Post-discharge health assessment in survivors of coronavirus disease: a time-point analysis of a prospective cohort study.


Journal

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
ISSN: 1573-2649
Titre abrégé: Qual Life Res
Pays: Netherlands
ID NLM: 9210257

Informations de publication

Date de publication:
Sep 2023
Historique:
accepted: 30 03 2023
medline: 2 8 2023
pubmed: 7 5 2023
entrez: 7 5 2023
Statut: ppublish

Résumé

 The objective of this study was to quantitatively evaluate psychological and quality of life-related complications at three months following discharge in hospitalized coronavirus disease 2019 (COVID-19) patients during the pandemic in Iran. In this time-point analysis of prospective cohort study data, adult patients hospitalized with symptoms suggestive of COVID-19 were enrolled. Patients were stratified in analyses based on severity. The primary outcomes consisted of psychological problems and pulmonary function tests (PFTs) in the three months following discharge, with Health-related quality of life (HRQoL) as the secondary outcome. Exploratory predictors were determined for both primary and secondary outcomes. 283 out of 900 (30%) eligible patients were accessible for the follow-up assessment and included in the study. The mean age was 53.65 ± 13.43 years, with 68% experiencing a severe disease course. At the time of the final follow-up, participants still reported persistent symptoms, among which fatigue, shortness of breath, and cough were the most common. Based on the regression-adjusted analysis, lower levels of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) ratio was associated with higher levels of depression (standardized β = - 0.161 (SE = 0.042), P = 0.017) and stress levels (standardized β =- 0.110 (SE = 0.047), P = 0.015). Furthermore, higher levels of anti-SARS-CoV-2 immunoglobulin-M (IgM) were associated with significantly lower levels of depression (standardized β = - 0.139 (SE = 0.135), P = 0.031). There is an association between lung damage during COVID-19 and the reduction of pulmonary function for up to three months from acute infection in hospitalized patients. Varying degrees of anxiety, depression, stress, and low HRQoL frequently occur in patients with COVID-19. More severe lung damage and lower COVID-19 antibodies were associated with lower levels of psychological health.

Identifiants

pubmed: 37149817
doi: 10.1007/s11136-023-03415-z
pii: 10.1007/s11136-023-03415-z
pmc: PMC10163985
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2681-2693

Subventions

Organisme : Isfahan University of Medical Sciences
ID : IR.MUI.MED.REC.1399.517

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Références

Lee, A. (2020). Wuhan novel coronavirus (COVID-19): Why global control is challenging? Public Health, 179, A1-2.
doi: 10.1016/j.puhe.2020.02.001 pubmed: 32111295
Xiang, Y. T., Yang, Y., Li, W., et al. (2020). Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry, 7(3), 228–229.
doi: 10.1016/S2215-0366(20)30046-8 pubmed: 32032543 pmcid: 7128153
Lai, C. C., Shih, T. P., Ko, W. C., Tang, H. J., & Hsueh, P. R. (2020). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. International Journal of Antimicrobial Agents, 55(3), 105924.
doi: 10.1016/j.ijantimicag.2020.105924 pubmed: 32081636 pmcid: 7127800
Gamberini, L., Mazzoli, C. A., Sintonen, H., Colombo, D., Scaramuzzo, G., Allegri, D., Tonetti, T., Zani, G., Capozzi, C., Giampalma, E., Agnoletti, V., Becherucci, F., Bertellini, E., Castelli, A., Cappellini, I., Cavalli, I., Crimaldi, F., Damiani, F., Fusari, M., … Spadaro, S. (2021). ICU-RER COVID-19 Collaboration. Quality of life of COVID-19 critically ill survivors after ICU discharge: 90 days follow-up. Quality of Life Research, 30(10), 2805–2817. https://doi.org/10.1007/s11136-021-02865-7
doi: 10.1007/s11136-021-02865-7 pubmed: 33977415 pmcid: 8113006
Mirzaei, N., Jahanian Sadatmahalleh, S., Bahri Khomami, M., Moini, A., & Kazemnejad, A. (2021). Sexual function, mental health, and quality of life under strain of COVID-19 pandemic in Iranian pregnant and lactating women: A comparative cross-sectional study. Health and Quality of Life Outcomes, 19, 66.
doi: 10.1186/s12955-021-01720-0 pubmed: 33648521 pmcid: 7919992
Montazeri, A.L.I., Tavousi, M., Rakhshani, F., Azin, S.A., Jahangiri, K., Ebadi, M., Naderimagham, S., Solimanian, A., Sarbandi, F., Motamedi, A., & Sistani, M.M.N. (2014). Health Literacy for Iranian Adults (HELIA): Development and psychometric properties. Payesh (Health Monitor), 13(5), 589–599. http://payeshjournal.ir/browse.php?a_id=279&sid=1&slc_lang=en
Sami, R., Soltaninejad, F., Amra, B., Naderi, Z., Haghjooy Javanmard, S., Iraj, B., Haji Ahmadi, S., Shayganfar, A., Dehghan, M., Khademi, N., Sadat Hosseini, N., Mortazavi, M., Mansourian, M., Mañanas, M. A., Marateb, H. R., & Adibi, P. (2020). A one-year hospital-based prospective COVID-19 open-cohort in the Eastern Mediterranean region: The Khorshid COVID Cohort (KCC) study. PLoS ONE, 15(11), e0241537.
doi: 10.1371/journal.pone.0241537 pubmed: 33151983 pmcid: 7644058
Li, J., Zhang, K., Bao, J., Yang, J., & Wu, C. (2022). Potential mechanism of action of Jing Fang Bai Du San in the treatment of COVID-19 using docking and network pharmacology. International Journal of Medical Sciences, 19(2), 213–224.
doi: 10.7150/ijms.67116 pubmed: 35165507 pmcid: 8795796
Ai, T., Yang, Z., Hou, H., Zhan, C., Chen, C., Lv, W., et al. (2020). Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology, 296, 32–40.
doi: 10.1148/radiol.2020200642
Sami, R., Soltaninejad, F., Shayganfar, A., Mirfendereski, S., Mansourian, M., Khademi, N., Dehghan, M., Khorrami, Z., Jalali, S., & Mokhtari, Z. (2022). Severity of disease and COVID-19 complications during hospital stay: A prospective cohort study. Archives of Iranian Medicine, 25(6), 383–393.
doi: 10.34172/aim.2022.62 pubmed: 35943018
Montazeri, A., Goshtasebi, A., Vahdaninia, M., & Gandek, B. (2005). The Short Form Health Survey (SF-36): Translation and validation study of the Iranian version. Quality of Life Research, 14(3), 875–882. https://doi.org/10.1007/s11136-004-1014-5
doi: 10.1007/s11136-004-1014-5 pubmed: 16022079
Ell, K., Unützer, J., Aranda, M., Sanchez, K., & Lee, P.-J. (2005). Routine PHQ-9 depression screening in home health care: Depression, prevalence, clinical and treatment characteristics and screening implementation. Home Health Care Services Quarterly, 24, 1–19.
doi: 10.1300/J027v24n04_01 pubmed: 16446263 pmcid: 1421520
Taft, C., Karlsson, J., & Sullivan, M. (2001). Do SF-36 summary component scores accurately summarize subscale scores? Quality of Life Research, 10(5), 395–404. https://doi.org/10.1023/a:1012552211996
doi: 10.1023/a:1012552211996 pubmed: 11763202
Nguyen, H. C., Nguyen, M. H., Do, B. N., et al. (2020). People with suspected covid-19 symptoms were more likely depressed and had lower health-related quality of life: the potential benefit of health literacy. Journal of Clinical Medicine, 9(4), 965. https://doi.org/10.3390/jcm9040965
doi: 10.3390/jcm9040965 pubmed: 32244415 pmcid: 7231234
Kroenke, K., Spitzer, R. L., Williams, J. B., & Löwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32(4), 345–359. https://doi.org/10.1016/j.genhosppsych.2010.03.006
doi: 10.1016/j.genhosppsych.2010.03.006 pubmed: 20633738
Tapak, L., Cheraghi, F., Sadeghi, A., Shirmohammadi, N., & Feizybarnaji, A. (2022). Usefulness of the SF-36 Health Survey questionnaire in screening for health-related quality of life among parents of children with cancer: Latent profile analysis. Journal of Preventive Medicine and Hygiene, 63(1), 142–151. https://doi.org/10.15167/2421-4248/jpmh2022.63.1.2279
doi: 10.15167/2421-4248/jpmh2022.63.1.2279
Singh, D., Agusti, A., Anzueto, A., Barnes, P. J., Bourbeau, J., Celli, B. R., Criner, G. J., Frith, P., Halpin, D. M. G., Han, M., López Varela, M. V., Martinez, F., Montes de Oca, M., Papi, A., Pavord, I. D., Roche, N., Sin, D. D., Stockley, R., Vestbo, J., … Vogelmeier, C. (2019). Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: the GOLD science committee report 2019. European Respiratory Journal, 53(5), 1900164. https://doi.org/10.1183/13993003.00164-2019
doi: 10.1183/13993003.00164-2019 pubmed: 30846476
Zhao, Y. M., Shang, Y. M., Song, W. B., et al. (2020). Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery. EClinicalMedicine, 25, 100463.
doi: 10.1016/j.eclinm.2020.100463 pubmed: 32838236 pmcid: 7361108
Shah, A. S., Wong, A. W., Hague, C. J., et al. (2020). A prospective study of 12-week respiratory outcomes in COVID-19-related hospitalisations. Thorax. https://doi.org/10.1136/thoraxjnl-2020-216308
doi: 10.1136/thoraxjnl-2020-216308 pubmed: 33273023
Carfì, A., Bernabei, R., & Landi, F. (2020). Gemelli against COVID-19 post-acute care study group persistent symptoms in patients after acute COVID-19. JAMA, 324(6), 603–605. https://doi.org/10.1001/jama.2020.12603
doi: 10.1001/jama.2020.12603 pubmed: 32644129 pmcid: 7349096
Barman, M. P., Rahman, T., Bora, K., & Borgohain, C. (2020). COVID-19 pandemic and its recovery time of patients in India: A pilot study. Diabetes & Metabolic Syndrome, 14(5), 1205–1211. https://doi.org/10.1016/j.dsx.2020.07.004
doi: 10.1016/j.dsx.2020.07.004
Xiong, Q., Xu, M., Li, J., Liu, Y., Zhang, J., Xu, Y., & Dong, W. (2021). Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clinical Microbiology and Infection, 27(1), 89–95. https://doi.org/10.1016/j.cmi.2020.09.023
doi: 10.1016/j.cmi.2020.09.023 pubmed: 32979574
Arnold, D. T., Hamilton, F. W., Milne, A., Morley, A. J., Viner, J., Attwood, M., Noel, A., Gunning, S., Hatrick, J., Hamilton, S., Elvers, K. T., Hyams, C., Bibby, A., Moran, E., Adamali, H. I., Dodd, J. W., Maskell, N. A., & Barratt, S. L. (2021). Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax, 76(4), 399–401. https://doi.org/10.1136/thoraxjnl-2020-216086
doi: 10.1136/thoraxjnl-2020-216086 pubmed: 33273026
Huang, L., Yao, Q., Gu, X., Wang, Q., Ren, L., Wang, Y., Hu, P., Guo, L., Liu, M., Xu, J., Zhang, X., Qu, Y., Fan, Y., Li, X., Li, C., Yu, T., Xia, J., Wei, M., Chen, L., … Cao, B. (2021). 1-year outcomes in hospital survivors with COVID-19: A longitudinal cohort study. Lancet, 398(10302), 747–758. https://doi.org/10.1016/S0140-6736(21)01755-4
doi: 10.1016/S0140-6736(21)01755-4 pubmed: 34454673 pmcid: 8389999
Hui, D. S., Wong, K. T., Ko, F. W., Tam, L. S., Chan, D. P., Woo, J., & Sung, J. J. (2005). The 1-year impact of severe acute respiratory syndrome on pulmonary function, exercise capacity, and quality of life in a cohort of survivors. Chest, 128(4), 2247–2261. https://doi.org/10.1378/chest.128.4.2247
doi: 10.1378/chest.128.4.2247 pubmed: 16236881
Ngai, J. C., Ko, F. W., Ng, S. S., To, K. W., Tong, M., & Hui, D. S. (2010). The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology, 15(3), 543–550. https://doi.org/10.1111/j.1440-1843.2010.01720.x
doi: 10.1111/j.1440-1843.2010.01720.x pubmed: 20337995 pmcid: 7192220
Hui, D. S., Joynt, G. M., Wong, K. T., Gomersall, C. D., Li, T. S., Antonio, G., Ko, F. W., Chan, M. C., Chan, D. P., Tong, M. W., Rainer, T. H., Ahuja, A. T., Cockram, C. S., & Sung, J. J. (2005). Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax, 60(5), 401–409. https://doi.org/10.1136/thx.2004.030205
doi: 10.1136/thx.2004.030205 pubmed: 15860716 pmcid: 1758905
Su, M. C., Hsieh, Y. T., Wang, Y. H., Lin, A. S., Chung, Y. H., & Lin, M. C. (2007). Exercise capacity and pulmonary function in hospital workers recovered from severe acute respiratory syndrome. Respiration, 74, 511–516.
doi: 10.1159/000095673 pubmed: 16960439
Tsai, L. K., Hsieh, S. T., Chao, C. C., et al. (2004). Neuromuscular disorders in severe acute respiratory syndrome. Archives of Neurology, 61, 1669–1673.
doi: 10.1001/archneur.61.11.1669 pubmed: 15534177
Huang, C., Huang, L., Wang, Y., Li, X., Ren, L., Gu, X., Kang, L., Guo, L., Liu, M., Zhou, X., Luo, J., Huang, Z., Tu, S., Zhao, Y., Chen, L., Xu, D., Li, Y., Li, C., Peng, L., … Cao, B. (2021). 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet, 397(10270), 220–232. https://doi.org/10.1016/S0140-6736(20)32656-8
doi: 10.1016/S0140-6736(20)32656-8 pubmed: 33428867 pmcid: 7833295
Lerum, T. V., Aaløkken, T. M., Brønstad, E., Aarli, B., Ikdahl, E., Lund, K. M. A., Durheim, M. T., Rodriguez, J. R., Meltzer, C., Tonby, K., Stavem, K., Skjønsberg, O. H., Ashraf, H., & Einvik, G. (2021). Dyspnoea, lung function and CT findings 3 months after hospital admission for COVID-19. European Respiratory Journal, 57(4), 2003448. https://doi.org/10.1183/13993003.03448-2020
doi: 10.1183/13993003.03448-2020 pubmed: 33303540
Ramani, C., Davis, E. M., Kim, J. S., Provencio, J. J., Enfield, K. B., & Kadl, A. (2021). Post-ICU COVID-19 Outcomes: A case series. Chest, 159(1), 215–218. https://doi.org/10.1016/j.chest.2020.08.2056
doi: 10.1016/j.chest.2020.08.2056 pubmed: 32835708
Guler, S. A., Ebner, L., Aubry-Beigelman, C., Bridevaux, P. O., Brutsche, M., Clarenbach, C., Garzoni, C., Geiser, T. K., Lenoir, A., Mancinetti, M., Naccini, B., Ott, S. R., Piquilloud, L., Prella, M., Que, Y. A., Soccal, P. M., von Garnier, C., & Funke-Chambour, M. (2021). Pulmonary function and radiological features 4 months after COVID-19: First results from the national prospective observational Swiss COVID-19 lung study. European Respiratory Journal, 57(4), 2003690. https://doi.org/10.1183/13993003.03690-2020
doi: 10.1183/13993003.03690-2020 pubmed: 33419891
de Graaf, M. A., Antoni, M. L., Ter Kuile, M. M., Arbous, M. S., Duinisveld, A. J. F., Feltkamp, M. C. W., Groeneveld, G. H., Hinnen, S. C. H., Janssen, V. R., Lijfering, W. M., Omara, S., Postmus, P. E., Ramai, S. R. S., Rius-Ottenheim, N., Schalij, M. J., Schiemanck, S. K., Smid, L., Stöger, J. L., Visser, L. G., … Roukens, A. H. E. (2021). Short-term outpatient follow-up of COVID-19 patients: A multidisciplinary approach. EClinicalMedicine, 32, 100731. https://doi.org/10.1016/j.eclinm.2021.100731
doi: 10.1016/j.eclinm.2021.100731 pubmed: 33532720 pmcid: 7843037
Bellan, M., Soddu, D., Balbo, P. E., Baricich, A., Zeppegno, P., Avanzi, G. C., Baldon, G., Bartolomei, G., Battaglia, M., Battistini, S., Binda, V., Borg, M., Cantaluppi, V., Castello, L. M., Clivati, E., Cisari, C., Costanzo, M., Croce, A., Cuneo, D., … Pirisi, M. (2021). Respiratory and psychophysical sequelae among patients with COVID-19 four months after hospital discharge. JAMA Network Open, 4(1), e2036142. https://doi.org/10.1001/jamanetworkopen.2020.36142
doi: 10.1001/jamanetworkopen.2020.36142 pubmed: 33502487 pmcid: 7841464
Gamberini, L., Mazzoli, C. A., Prediletto, I., Sintonen, H., Scaramuzzo, G., Allegri, D., Colombo, D., Tonetti, T., Zani, G., Capozzi, C., Dalpiaz, G., Agnoletti, V., Cappellini, I., Melegari, G., Damiani, F., Fusari, M., Gordini, G., Laici, C., Lanza, M. C., … Spadaro, S. (2021). Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study. Respiratory Medicine, 189, 106665. https://doi.org/10.1016/j.rmed.2021.106665
doi: 10.1016/j.rmed.2021.106665 pubmed: 34717097 pmcid: 8531241
Xie, Y., Xu, E., & Al-Aly, Z. (2022). Risks of mental health outcomes in people with covid-19: Cohort study. BMJ, 16(376), e068993. https://doi.org/10.1136/bmj-2021-068993
doi: 10.1136/bmj-2021-068993
Rogers, J. P., Chesney, E., Oliver, D., Pollak, T. A., McGuire, P., Fusar-Poli, P., Zandi, M. S., Lewis, G., & David, A. S. (2020). Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: A systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry, 7(7), 611–627. https://doi.org/10.1016/S2215-0366(20)30203-0
doi: 10.1016/S2215-0366(20)30203-0 pubmed: 32437679 pmcid: 7234781
Taquet, M., Geddes, J. R., Husain, M., Luciano, S., & Harrison, P. J. (2021). 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry, 8(5), 416–427. https://doi.org/10.1016/S2215-0366(21)00084-5
doi: 10.1016/S2215-0366(21)00084-5 pubmed: 33836148 pmcid: 8023694
Yang, A. C., Kern, F., Losada, P. M., Agam, M. R., Maat, C. A., Schmartz, G. P., Fehlmann, T., Stein, J. A., Schaum, N., Lee, D. P., Calcuttawala, K., Vest, R. T., Berdnik, D., Lu, N., Hahn, O., Gate, D., McNerney, M. W., Channappa, D., Cobos, I., … Wyss-Coray, T. (2021). Dysregulation of brain and choroid plexus cell types in severe COVID-19. Nature, 595(7868), 565–571. https://doi.org/10.1038/s41586-021-03710-0
doi: 10.1038/s41586-021-03710-0 pubmed: 34153974 pmcid: 8400927
Panigada, M., Bottino, N., Tagliabue, P., Grasselli, G., Novembrino, C., Chantarangkul, V., Pesenti, A., Peyvandi, F., & Tripodi, A. (2020). Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis. Journal of Thrombosis and Haemostasis, 18(7), 1738–1742. https://doi.org/10.1111/jth.14850
doi: 10.1111/jth.14850 pubmed: 32302438 pmcid: 9906150
Meinhardt, J., Radke, J., Dittmayer, C., Franz, J., Thomas, C., Mothes, R., Laue, M., Schneider, J., Brünink, S., Greuel, S., Lehmann, M., Hassan, O., Aschman, T., Schumann, E., Chua, R. L., Conrad, C., Eils, R., Stenzel, W., Windgassen, M., … Heppner, F. L. (2021). Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nature Neuroscience, 24(2), 168–175. https://doi.org/10.1038/s41593-020-00758-5
doi: 10.1038/s41593-020-00758-5 pubmed: 33257876
Townsend, E. (2020). COVID-19 policies in the UK and consequences for mental health. Lancet Psychiatry, 7(12), 1014–1015. https://doi.org/10.1016/S2215-0366(20)30457-0
doi: 10.1016/S2215-0366(20)30457-0 pubmed: 33069273 pmcid: 7561293
Goodwin, R. D., Chuang, S., Simuro, N., Davies, M., & Pine, D. S. (2007). Association between lung function and mental health problems among adults in the United States: Findings from the first national health and nutrition examination survey. American Journal of Epidemiology, 165(4), 383–388. https://doi.org/10.1093/aje/kwk026
doi: 10.1093/aje/kwk026 pubmed: 17158187
O’Leary, C. J., Wilson, C. B., Hansell, D. M., Cole, P. J., Wilson, R., & Jones, P. W. (2002). Relationship between psychological well-being and lung health status in patients with bronchiectasis. Respiratory Medicine, 96(9), 686–692. https://doi.org/10.1053/rmed.2002.1330
doi: 10.1053/rmed.2002.1330 pubmed: 12243314
Liu, L., To, K. K., Chan, K. H., Wong, Y. C., Zhou, R., Kwan, K. Y., Fong, C. H., Chen, L. L., Choi, C. Y., Lu, L., Tsang, O. T., Leung, W. S., To, W. K., Hung, I. F., Yuen, K. Y., & Chen, Z. (2020). High neutralizing antibody titer in intensive care unit patients with COVID-19. Emerging Microbes & Infections, 9(1), 1664–1670. https://doi.org/10.1080/22221751.2020.1791738
doi: 10.1080/22221751.2020.1791738
Wang, E. Y., Mao, T., Klein, J., Dai, Y., Huck, J. D., Jaycox, J. R., Liu, F., Zhou, T., Israelow, B., Wong, P., Coppi, A., Lucas, C., Silva, J., Oh, J. E., Song, E., Perotti, E. S., Zheng, N. S., Fischer, S., Campbell, M., & Ring, A. M. (2021). Diverse functional autoantibodies in patients with COVID-19. Nature, 595(7866), 283–288. https://doi.org/10.1038/s41586-021-03631-y
doi: 10.1038/s41586-021-03631-y pubmed: 34010947

Auteurs

Ramin Sami (R)

Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Sina Arabi (S)

Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Khojasteh Ghasemi (K)

Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, 81746-73461, Iran.

Mahsa Akafzadeh (M)

Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Sara Ebrahimi (S)

Alzahra Research Institute, Alzahra University Hospital Isfahan University of Medical Sciences, Isfahan, Iran.

Arash Toghyani (A)

School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Razieh Mahvari (R)

Department of Clinical Toxicology, School of Medicine, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Reza Moayednia (R)

Arya Medical Lab Institute, Isfahan, Iran.

Seyed Amir Dadkhahi (SA)

Amin Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Sara Sadeghi (S)

School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Hamid Reza Marateb (HR)

Biomedical Engineering Research Centre (CREB), Automatic Control Department (ESAII), Universitat Politècnica de Catalunya-Barcelona, 08028, Barcelona, Spain.

Peyman Adibi (P)

Isfahan Gastroenterology and Hepatology Research Center, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Aryan Kavosh (A)

School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Marjan Mansourian (M)

Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, 81746-73461, Iran. marjan.mansourian@upc.edu.
Biomedical Engineering Research Centre (CREB), Automatic Control Department (ESAII), Universitat Politècnica de Catalunya-Barcelona, 08028, Barcelona, Spain. marjan.mansourian@upc.edu.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH