPI in COVID-19 in Iran and other countries. [ABSTRACT FROM AUTHOR]

With the severe outbreak of the novel coronavirus (COVID-19), researchers are motivated to develop efficient methods to face related issues. The present study aims to design a resilient health system to offer medical services to COVID-19 patients and prevent further disease outbreaks by social distancing, resiliency, cost, and commuting distance as decisive factors. It incorporated three novel resiliency measures (i.e., health facility criticality, patient dissatisfaction level, and dispersion of suspicious people) to promote the designed health network against potential infectious disease threats. Also, it introduced a novel hybrid uncertainty programming to resolve a mixed degree of the inherent uncertainty in the multi-objective problem, and it adopted an interactive fuzzy approach to address it. The actual data obtained from a case study in Tehran province in Iran proved the strong performance of the presented model. The findings show that the optimum use of medical centers' potential and the corresponding decisions result in a more resilient health system and cost reduction. A further outbreak of the COVID-19 pandemic is also prevented by shortening the commuting distance for patients and avoiding the increasing congestion in the medical centers. Also, the managerial insights show that establishing and evenly distributing camps and quarantine stations within the community and designing an efficient network for patients with different symptoms result in the optimum use of the potential capacity of medical centers and a decrease in the rate of bed shortage in the hospitals. Another insight drawn is that an efficient allocation of the suspect and definite cases to the nearest screening and care centers makes it possible to prevent the disease carriers from commuting within the community and increase the coronavirus transmission rate. [ABSTRACT FROM AUTHOR]

Background: The impacts of caring for hospitalized COVID-19 patients on nurses are wide and varied and have not been comprehensively explained in the existing literature. The aim of this study was to explore the nurses' perception of the impacts of caring for hospitalized COVID-19 patients. Materials and Methods: In this qualitative descriptive study, data were collected via semi-structured interviews with 20 nurses and head nurses of emergency/internal wards and Intensive Care Units (ICUs) of 2 hospitals in Tehran, Iran. The purposive sampling method was used, and data analysis was performed using a conventional content analysis approach. Results: After data analysis, 12 subcategories, 3 main categories, and 1 theme (professional resilience) were extracted. The three main categories included "complex care," "professional development," and "caring self-efficacy." Caring for hospitalized COVID-19 patients was complex for nurses; however, the care provided to these patients could also lead to the nurses' professional development and caring self-efficacy. Conclusions: Health organizations and nursing managers can better manage the COVID-19 pandemic and other similar future crises through strategies such as providing nurses with adequate and diverse resources and facilities, encouraging and supporting nurses in various dimensions, providing positive media advertisements for the nursing profession and nurses, and providing nurses with necessary and applicable knowledge and skills. [ABSTRACT FROM AUTHOR]

Background: The medium and long-term problems of COVID-19 survivors after hospital discharge are currently unknown, but new evidence is emerging. This study was conducted with the aim of the effectiveness of mindfulness-based cognitive therapy (MBCT) on resilience and psychological distress of recovered patients from COVID-19 in Tehran City, Iran, in 2021. Methods: The study was a quasi-experimental type of pre-test-post-test design with a control group with a 2-month follow-up. The statistical population included all patients 25-55 years in Tehran City in 2021 with 4 to 8 weeks of discharge. The sample included 30 people who recovered from COVID-19 who had symptoms of depression, anxiety, and stress (based on [depression, anxiety and stress scale] DASS-21 scores) and was selected by purposive sampling and based on the inclusion criteria, and then matching assigned to an experimental (MBCT) and a control group (n=15each). The experimental group received 8 sessions of 60 minutes of mindfulness-based cognitive therapy (individual and online) but the control group received no intervention. The research tools were the DASS21 and Connor-Davidson resilience scale (CD-RISC). Data were analyzed using a mixed analysis test and Ben Foroni post hoc test using SPSS version 23 software. Results: The results showed that MBCT in the post-test positively affected the resilience (F=30.31, P=0.001) and negatively affected the psychological distress (F=120.70, P=0.001) of those who Recovered from COVID-19. This therapeutic effect continued until the follow-up phase. According to the results, MBCT is effective in increasing resilience and reducing psychological distress and a significant difference is observed between the experimental and control groups (P=0.01). Conclusion: Based on the findings, MBCT is effective in increasing resilience and reducing psychological distress after illness and the use of this model can be useful in the psychological rehabilitation of those who have recovered from COVID-19. [ABSTRACT FROM AUTHOR]

Background: The first human case of COVID-19 was reported on 19 February 2020 in Iran, since then the number of infected cases has dramatically increased to about 1.800 million and about 62 000 deaths, also elderly people have accounted for the largest frequency of mortality. Objective: This study aims to evaluate the prevalence of Covid-19 RT-PCR positive among Iranian patients and to evaluate the most important clinical symptoms of identified patients based on age, gender, and their background diseases to be used as an aid for early diagnosis. Methods: During 9 months, swab samples of 11 034 patients' nasopharynx and oropharynx secretions were obtained and were referred to the laboratory for Covid-19 RT-PCR test. In addition, the history of signs and symptoms from patients was recorded. Results: In total, 11 034 Covid-19 RT-PCR tests that performed, 3358 samples had positive results (30.4%). Headache was the most commonly reported, which was found in 42.5% of our cases. Fever was the second most common symptom among the patients studied, with a prevalence rate of 36.2%. Conclusion: In this study, almost 30% of symptomatic patients had positive Covid-19 RT-PCR test results. Headache was the most common symptom; also diarrhea and nausea were the least common symptoms among patients under this study. [ABSTRACT FROM AUTHOR]

Background: It remains crucial to understand socio-demographic determinants of COVID-19 infection to improve access to care and recovery rates from the disease. This study aimed to investigate the urban and sub-urban disparities associated with COVID-19 in patients visiting healthcare facilities in the province of Tehran, Iran.Methods: Data from 234 418 patients who were diagnosed with COVID-19 infection from March 2020 to March 2021 in the province of Tehran were used in this analysis. Descriptive statistics were used to describe the characteristics of the study population. Chi-Squared test was applied to examine the association of study variables with residing area. Independent samples t-test was performed to compare mean age of patients in urban and sub-urban areas. Multiple Logistic Regression model was applied to examine the association of study variables with disease outcome.Results: Overall, most patients resided in the urban settings (73%). Mean age of patients was significantly lower in sub-urban areas compared to their counterparts in urban settings (49 ± 23.1 years versus 53 ± 21.1 years, P < 0.001). Positive PCR test results were more common in urban areas (48.5% versus 41.3%, P < 0.001). Yet, sub-urban settings had higher rates of positive chest CT scan reports (62.8% versus 53.4%, P < 0.001). After accounting for age and sex covariates, residing in urban areas was associated with higher likelihood of being admitted to an ICU (OR = 1.27, CI: 1.240-1.305). Yet, a greater vulnerability to fatal outcome of COVID-19 infection was shown in patients living in sub-urban areas (OR = 1.13, CI: 1.105-1.175).Conclusions: This study revealed a clear disparity in the health outcome of patients infected with COVID-19 between urban and sub-urban areas. [ABSTRACT FROM AUTHOR]

By applying multivariate regression to 2020 survey data from four Tehran hospitals, we measure eight recognized sources of Coronavirus disease 2019 (COVID-19) pandemic-related anxiety among 723 healthcare workers (HCWs) with diverse sociodemographic characteristics employed across different hospital areas and positions. The most prominent anxiety source identified is the risk of workplace COVID-19 contraction and transmission to family, followed by uncertainty about organizational support for personal and family needs in the event of worker infection. A supplemental qualitative analysis of 68 respondents in the largest hospital identifies four additional anxiety sources, namely, health, finances, workload, and leadership. This evidence of the multifaceted nature of anxiety sources among HCWs highlights the differentiated approaches that hospital policymakers must take to combat anxiety. [ABSTRACT FROM AUTHOR]

Background:There were no documents about the non-lung involvement of COVID-19, even in the absence of lung involvement. The present study aimed to report a single-centre experience of liver involvement caused by COVID-19 disease in Iran. MaterialsandMethods:We recorded information of 120 patients who suffered COVID-19 disease, and they were admitted to the intensive care unit at Taleghani hospital in Tehran, Iran, between March and May 2020. Along with clinical and diagnostic parameters, the outcome of patients concerning improvement, disease progression or death was also assessed. Results:In total, 68 patients (56.7%) had abnormal liver dysfunction. The most common changes in liverrelated parameters were elevated international normalized ratio (INR) (mean serum level of 2.5) followed by elevated alkaline phosphatase (ALP) (mean serum level of 412 mg/dl). The mean level of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased 4 and 9 times more than the standard limit. The overall death rate in COVID-19 patients was 38 patients (55.88%, n=68). Conclusion:Liver injuries are common findings in patients suffering COVID-19 infection and leading to poorer outcomes. Serum bilirubin level of more than 3mg/dl was associated with higher mortality in patients with liver damage. [ABSTRACT FROM AUTHOR]