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Introduction: Coronavirus disease 2019 (COVID-19) is a pulmonary involvement which was reported for the first time in December 2019 in the city of Wuhan, Hubei province, China. The aim of the study was to describe the demographic, clinical, laboratory, and radiological characteristics of 204 definitive laboratory-confirmed COVID-19 patients hospitalized in Mashhad, Khorasan Razavi province, Iran. Patients and Methods: This study was performed on 204 laboratory-confirmed COVID-19 patients. A set of laboratory tests combined with various patient information and results from lung high-resolution computed tomography (HRCT) were gathered in a checklist and analyzed to give us a better view of patients who are hospitalized due to the complications caused by this disease. Results: The average age of our patients was 58.83 ± 15.93 years. There were 122 (59.8%) male and 82 (40.2%) female patients, and almost all of our patients had at least one underlying disease. Nine (4.4%) of our patients reported having gone for a trip to COVID-19-epidemic areas in the last 2 weeks. The most common signs shared among all our patients were cough, fever, and decreased O2 saturation; the average respiratory rate was 25.50 ± 6.74/min, average axillary body temperature was 37.69°C ± 0.69°C, and average O2 saturation was 88.34% ± 7.34%. Conclusion: Based on our results, the most common signs of this disease are fever, cough, and shortness of breath, similar to seasonal influenza. Our data on disease severity showed that 33 (16.2%) patients had moderate disease, 139 (68.1%) had severe disease, and 28 (13.7%) were critical; 22 (10.8%) of our hospitalized patients died due to the complications of this disease.

Abstract Coronavirus disease 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease may be associated with several factors. Here, we review clinical features of COVID-19 inpatients with different severities. This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February–April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P

Abstract Leishmaniasis is a rare complication in adult cases even in endemic areas. Here, the first report of visceral leishmaniasis in a young woman in northeast of Iran has been described.

Abstract Objectives In this study, we investigate the effect of hydroxychloroquine on the prevention of Novel Coronavirus Disease (COVID-19) in cancer patients being treated. Trial design This is a multi-centre, two-arm, parallel-group, triple-blind, phase 2-3 randomised controlled trial. Participants All patients over the age of 15 from 5 types of cancer are included in the study. Patients with acute lymphoid and myeloid leukemias in the first line treated with curative intent, patients with high-grade non-Hodgkin's lymphoma treated with leukemia protocols and patients with non-metastatic breast and colon cancer in the first line of treatment will enter the study. The exclusion criteria will include known sensitivity to Hydroxychloroquine, weight below 35 kilograms, history of retinopathy, history of any cardiac disease, acute respiratory tract infection in the last 2 months, having COVID-19 in the first two weeks of entering the trial, having Diabetes Mellitus, having an immuno-suppressive disease other than cancer, having chronic pulmonary disease and taking immuno-suppressant drug other than chemotherapeutic agents for current cancer. This study is performed in five academic centres affiliated to Mashhad University of Medical Sciences, Mashhad, Iran. Intervention and comparator Patients are randomly assigned to two groups; one being given hydroxychloroquine and the other is given placebo. During two months of treatment, the two groups are treated with either hydroxychloroquine (Amin® Pharmaceutical Company, Isfahan, Iran) or placebo (identical in terms of shape, colour, smell) as a single 200 mg tablet every other day. Patients will be monitored for COVID-19 symptoms during the follow-up period. If signs or symptoms occur (fever, cough, shortness of breath), they will be examined and investigated with a high-resolution computed tomography (CT) scan of the lungs, COVID-19 specific IgM, IgG antibody assay and a nucleic acid amplification test (NAT) for the SARS-CoV-2 virus. Main outcomes The primary end point of this study is to investigate the incidence of COVID-19 in patients being treated for their cancer over a 2-month period. Randomisation Randomisation will be performed using randomly permuted blocks. By using an online website ( www.randomization.com ) the randomization sequence will be produced by quadruple blocks. The allocation ratio in intervention and control groups is 1:1. Blinding (masking) Participants and caregivers do not know whether the patient is in the intervention or the control group. The outcome assessor and the data analyst are also blinded to group assignment. Numbers to be randomised (sample size) The calculated total sample size is 60 patients, with 30 patients in each group. Trial Status The trial began on April 14, 2020 and recruitment is ongoing. Recruitment is anticipated to be completed by June 14, 2020 There has been no change in study protocol since approval, protocol version 1 was approved April 12, 2020. Trial registration This trial has been registered by the title of “Effect of Hydroxychloroquine on Novel Coronavirus Disease (COVID-19) prevention in cancer patients under treatment” in Iranian Registry of Clinical Trials (IRCT) with code “IRCT20200405046958N1”, https://www.irct.ir/trial/46946 . Registration date is April 14, 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Introduction: Novel Coronavirus outbreak has posed a global threat. While the infection appears to be mild in most patients, considering its high rate of transmission, a large number of people are at risk of developing severe to critical illness in total which makes prognosis studies a priority.The aim of the present study was to evaluate red blood cell distribution width (RDW) as a predictive factor for diagnosing severe cases of coronavirus disease 2019 (COVID-19).Materials and Methods: A total number of 204 inpatients diagnosed with COVID-19 including 122 men and 82 women (Mean age: 58.83±15.93 years old) treated at Imam Reza Hospital, Mashhad, Iran were included in the study. Patients were divided into severe and moderate groups according to their clinical signs and examinations and pulmonary imaging features. Demographic Data, laboratory test results, treatments, patients’ complications and outcome were recorded. Mann-Whitney U test and spearman correlation coefficient (r) were performed to assess RDW correlation with severity and serious complications in patients including intensive care unit (ICU) admission, shock, secondary infections, intubation, length of hospitalization and death. Receiver operating characteristics (ROC) curves analysis was carried out to define the reliability of RDW as a predictive indicator in severe COVID-19.Results: The results showed statistical significant correlations between high levels of RDW and developing secondary infections and longer hospitalization (P values ≤0.001). The optimal cutoff for RDW to predict the length of hospitalization (≤ 7 days or more than 7 days) was estimated to be 14.65% with 94% sensitivity and 71.3% specificity. The area under curve was calculated to be 0.895 through Roc curve analysis.Conclusion: High predictive value of RDW, a routine blood test parameter, could be used in diagnosing COVID-19 patients at higher risk for developing secondary infections and longer hospital stay which in turn helps with better management of the disease.

Introduction: For interpretation of the most common biochemical markers reference intervals (RIs) are widely considered and reported. Therefore, in this study, we aimed to determine age-specific RIs for some biochemical tests by removing and/or limiting critical gaps including sex, age group, geographical region, measurement device, and type of kits and reagents for routine laboratory biochemical variables in healthy adolescent girls aged 12-19 years.Materials and Methods: In this cross-sectional study a total of 1026 adolescent girl was recruited. According to the study aim, the levels of serum for some routine biochemical tests were measured on a BT-3000 auto-analyzer. On the basis of the non-parametric rank method and by use of CLSI Ep28-A3 guidelines, we determined age-specific RIs, including confidence interval 90%, under specific exclusion criteria.Results: Age partitioning was required for none of the upper and lower limits of biochemical markers. All Serum biochemical tests concentration remained relatively constant throughout the age range. Conclusion: By removing and/or limiting critical gaps involved in reference values of biochemical tests, it has provided an important understanding of metabolic processes and it has facilitated clinical application to track different diseases better