Original Article


Clinical, Laboratory, and Obstetrics Features of Novel Coronavirus Disease 2019 (COVID-19) during Pregnancy

Yekta Parsa, Nazila Shokri, Faranak Rafiee, Zahra Naeiji, Tayebeh Jahedbozorgan , Shahrzad Zadehmodares, Atefeh Moridi

Novelty in Biomedicine, Vol. 10 No. 2 (2022), 9 May 2022, Page 93-100
https://doi.org/10.22037/nbm.v10i2.36143

Background: The novel coronavirus disease 2019 (COVID-19) remains a new entity; the data on its clinical features, complications, and adverse outcomes during pregnancy are still to be identified and described. Several studies have reported a series of COVID-19 infections in pregnancy, the maternal and the neonatal outcome from different ethnicities and geographical regions.

Materials and Methods: This retrospective cross-sectional study was conducted in the obstetrics department of Mahdiyeh Hospital of Tehran, Iran, between February and April 2020. We included a series of 23 singleton pregnancies presenting to our department with fever and dry cough. All patients were tested for COVID-19 infection using nasopharyngeal swabs.

Results: We included 23 singleton pregnant patients with a mean age of 28.1 ± 6.16 (ranging from 15 to 39) years and gestational age of 29.96±10.2 [ranging from 7 to 40] weeks. Of these patients, 7 (30.4%) tested positive for the SARS‑CoV‑2. Among the total patient population, 16 (69.5%) had elevated serum levels of C-reactive protein (CRP), 1 [4.3%] had lymphopenia, and 8 (34.7%) had elevated erythrocyte sedimentation rate (ESR). Only 2 (8.7%) patients had positive findings of chest CT-scan. Most newborns had acceptable Apgar and birth weight, and only 4 (17.4%) required NICU admission.

Conclusion: The clinical characteristics of the COVID-19 infection in pregnant patients were comparable to those of non-pregnant patients. We did not record a high frequency of lymphopenia and leukopenia, probably due to leukocytosis during pregnancy. CRP was a sensitive marker for COVID-19 pneumonia in pregnant patients.

The Effect of Rosuvastatin on the Liver Enzyme of NMRI Mouse

Atena Nehzati Asl, Azadeh Rasooli, Maryam Fazeli, Mehranoush Saffarpour

Novelty in Biomedicine, Vol. 10 No. 2 (2022), 9 May 2022, Page 101-106
https://doi.org/10.22037/nbm.v10i2.30759

Background: Rosuvastatin is the newest statin family drug and acts as an HMG-CoA reductase inhibitor. Rosuvastatin can decrease the amount of cholesterol made by the liver and reduce the risk of heart disease. Since liver diseases are one of the significant causes of morbidity and mortality due to drugs toxicity, it is essential to check the liver’s function during widely used drugs such as rosuvastatin. Therefore, this study aimed to investigate the effect of rosuvastatin on the liver in the mature female NMRI mouse strain.

Materials and Methods: In this experimental study, 30 adult female NMRI strains (mice) at a mean weight of 25-30 grams were divided into five groups control, sham, and treatment groups. The mice of treated groups, including 1, 2, and 3, received rosuvastatin in doses of 10, 20, and 40 mg/Kg of body mass by oral gavage for 21 days. The mice in all groups were dissected after completing the gavage, their hearts were examined, and blood samples were obtained to measure liver enzymes. Then, the mice were sacrificed, and the liver tissue was subjected to antioxidant enzymes. The ELISA test measured the concentrations of the antioxidant and liver enzymes.

Results: The results showed that rosuvastatin decreased GPX, MDA, and FRAP with an increase in SOD, AST, and ALT (P<0.05).

Conclusion: It was concluded that high doses of rosuvastatin could damage the liver.

Echocardiographic Findings of ICU-Admitted COVID-19 Patients: a Multicenter Retrospective Study

Hossein Hatami, Mohammad Ali Akbarzadeh, Latif Gachkar, Amirreza Keyvanfar

Novelty in Biomedicine, Vol. 10 No. 2 (2022), 9 May 2022, Page 107-114
https://doi.org/10.22037/nbm.v10i2.36825

Background: The coronavirus disease 2019 (COVID-19) pandemic has left many victims and caused many problems for the healthcare systems of different countries. Many COVID-19 patients have cardiovascular complications, which are detectable using echocardiography. This study aimed to determine the echocardiographic findings and their association with mortality in an intensive care unit (ICU)-admitted COVID-19 patients.

Materials and Methods: In this retrospective study, COVID-19 patients admitted to the ICU of four hospitals in Tehran, Iran, from April 2020 to March 2021 were recruited. Data were collected by the census method. We reviewed the medical records regarding demographic features, clinical history, laboratory results, and echocardiographic findings. Finally, variables were compared regarding disease outcomes at the end of hospitalization. We used the Chi-square test, Fishers exact test, independent-samples t-test, and logistic regression model to analyze the data.

Results: This study showed that the mean age of 629 COVID-19 patients was 66.42±14.53 years. Overall, 56.8% of the patients were male. Multivariate regression analysis showed that age (OR=1.03; 95% CI: 1.01-1.05), left ventricular ejection fraction (OR=0.95; 95% CI: 0.92-0.98), and systolic pulmonary arterial pressure (OR=1.12; 95% CI: 1.06-1.18) were predictors of mortality.

Conclusion: Cardiovascular involvement is prevalent among critically ill COVID-19 patients. Among echocardiographic findings, EF and s-PAP were significantly associated with the disease outcomes.

The effect of L-carnitine on Oocyte Mitochondrial Activity after Cryopreservation

Maryam Hosseinzadeh Shirzeyli, Bita Pourkaveh, Saman Ayoubi, Zahra Shams Mofarahe

Novelty in Biomedicine, Vol. 10 No. 2 (2022), 9 May 2022, Page 115-120
https://doi.org/10.22037/nbm.v10i2.36138

Background: Mitochondria are cellular organelles required for energy production, vital to reproduction, especially oocyte maturation and fertilization. It has been seen that oocyte cryopreservation (OC) can cause mitochondria damage, aggregation of lipid droplets near mitochondria and endoplasmic reticulum, and cryoinjury. In recent studies use of antioxidants such as L- carnitine can increase the number of active mitochondria and decrease intracellular ROS levels. The present study aimed to determine the beneficial effect of L –carnitine on oocyte mitochondrial activity after vitrification.

Materials and Methods: In the present experimental study, 6-8 weeks of female NMRI mice were taken from the Royan Institute of Iran and stimulated with 7.5 IU Pregnant Mare Serum Gonadotrophin (PMSG) and 10 IU of human chorionic gonadotropin (HCG) after 48 hours was injected. After stimulation, oocytes were collected, and MII oocytes were selected. A two-step vitrification procedure was done, and 0.6mg/ml of L –carnitine was added to both ES and VS mediums. After two weeks, oocyte thawing was performed, intracellular GSH level was also measured mitochondrial membrane potential was measured. Captured images were analyzed by J software (Version 1.40; and obtained data were analyzed using SPSS Ver.20.

Results: Average difference in intracytoplasmic GSH level in the study group was significantly higher than the control group (P<0.001). So, L –carnitine could successfully increase the oocyte intracytoplasmic GSH level. Also, it has been seen that the LC supplement could successfully grow oocyte mitochondrial function and subsequent mitochondrial membrane potentials(P<0.001).

Conclusion: Adding LC to the cryopreservation media could increase mitochondrial activity, GSH level, and mitochondrial membrane potentials. Adding LC to the cryopreservation could enjoy the beneficial effect of L –carnitine on oocyte mitochondrial activity after vitrification and minimize mitochondrial damage and boost oocyte quality which can lead to successful fertilization and embryo growth.

Review Article


Toxoplasmosis in Patients with Cardiac Disorders: a Systematic Review and Meta-Analysis

Sasan Khazaei, Negar Asadi, Hamidreza Majidiani, Masoud Foroutan, Hamidreza Khalkhali, Khosrow Hazrati-Tappeh, Kamal Khademvatan, Elham Yousefi, Shahram Khademvatan

Novelty in Biomedicine, Vol. 10 No. 2 (2022), 9 May 2022, Page 121-127
https://doi.org/10.22037/nbm.v10i2.36294

Toxoplasmosis is a common and serious infection caused by an obligatory intracellular protozoan, Toxoplasma gondii. This study investigated the possible association between heart failure and toxoplasmosis. We searched for toxoplasmosis and heart failure patients in English databases including PubMed, Scopus, ISI Web of Sciences, Science Direct, EMBASE, and Google Scholar up to June 2018. A total of 6 studies and 1,795 participants, comprising 934 cases and 861 controls, had acceptable criteria for entering the study. Im­munoglobulin G (IgG) antibodies against T. gondii were found in 53% (22 to 83) of patients with heart diseases and 26% (11 to 42) of healthy controls. In comparison, immunoglobulin M (IgM) antibodies were found in 0.5% (0.1 to 1) in patients with heart diseases and 0.3% (0 to 0.7) of healthy controls. The patients suffering from cardiac disorders were more significantly correlated to anti-T. gondii IgG (OR: 3.53; 95% CI, 2.27 to 5.47; P = 0.014) and IgM (OR: 1.80; 95% CI, 0.31 to 10.4; P = 0.028) seropositivity than healthy controls. Despite limitations such as the low number of studies, our research showed a high association between toxoplasmosis and cardiac disorders. Therefore, toxoplasmosis may be a risk factor in cardiac patients, and more studies are being done.

Use of Complementary Medicine in SARS-CoV-2 and MERS-CoV: a Narrative Review

Maryam Rahmannia, Marzieh Gholampoor, Narges Ketabchi, Leila Miri, Shabboo Ansari, Maryam Fallah, Zainab MohieAldeen, Zaynab Nassereldine, Elnaz Ghafoori, Zaynab Ghashamy, Hossein Goudarzi, Seyyed Mohammad Javad Mousavi, Mohammad Javad Nasiri

Novelty in Biomedicine, Vol. 10 No. 2 (2022), 9 May 2022, Page 128-139
https://doi.org/10.22037/nbm.v10i2.36761

Severe acute respiration syndrome coronavirus 2 (SARS-CoV-2) is characterized by severe cytokine storm syndrome following inflammation. SARS-CoV-2 is the 7th coronavirus that causes infection in human bodies; SARS-CoV, MERS-CoV, and SARS-CoV-2 can purpose severe diseases. SARS-CoV-2 at once interacts with angiotensin-converting enzyme 2 (ACE-2) receptors inside the body and causes respiratory problems. Interestingly, complementary medicines and herbal drugs affect the expression of IgE and IgG antibodies and improve the immune system; for that reason, complementary medicine could be beneficial for infectious diseases like SARS-COV-2. In this review, we assessed some related articles to evaluate the effect of complementary medicine on SARS-COV2 and MERS-COV.

Letter to editor


Management of Molar Pregnancy During COVID-19 Pandemic

Yekta Parsa, Nazila Shokri, Pedram Keshavarz, Atefeh Moridi

Novelty in Biomedicine, Vol. 10 No. 2 (2022), 9 May 2022, Page 140-141
https://doi.org/10.22037/nbm.v10i2.36722

Molar pregnancy is a group of diseases called gestational trophoblastic disease (GTD) that originates in the placenta and has the potential to invade the uterus and metastasize locally1, 2. During the past months, the novel coronavirus disease 2019 (COVID-19) has been responsible for the worldwide pandemic3 Patients usually go to the hospital only if they need high emergency aid or have a high-risk condition in this quarantine situation. Hence, this situation can impact diagnosing and managing benign and malignant molar pregnancy, and the diagnosis might be delayed.

A Potential Role of Cytomegalovirus Reactivation in the Severity of COVID-19 in the Elderly

Shabnam Tehrani, Amirreza Keyvanfar

Novelty in Biomedicine, Vol. 10 No. 2 (2022), 9 May 2022, Page 142-143
https://doi.org/10.22037/nbm.v10i2.37474

In late 2019, severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) was reported in Wuhan, China. This virus spread quickly worldwide, with millions of victims until now. The clinical manifestations of the novel coronavirus disease (COVID-19) are a broad spectrum, from asymptomatic and mild cases with a flu-like syndrome to severe cases requiring intensive care1.

The severity of diseases and risk of mortality is higher in the elderly, which most authorities attribute to underlying conditions, including diabetes, hypertension, cardiovascular diseases, and respiratory diseases. However, some neglected factors, such as cytomegalovirus (CMV) reactivation, can affect patient outcomes2.

Correction


The authors regret that in the published version of the above-mentioned paper we have wrongly entered the affiliation (1). The correct first affiliation is "Medicine Faculty, Yazd Branch, Islamic Azad University, Yazd, Iran". The authors would like to apologize for any inconvenience caused.