Demographic and Clinical Characteristics of Patients Who Died of Methanol Toxicity During COVID 19 Period in Loghman-e Hakim Hospital in Tehran
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 12 No. 1 (2022),
13 January 2022
,
Page 36171
https://doi.org/10.32598/ijmtfm.v12i1.36171
Abstract
Background: Outbreaks of methanol poisoning were observed during the COVID-19 pandemic. Acute methanol poisoning is a global crisis. Methanol can cause acute and fatal toxicity through metabolic acidosis. In the present study, we evaluated demographic, clinical, and paraclinical characteristics of patients who died in the recent outbreak of methanol poisoning in Tehran from March to April 2020.
Methods: This cross-sectional study was accomplished at the Loghman-Hakim Hospital in Tehran on 80 patients who died of methanol toxicity. Demographic, clinical, and laboratory data were collected retrospectively from the patient’s files and analyzed with appropriate statistical tests.
Results: Men were significantly more involved than women (%85 vs. %15). There were no significant differences between other characteristics of male and female patients, including the time between consumption to arrive hospital, dialysis sessions, pulse rate, respiratory rate, loss of consciousness, seizure, acute kidney injury, brain CT, and Intracerebral Hemorrhage ( ICH). Blood sugar, serum potassium, and liver function tests were higher than average in most of the patients.
Conclusion: Our study showed that this outbreak of methanol poisoning was due to the use of alcoholic drinks that contain methanol. Men were primarily affected that could be because of the cultural and social status of our country. The greater seizure probability in females could be because of enhancing the NMDA receptor by estrogen. Abnormalities in Alanine aminotransferase (ALT), Aspartate Aminotransferase (AST), and Prothrombin Time (PT) were seen in most patients, indicating liver damage. Misbeliefs about the protective effects of alcohol consumption against COVID-19 may lead many to consume poorly made alcohols that contain methanol and outbreaks of methanol intoxication.
- Methanol Toxicity
- COVID-19
- Metabolic Acidosis
- Formic acid
- Outbreak
How to Cite
References
Ravichandran R, Dudani RA, Almeida AF, Chawla KP, Acharya VN. Methyl alcohol poisoning. (Experience of an outbreak in Bombay). Journal of Postgraduate Medicine. 1984; 30(2):69-74. [PMID]
Divekar MV, Mamnani KV, Tendolkar UR, Bilimoria FR. Acute methanol poisoning: Report on a recent outbreak in Maharashtra. JAPI: Journal of the Association of Physicians of India. 1974; 22:477-83.
Kumar M, Kaeley N, Nagasubramanyam V, Bhardwaj BB, Kumar S, Kabi A, et al. Single center experience of managing methanol poisoning in the hilly state of Uttarakhand: A cross sectional study. International Journal of Critical Illness and Injury Science. 2019; 9(4):172-6. [DOI:10.4103/IJCIIS.IJCIIS_49_19] [PMID] [PMCID]
Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA. American Academy of Clinical Toxicology Ad Hoc committee on the treatment guidelines for methanol poisoning. American academy of clinical toxicology practice guidelines on the treatment of methanol poisoning. Journal of Toxicology: Clinical Toxicology. 2002; 40(4):415-46. [DOI:10.1081/clt-120006745] [PMID]
Doreen B, Eyu P, Okethwangu D, Biribawa C, Kizito S, Nakanwagi M, et al. Fatal methanol poisoning caused by drinking adulterated locally distilled alcohol: Wakiso district, Uganda, june 2017. Journal of Environmental and Public Health. 2020; 2020:5816162. [DOI:10.1155/2020/5816162] [PMID] [PMCID]
Kerns W, Tomaszewski C, McMartin K, Ford M, Brent J. META study group. Methylpyrazole for toxic alcohols. Formate kinetics in methanol poisoning. Journal of Toxicology: Clinical Toxicology. 2002; 40(2):137-43. [DOI:10.1081/clt-120004401] [PMID]
McMartin K, Jacobsen D, Hovda KE. Antidotes for poisoning by alcohols that form toxic metabolites. British Journal of Clinical Pharmacology. 2016; 81(3):505-15. [DOI:10.1111/bcp.12824] [PMID] [PMCID]
Sivilotti ML, Burns MJ, Aaron CK, McMartin KE, Brent J. Reversal of severe methanol-induced visual impairment: No evidence of retinal toxicity due to fomepizole. Journal of Toxicology: Clinical Toxicology. 2001; 39(6):627-31. [DOI:10.1081/clt-100108496] [PMID]
Chick J. Alcohol and COVID-19. Alcohol and Alcoholism (Oxford, Oxfordshire). 2020; 55(4):341–2. [DOI:10.1093/alcalc/agaa039]
Arasteh P, Pakfetrat M, Roozbeh J. [A surge in methanol poisoning amid COVID-19 pandemic: Why Is this occurring? (Persian)]. The American Journal of the Medical Sciences. 2020; 360(2):201. [DOI:10.1016/j.amjms.2020.05.019] [PMID] [PMCID]
Banagozar Mohammadi A, Delirrad M. [Problems with methanol poisoning outbreaks in Iran (Persian)]. Alcohol and Alcoholism. 2019; 54(3):338. [DOI:10.1093/alcalc/agz028] [PMID]
Chegeni M, Kamel Khodabandeh A, Karamouzian M, Shokoohi M, Abedi L, Khalili M, et al. [Alcohol consumption in Iran: A systematic review and meta-analysis of the literature (Persian)]. Drug and Alcohol Review. 2020; 39(5):525-38. [DOI:10.1111/dar.13093] [PMID]
Hovda KE, Hunderi OH, Tafjord AB, Dunlop O, Rudberg N, Jacobsen D. Methanol outbreak in Norway 2002-2004: Epidemiology, clinical features and prognostic signs. Journal of Internal Medicine. 2005; 258(2):181-90. [DOI:10.1111/j.1365-2796.2005.01521.x] [PMID]
Paasma R, Hovda KE, Tikkerberi A, Jacobsen D. Methanol mass poisoning in Estonia: Outbreak in 154 patients. Clinical Toxicology (Philadelphia). 2007; 45(2):152-7. [DOI:10.1080/15563650600956329] [PMID]
Zakharov S, Pelclova D, Urban P, Navratil T, Diblik P, Kuthan P, et al. Czech mass methanol outbreak 2012: Epidemiology, challenges and clinical features. Clinical Toxicology (Philadelphia). 2014; 52(10):1013-24. [DOI:10.3109/15563650.2014.974106] [PMID]
Mostafazadeh B, Eghbali H. [An epidemiologic study on methyl alcohol poisoning in Tehran, Iran (Persian)]. Asia Pacific Journal of Medical Toxicology. 2014; 3(Supplement1):8-8. [DOI:10.22038/apjmt.2014.2879]
Morteza Bagi HR, Tagizadieh M, Moharamzadeh P, Pouraghaei M, Kahvareh Barhagi A, Shahsavari Nia K. [Epidemiology of alcohol poisoning and its outcome in the north-west of Iran (Persian)]. Emergency. 2015; 3(1):27-32. [PMID] [PMCID]
Shokoohi M, Nasiri N, Sharifi H, Baral S, Stranges S. [A syndemic of COVID-19 and methanol poisoning in Iran: Time for Iran to consider alcohol use as a public health challenge? (Persian)]. Alcohol. 2020; 87:25-27. [DOI:10.1016/j.alcohol.2020.05.006] [PMID] [PMCID]
Singleton A. “ It’s because of the invincibility thing”: Young men, masculinity, and testicular cancer. International Journal of Men’s Health. 2008; 7(1). https://web.s.ebscohost.com/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jnl=15326306&AN=%3d31381756
O’Connor SE, Zupanc ML. Women and epilepsy. The Journal of Pediatric Pharmacology and Therapeutics. 2009; 14(4):212-20. [DOI:10.5863/1551-6776-14.4.212] [PMID] [PMCID]
Sanaei-Zadeh H, Esfeh SK, Zamani N, Jamshidi F, Shadnia S. [Hyperglycemia is a strong prognostic factor of lethality in methanol poisoning (Persian)]. Journal of Medical Toxicology. 2011; 7(3):189-94. [DOI:10.1007/s13181-011-0142-x] [PMID] [PMCID]
Mousavi-Roknabadi RS, Arzhangzadeh M, Safaei-Firouzabadi H, Mousavi-Roknabadi RS, Sharifi M, Fathi N, et al. Methanol poisoning during COVID-19 pandemic; A systematic scoping review. The American Journal of Emergency Medicine. 2022; 52:69-84. [DOI:10.1016/j.ajem.2021.11.026]
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