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Background and aims: In late December 2019, a cluster of progressive pneumonia-like respiratory syndromes broke out in Wuhan, China. As the number of cases continued to rise, the 2019 coronavirus disease (COVID-19) has been declared a global public health emergency. The causative agent, i.e., SARS-CoV-2, is a highly contagious strain, which has resulted in the rapid worldwide outbreak of COVID-19. COVID-19 is an overwhelmingly transmissible disease that requires early and accurate diagnosis for proper and timely treatment of suspected cases. Materials and Methods: In order to accessthe scientific documentation and evidence related to the subject published during 2019 to 2021, English keywords including "COVID-19", "SARS-CoV-2", "Diagnosis", "Immunoglobulin G (IgG)", "Immunoglobulin M (IgM)", and ‘Polymerase Chain Reaction (PCR)" were searched in Medline, PubMed, and Google Scholar databases and Persian versions of these keywords were also looked for in Jihad-e Daneshgahi’s Scientific Information Database (SID) and Iranian Journals database (Magiran). Results: With respect to diagnosis, serum antibody assays, nucleic acid sequencing, and radiologic evaluation are among the most reliable methods to rule out the disease in suspicious cases. This review is a synopsis of the pathogenesis of coronavirus, which will mainly focus on the diagnostic methods, as well as laboratory changes in immunoglobulins, polymerase chain reaction results, and computed tomography (CT) findings. Conclusion: Early diagnosis matters in that it not only contributes to the prevention of further transmission of the virus by asymptomatic carriers but also paves the way for clinicians to accurately choose the best therapeutic approach depending on the status of the patients.

Zika virus is an emerging public health threat. The large outbreak related to this infection was first reported in 2007 in Yap Island. This virus is associated with microcephaly, Guillain Barre syndrome and some of the presentations of Zika infection include fever, maculopapular rash, arthralgia, bilateral conjunctivas, headache, arthritis/arthralgia with edema of tiny joints of feet and hands, retro-orbital pain, myalgia, asthenia and vertigo. In most of the cases, the infection is asymptomatic and self-limited. One of the largest known outbreaks of the virus was reported in French Polynesia, south pacific in October 2013. At the beginning of 2016, more than 52 countries have had reported the active transmission of the Zika virus. In general, there are two transmission modes for the Zika infection: Vector-borne transmission and Non-vector-borne transmission. Some diagnostic tests for Zika infection are RT-PCR, ELISA, and PRNT. Up to now, there is no specific antiviral medicine for the treatment of Zika infection and also no vaccine is available for immunization. As far as we know, more than half of the world’s people live in areas where the Aedes mosquito lives. There is a probability occurrence of the Zika virus epidemic at any time and in any place without prior notice in today’s “global village”. Therefore, health systems in all the involved countries should implement better triage and early warning surveillance systems for morbid cases of Zika to prevent large epidemics and the spread of the virus among mosquitoes and finally to avoid its disastrous consequences.

Jamal Ahmadzadeh, Kazhal MobarakiSocial Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, IranCorrespondence: Kazhal MobarakiEpidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences, Resalat Street, Urmia, IranTel +98 918 173 2869Fax +98 443 224 0642Email Mobaraki.k@umsu.ac.irPurpose: This study represents the current epidemiological status of Middle East respiratory syndrome coronavirus (MERS-CoV) worldwide in the first three months of 2019.Patients and methods: Full details of the MERS-CoV cases available and published in the disease outbreak news on the WHO website were retrieved. Related details of laboratory-confirmed MERS-CoV were extracted and analyzed by standard statistical methods.Results: A total of 107 cases of MERS-CoV, including 18 deaths (overall case fatality rate (CFR), 16.8%; male-specific CFR was 17.5% [14/80] and female-specific CFR was 14.8% [4/27]) were reported to WHO from the National International Health Regulation Focal Points of Saudi Arabia and Oman. The overall mean age was 50±17 years and 80 patients (74.8%) were male. The average time from the onset of the symptoms to the first hospitalization was 3±3.3 days; from the first hospitalization to laboratory confirmation was 3.6±6.5 days; from the onset of symptom to death was 17.5±11.7 days; and the mean length of hospitalization forpatients with MERS-CoV was 3.5±3.9 days. Males in comparison to females had a 1.5-fold increased chance (adjusted OR =1.5 [95% CI: 1.3–1.8]) of death related to MERS-CoV infection; 1.05 [95% CI: 1.1–3.3], 1.05 [95% CI: 1.2–2.8] and 1.06 [95% CI: 1.2–2.0] for those who had exposure to camels, camel milk consumption, and close contact with MERS-CoV cases, respectively. Health care workers had 2.4 fold [95% CI: 1.2–3.1] greater odds of death compared to other people.Conclusion: The knowledge obtained from this study can contribute to the development of a prevention program and early system warning against MERS-CoV infection.Keywords: Middle East respiratory syndrome coronavirus, emerging infectious disease, disease outbreaks

Zohre Foroozanfar,1 Maryam Zamanian,2 Rahmatollah Moradzadeh,2 Fatemeh Hajiabadi,1 Jamal Ahmadzadeh,3 Zahra Hosseinkhani4,5 1Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran; 2Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran; 3Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran; 4Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran. School of Health, Qazvin University of Medical Sciences, Qazvin, Iran; 5School of Health, Qazvin University of Medical Sciences, Qazvin, IranCorrespondence: Zahra HosseinkhaniMetabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, IranTel +98-9127801064Fax +98- 2833355162Email zhosseinkhani122@gmail.comIntroduction: Coronavirus disease 2019 (COVID-19) has now turned into a public health emergency. Isolation of patients is a possible solution for controlling epidemic infectious diseases. We assessed the compliance of isolation and associated factors among patients with COVID-19.Methods: This cross-sectional study was conducted on 320 COVID-19 patients discharged from hospitals of Qazvin province. Patients’ isolation, self-care health behaviors, reference to public health services and possible related factors were assessed. Data were analyzed using multiple logistic regression.Results: In this study, 320 patients were enrolled, including 175 men (54.7%). Two hundred and eighty-six patients (89.4%) had complete isolation. Factors such as phone tracking by health center (OR = 1.30; 95% CI: 1.01 to 1.75) and dry cough (OR = 2.36; 95% CI: 1.09 to 5.09) increased odds of complete isolation in COVID-19 patients, but having a COVID-19 patient in the family (OR = 0.32; 95% CI: 0.15 to 0.71) and symptoms of disease like shortness of breath (OR = 0.39; 95% CI: 0.18 to 0.85) and muscle pain (OR = 0.43; 95% CI: 0.20 to 0.95) decreased odds ratio for these patients.Conclusion: Phone tracking by the health center was the most important factor to increase the odds of patient isolation. Thus, the health system should consider improving health workers’ knowledge and skills through education.Keywords: COVID-19, isolation, self-care, compliance, Iran

Maryam Salamatbakhsh,1 Kazhal Mobaraki,2 Jamal Ahmadzadeh2 1Critical Care Nursing, Urmia University of Medical Sciences, Urmia, Iran; 2Epidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, IranCorrespondence: Jamal AhmadzadehEpidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences, Resalat Street, Urmia, IranTel +98-9143444924Fax +98-4432240642Email ahmadzadeh.j@umsu.ac.irAbstract: This commentary presents a novel outlook for public health authorities in the affected countries to detect and respond quickly to the emerging public health threats such as Middle East respiratory syndrome coronavirus (MERS-CoV). Implementing an innovative electronic surveillance system called syndromic surveillance system is essential for global health security.Keywords: syndromic surveillance system, traditional surveillance system, Middle East respiratory syndrome

As a result of the global crisis related to coronavirus disease 2019 (COVID-19), confusion, anxiety, fear, and some psychological effects have been created among the general population in this global village. Unfortunately, these factors have provoked inappropriate behavior converting the infection to the virus to a social stigma, which can affect the dignity of people died due to COVID-19. In addition to the patient, the stigma can also affect interpersonal relationship among nurses, family members, friends, as well as social relationships. In this critical situation, we need to take care of each other with empathy, which is the key to successfully cope with the issue and prevent social stigma associated with COVID-19. This commentary evaluates the effects of social stigma related to COVID-19 and suggests some practical measures for the world communities to deal with this global public health problem.

This commentary provides a quick overview to 2019 novel coronavirus (COVID-19) and other emerging viruses in recent decades. All the evidence related to emerging infections suggests that we are faced with unknown threats and challenges in the epidemiological and heath transition. The coronaviruses already identified such as severe acute respiratory syndrome coronavirus (SARS-COV), Middle East respiratory syndrome coronavirus (MERS-COV), and nowadays COVID-19, may only be the tips of the icebergs, and probably more novel and severe emerging infections might be revealed in the near future in the humans’ communities.

Background It has been 8 years since the first case of Middle East respiratory syndrome coronavirus (MERS-CoV) was reported in Saudi Arabia and the disease is still being reported in 27 countries; however, there is no international study to estimate the overall burden related of this emerging infectious disease. The present study was conducted to assess the burden of premature mortality due to Middle East respiratory syndrome (MERS) worldwide. Methods In this retrospective analysis, we have utilized publicly available data from the WHO website related to 1789 MERS patients reported between September 23, 2012 and May 17, 2019. To calculate the standard expected years of life lost (SEYLL), life expectancy at birth was set according to the 2000 global burden of disease study on levels 25 and 26 of West model life tables from Coale-Demeny at 82.5 and 80 years for females and males, respectively. Results Overall, the total SEYLL in males and females was 10,702 and 3817.5 years, respectively. The MERS patients within the age range of 30–59 year-olds had the highest SEYLL (8305.5 years) in comparison to the patients within the age groups 0–29 (SEYLL = 3744.5 years) and ≥ 60 years (SEYLL = 2466.5 years). The total SEYLL in all age groups in 2012, 2013, 2014, 2015, 2016, 2017, 2018, and 2019 were 71.5, 2006.5, 3162, 4425.5, 1809.5, 878, 1257.5 and 909 years, respectively. The most SEYLL related to MERS-CoV infection was in the early four years of the onset of the pandemic (2012 to 2015) and in the last four years of the MERS-CoV pandemic (216 to 2019), a significant reduction was observed in the SEYLL related to MERS-CoV infection in the MERS patients. Conclusion We believe that the findings of this study will shed light about the burden of premature mortality due to MERS infection in the world and the results may provide necessary information for policy-makers to prevent, control, and make a quick response to the outbreak of MERS-CoV disease.

Background Middle East respiratory syndrome coronavirus (MERS-CoV) is considered to be responsible for a new viral epidemic and an emergent threat to global health security. This study describes the current epidemiological status of MERS-CoV in the world. Methods Epidemiological analysis was performed on data derived from all MERS-CoV cases recorded in the disease outbreak news on WHO website between 1.1.2017 and 17.1.2018. Demographic and clinical information as well as potential contacts and probable risk factors for mortality were extracted based on laboratory-confirmed MERS-CoV cases. Results A total of 229 MERS-CoV cases, including 70 deaths (30.5%), were recorded in the disease outbreak news on world health organization website over the study period. Based on available details in this study, the case fatality rate in both genders was 30.5% (70/229) [32.1% (55/171) for males and 25.8% (15/58) for females]. The disease occurrence was higher among men [171 cases (74.7%)] than women [58 cases (25.3%)]. Variables such as comorbidities and exposure to MERS-CoV cases were significantly associated with mortality in people affected with MERS-CoV infections, and adjusted odds ratio estimates were 2.2 (95% CI: 1.16, 7.03) and 2.3 (95% CI: 1.35, 8.20), respectively. All age groups had an equal chance of mortality. Conclusions In today’s “global village”, there is probability of MERS-CoV epidemic at any time and in any place without prior notice. Thus, health systems in all countries should implement better triage systems for potentially imported cases of MERS-CoV to prevent large epidemics.

Objective The present study applied the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement to observational studies published in prestigious occupational medicine and health journals. Results A total of 60 articles was evaluated. All sub-items were reported in 63.74% (95% confidence interval [CI], 56.24–71.24%), not reported in 29.70% (95% CI, 20.2–39.2%), and not applicable in 6.56% (95% CI, 4.86–8.26%) of the studies. Of the 45 sub-items investigated in this survey, eight were reported 100% of the time, 13 were addressed in more than 90% of the articles, 22 were included in more than 75% of the studies, and 27 sub-items were applied in more than 50% of the articles published in the journals included in this study. Electronic supplementary material The online version of this article (10.1186/s13104-018-3367-9) contains supplementary material, which is available to authorized users.

Javad Aghazadeh-Attari,1 Behnam Mansorian,2 Mohammad Mirza-Aghazadeh-Attari,3 Jamal Ahmadzadeh,2 Iraj Mohebbi2 1Social Determinants of Health Research Center, Department of Neurosurgery, 2Social Determinants of Health Research Center, Occupational Medicine Center, Urmia University of Medical Sciences, Urmia, 3Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Background/objectives: Hearing loss (HL) is associated with certain diseases and affects health, resulting in a low quality of life. Some components of the metabolic syndrome (MetS) coincide with the risk factors for sensorineural hearing loss (SNHL). To date, very few studies have examined the link between MetS and HL. The aim of the current study was to try to understand the potential association between MetS and HL.Methods: Using Iranian health surveys of professional drivers, we enrolled 11,114 individuals aged 20–60years, whose main job is to operate a motor vehicle. We examined participants for the presence and absence of SNHL and the components of the MetS. Additionally, we investigated the relationship between MetS and the pure tone air conduction hearing thresholds of participants with SNHL, including low-frequency and high-frequency thresholds.Results: This cross-sectional study consisted of 11,114 participants: 3202 (28.81%) diagnosed with MetS and 7911 (71.18%) without and 2772 (24.94%) with SNHL and 8432 (75.86%) without. Participants with SNHL had a higher number of components of MetS (P

Risk factors associated with Middle East respiratory syndrome coronavirus (MERS-CoV) infection outcome were established by analyses of WHO data from September 23, 2012 to 18 June 2018. Of the 2220 reported cases, 1408 cases, including 451 MERS-CoV deaths, were analyzed. The case fatality rate was 32% (95% CI: 29.4–34.5). Compared to MERS patients ≤30 years old, those with >30 years had the adjusted odds ratio estimate for death of 2.38 [95% CI: 1.75–3.22]. This index was 1.43 [95% CI: 1.06–1.92] for Saudi patients in comparison to non-Saudi; 1.76 [95% CI: 1.39–2.22] for patient with comorbidity in comparison to those without comorbidity; 0.58 [95% CI: 0.44–0.75] for those who had close contact to a camel in the past 14 days and 0.42 [95% CI: 0.31–0.57] for patients with >14 days with onset of signs and hospital admission compared to patients with ≤14 days.