Coronavirus Disease 2019 In Iran Research Articles

Public Preference for Financing Preventive Vaccines in Health Shocks: The Case of COVID-19 Vaccines in a Middle-Income Country.

To effectively manage health crises such as disease pandemics, health authorities require reliable information regarding people's preferences. This helps to ensure timely and targeted interventions and avoids increasing societal costs through developing evidence-based policies. This study investigates the Iranian people's preference for financing coronavirus disease 2019 (COVID-19) vaccines and the factors affecting this. A cross-sectional survey was performed during the third-wave peak of COVID-19 in Iran from 1 to 20 February 2021 utilizing various data collection methods. The public preference regarding imported and domestically produced vaccines, their willingness to fully or partially contribute to the financing of these vaccines, and their willingness to pay (WTP) for domestically produced vaccines using the contingent valuation method was assessed in different scenarios. The determinants of the probability of positive financing preferences were evaluated using an ordered probit regression model. Among the 2071 survey respondents, approximately 60% stated willingness to contribute to vaccine financing in the form of partial or full user fee payments. Forty percent of respondents are willing to be vaccinated if it is provided for free by the government. Interestingly, people's preference for financing the vaccine was not related to the type of vaccine. The regression analysis showed that income, having supplementary insurance, being male, perceived COVID-19 risk, education, and working in the health sector are significantly related to a higher probability of contribution to vaccine financing. Regardless of country of origin of COVID-19 vaccines, vaccination is very important for the Iranian people, and the majority of respondents in our study showed an inclination to contribute to vaccine funding, from partial to full user fees, to achieve higher protection against COVID-19 disease. Hence, ensuring timely access to vaccines during health crises such as pandemics is imperative, as it saves lives and reduces the economic burden of disease. This commitment from the health system can be supported by financial contributions from the general public. In this regard, considering public preferences is strongly advised to policymakers.

Blood Features Associated with Viral Infection Severity: An Experience from COVID-19-Pandemic Patients Hospitalized in the Center of Iran, Yazd.

Pandemics such as coronavirus disease 2019 (COVID-19) can manifest as systemic infections that affect multiple organs and show laboratory manifestations. We aimed to analyze laboratory findings to understand possible mechanisms of organ dysfunction and risk stratification of hospitalized patients in these epidemics. Methods. This retrospective study was conducted among patients admitted to COVID-19 referral treatment center, Shahid Sadoughi Hospital, Yazd, Iran, from April 21 to November 21, 2021. It was the fifth peak of COVID-19 in Iran, and Delta (VOC-21APR-02; B.1-617.2) was the dominant and most concerning strain. All cases were positive for COVID-19 by RT-PCR test. Lab information of included patients and association of sex, age, and outcome were analyzed, on admission. Results. A total of 466 COVID-19 patients were included in the study, the majority of whom were women (68.9%). The average age of hospitalized patients in male and female patients was 57.68 and 41.32 years, respectively (p < 0.01). During hospitalization, abnormality in hematological and biochemical parameters was significant and was associated with the outcome of death in patients. There was incidence of lymphopenia, neutrophilia, anemia, and thrombocytopenia. The changes in neutrophil/lymphocyte (N/L) and hematocrit/albumin (Het/Alb) ratio and potassium and calcium levels were significant. Conclusion. Based on these results, new biochemical and hematological parameters can be used to predict the spread of infection and the underlying molecular mechanism. Viral infection may spread through blood cells and the immune system.

Estimating the disability adjusted life years associated with COVID-19 in Iran for the first 2 years of the pandemic.

The World Health Organization (WHO) declared a pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on 11 March 2020. Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population. The purpose of this study was to estimate DALYs due to COVID-19 in Iran for the first 2 years of the pandemic. DALYs were estimated as the sum of Years of Life Lost (YLLs) and Years Lived with Disability (YLDs) associated with COVID-19 in Iran from 19 February 2020 to 20 March 2022. The life expectancy for COVID-19 YLL estimations was based on the Global Burden of Disease (GBD) 2019 study. There were 15,639,243 outpatients and 1,170,602 hospitalized confirmed cases, of which 120,965 deaths were as a direct result of COVID-19. DALYs were estimated to be 2,376,552. Overall, YLL contributed to 99.34% of the DALYs, while the remaining 0.66% was attributed to YLD. COVID-19 had a significant impact on population health in Iran during the first 2 years of the pandemic; this study provides a comprehensive depiction of COVID-19's burden and is helpful for comparing its impact with other diseases in the population and across populations.

Professional Quality of Life (QoL) Among Medical Interns in Hospitals Affiliated to Guilan University of Medical Sciences During the COVID-19 Pandemic

Background: The coronavirus disease 2019 (COVID-19) pandemic led to depression, stress and mental health problems in medical students working in hospitals. Objective: The present study aims to evaluate the professional quality of life (QoL) of medical interns in Rasht, Iran during the COVID-19 pandemic. Methods: This cross-sectional study was conducted on 152 medical interns working in hospitals affiliated to Guilan University of Medical Sciences in 2020. The professional QoL was assessed using the professional quality of life scale (ProQOL). Results: The mean scores of compassion satisfaction, burnout, and secondary traumatic stress were 38.4±8.3, 30.9±5.4, and 25.3±7.5, respectively. Compassion satisfaction had a significant relationship with marital status, history of underlying diseases, being resident of the city, and work shift duration. Conclusion: The professional QoL of medical interns in Rasht is low. Considering the differences in the spread of COVID-19 in Iran, it is necessary to conduct more study in other cities and on other medical trainees.

Burden of COVID‐19 disease in Kurdistan province in west of Iran using disability‐adjusted life years

During the coronavirus disease 2019 (COVID-19) pandemic, about seven million people were infected with the disease, of which more than 133,000 died. Health policymakers need to know the extent and magnitude of the disease burden to decide on how much to allocate resources for disease control. The results of this investigation could be helpful in this field. We used the secondary data released by the Kurdistan University of Medical Sciences between February 2020 to October 2021 to estimate the age-sex standardized disability-adjusted life years (DALY) by the sum of the years of life lived with disability (YLD) and the years of life lost (YLL). We also applied the local and specific values of the disease utility in the calculations. The total DALY was estimated at 23316.5 and 1385.5 per 100,000 populations The YLD and YLL constituted 1% and 99% of the total DALY, respectively. The DALY per 100,000 populations was highest in the men and people aged more than 65 years, but the prevalence was the highest in people under the age of 40. Compared to the findings of the "burden of disease study 2019," the burden of COVID-19 in Iran is ranked first and eighth among communicable and noncommunicable diseases, respectively. Although the disease affects all groups, the elderly suffer the most from it. Given the very high YLL of COVID-19, the best strategy to reduce the burden of COVID-19 in subsequent waves should be to focus on preventing infection in the elderly population and reducing mortality.

Lived experiences of Iranian nursing managers in organizing and confronting the COVID-19 pandemic.

The prevalence of the new infectious disease is a global health issue and a threat to nurses and other health care workers. In addition to nurses who have been directly involved in the care of patients with coronavirus disease 2019 (COVID-19), nursing managers have also played a key role in the management and control of this disease. The present study aimed to investigate the lived experiences of nursing managers in organizing and confronting COVID-19 in Iran. This study was a qualitative research design conducted by descriptive phenomenology based on Husserl philosophy. Participants consisted of 32 nursing managers working in general public hospitals in East Guilan, north of Iran, selected using purposive sampling. In-depth and semi-structured interviews were used to collect data. Colaizzi's strategy was used to analyze the data. Coding was done with MAXQDA 2007 software. Lincoln and Guba trustworthiness criteria were used to achieve accuracy and reliability of the data. Data analysis led to the emergence of a main theme called "Management in the COVID-19 Crisis" and three sub-themes: "Dealing with the unknown", "Managing deficiencies and assets" and "Structural challenges". In this study the nursing managers experienced how to deal with the COVID-19 crisis. By examining the experiences of managers involved in the COVID-19 pandemic, a rich set of managerial experiences can be gathered that prepare them for other infectious diseases in the future.

C-reactive protein, D-dimer, erythrocyte sedimentation rate, and troponin in intensive care unit patients with COVID-19 in Iran.

The coronavirus disease 2019 (COVID-19) pandemic in Iran has led to a lack of intensive care unit (ICU) facilities. This study examines C-reactive protein (CRP), D-dimer, erythrocyte sedimentation rate (ESR), and troponin in ICU patients with COVID-19 in comparison to COVID-19 patients admitted to the wards in Iran. In a case-control study, troponin, CRP, ESR, and D-dimer were compared in the case samples of 109 COVID-19 patients admitted to the ICU, and in the control group, 140 COVID-19 patients admitted to the wards. The mean of CRP (P < 0.001) and D-dimer (P < 0.001) was higher, whereas troponin (P < 0.001) was lower in patients admitted to the ICU, but no significant difference was observed between the values of ESR (P = 0.292) in the two groups. This study showed that the values of CRP and D-dimer were higher in patients admitted to the ICU, but no significant difference was observed between the values of ESR in the two groups.

General Vaccination and Active Prevention of COVID-19 Epidemic at the Primary Health Care Level: The Fifth Step of the National Mobilization Program against COVID-19

Background. One of the most effective ways to prevent coronavirus disease 2019 (COVID-19) is to perform general vaccination and actively prevent the outbreak at the primary health care level. The present study aimed to review the measures against COVID-19 in Iran from April to September 2021. Methods. A cross-sectional and descriptive study was conducted at the national level from April to September 2021. Data related to COVID-19 vaccination, prevention, care, and outpatient services was collected from databases, including first level electronic health record systems, the portal of Network Management Center, the portal of Infectious Diseases Management Center, and the portal of Health Observatory. The target population of the study included medical universities and schools in Iran. Using a census sampling method, all 63 medical universities and schools in the country were included in the study. The Statistical Package for the Social Sciences (SPSS) version 16 was utilized to analyze the collected data. Results. In the fifth step of the national mobilization program against COVID-19 epidemic, a total of 1,228 vaccination centers with 6,490 stations were established across the country from April to September 2021. In these centers, more than 47 million doses of the COVID-19 vaccines were injected. At this step, over 15 million people exposed to close contact with infected people were intercepted. A home care team was deployed at each selected health center for COVID-19, providing 532,551 home care services. At the fifth step, the monitoring teams issued 1,015,831 warnings to trading, industrial, or administrative units, which led to the sealing of 73,443 units. Also, more than six million rapid tests were performed in homes and health units. During the same period, 30,843 vulnerable households received support packages. Conclusion. The national mobilization program to combat COVID-19 in Iran focused on the community and primary health care system. The program was successful in strengthening the health system to expand vaccination and actively prevent COVID-19 epidemic.

Inpatient cardiology consultation for COVID-19: What are cardiologists' diagnostic approaches?

Aim: Despite concerns about cardiovascular implications in coronavirus disease-2019 (COVID-19) patients, not all COVID-19 patients are visited by cardiologists and recommended to perform comprehensive cardiovascular assessments including measurement of biomarkers and echocardiography. We aimed to investigate the reasons for seeking cardiology care and to assess our cardiologists' diagnostic approaches to COVID-19 patients with potential cardiovascular involvement. Methods and Results: In this prospective, observational study, data of all consecutive COVID-19 patients admitted to six designated hospitals for COVID-19 in Iran in whom bedside cardiology consultation was requested were collected. A total of 148 patients including 105 (71%) males were included. The mean age was 57 ± 17 years. The most common reasons for cardiology consultation were dyspnea (56.7%), chest pain (12.8%), and suspected arrhythmias (10.8%). The most common comorbidities were hypertension (40.5%), diabetes mellitus (19.6%), and coronary heart disease (18.9%). A 12-lead electrocardiography (ECG) was obtained in all patients. Point-of-care ultrasonography or limited transthoracic echocardiography (TTE) was performed in 106 (71.6%) patients, and complete TTE was performed in 35 (23.4%) patients. Cardiac troponin was measured in 63 (42.6%) patients, and N-terminal pro B-type natriuretic peptide level was measured in 34 (23%) patients. Overall, 51 (34.5%) patients underwent invasive mechanical ventilation, inotropes were used in 29 (19.6%) patients, and 40 (27%) patients died. Conclusions: While preventing unnecessary investigations, the cardiologists should not overlook the lifesaving role of ubiquitous diagnostic modalities (such as ECG and TTE) in early detection and management of cardiac involvement in COVID-19.

Understanding uptake of prevention and mitigation of COVID-19 at work actions in Iran.

The coronavirus disease 2019 (COVID-19) pandemic has required organizations to make changes to ways of working to prevent and mitigate COVID-19 in employees. To assess the workplace response to COVID-19 in Iran. 255 organizations completed a two-part survey. Part 1 collected data describing the business; part 2 comprised the International Labor Organization (ILO) 30-item Prevention and Mitigation of COVID-19 at Work Actions Checklist. Afour-point Likert scale was used to score each item according to whether preventative measures had been actioned. We found a dichotomy of commitment to managing COVID-19 at work. 42.5%of organizations had fully implemented the ILO recommended preventative actions, and 45.6%workplaces had not implemented any. Large organizations had significantly more preventative actions than SMEs; the healthcare sector had significantly better COVID-19 mitigation measures in place than construction projects; and organizations with a health and safety management system had significantly more prevention actions in place. ILO provided a good framework to support risk assessment of COVID-19, however only half the organizations were undertaking the necessary biological hazard control actions to prevent COVID-19 at work. There remains a need to understand the inaction of organizations who do not risk assess despite being in a pandemic.

Health Belief Model in Adopting Protective Behaviors Against COVID-19 in Iran

Background: Adoption of protective health behaviors is extremely important to prevent the coronavirus disease 2019 (COVID-19) outbreak. Objectives: This study aimed to evaluate the influencing factors on adopting preventive behaviors during COVID-19 using health belief model (HBM) among the urban population in Maragheh, a city from North West of Iran. Methods: We investigated 383 people via an online questionnaire from December 5 to 11, 2020. The validity of the questionnaire was confirmed with an experts' panel of 10 health professionals, and its reliability was 0.74 through Cronbach’s alpha. Multiple regression analysis was conducted to analyze data. Results: The self-efficacy (17.1 ± 2.5) and perceived benefits (5.7 ± 0.5) were evaluated at a high level. The health behavior was also appraised with a high mean score (21.2 ± 3.2). Among the components of the health belief model, perceived risk, self-efficacy, perceived benefits, and perceived barriers, and among demographic variables, gender and marital status were the predictors of protective behaviors against COVID-19. Conclusions: Self-efficacy, perceived benefits, and perceived risk increased the incidence of protective behavior by 69% and 30%, respectively, and perceived barriers decreased it by 0.07%. Strengthening the ability to adopt protective behaviors and improving the public’s perception of the effectiveness of these behaviors can be useful.

Generalized Anxiety Disorder 7-Item Scale and Templer’s Death Anxiety Scale in Iranian Inpatients with COVID-19: Evaluation of Psychometric Properties and Diagnostic Accuracy

Background: During the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, anxiety has always been with patients. Objectives: It is necessary to obtain a valid instrument for the evaluation and screening of patients with anxiety. The current study attempted to evaluate the sensitivity and specificity and provide the clinical cut-off scores for the Death Anxiety Scale (DAS) and Generalized Anxiety Disorder 7-Item (GAD-7) Scale in hospitalized patients diagnosed with COVID-19 in Iran. Methods: This diagnostic accuracy study was carried out for 4 months on 150 hospitalized patients diagnosed with COVID-19 to evaluate generalized anxiety disorder and death anxiety. Cronbach’s alpha was used to evaluate reliability. For the determination of the presence of anxiety disorders, the Structured Clinical Interview with hospitalized subjects was conducted by a psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition diagnostic criteria. Results: The Cronbach’s alpha coefficients for the GAD-7 Scale and DAS questionnaires were observed to be 0.88 and 0.74, respectively, confirming their reliability. Based on cut-off scores with the best balance, the sensitivity and specificity of the GAD-7 Scale questionnaire were 61.9% and 86.9%, respectively. Moreover, the sensitivity and specificity values related to the DAS questionnaire were 47.8% and 73.8%, respectively. The values for the area under the curve were 0.75 and 0.63 for the GAD-7 Scale and DAS, respectively. With this scoring method, those who scored higher than 8 and 7 in the GAD-7 Scale and DAS questionnaires were considered patients, respectively. Moreover, in these two tests, higher levels of generalized anxiety and death anxiety were reported in female patients. Conclusions: The GAD-7 Scale and DAS both showed adequate psychometric properties and diagnostic accuracy; therefore, they are applicable for anxiety screening in patients with COVID-19. It will likely take a few years to bring the virus under control worldwide. Iran’s Ministry of Health should implement exact psychological interventions during hospitalization and after discharge to prevent the adverse mental health consequences of COVID-19.

Knowledge of general physicians in interpreting chest computed tomography used to examine Coronavirus Disease-2019 in Iran

BACKGROUND: Lung is the primary organ affected by the Coronavirus Disease-2019 (COVID-19) virus, which causes pneumonia, an acute respiratory distress syndrome (ARDS). Lung computed tomography (CT) is a very useful and practical modality in diagnosing COVID-19 due to its speed and high sensitivity in determining the severity. When visiting patients with suspected COVID-19 in hospitals, general practitioners are usually the first medical staff to visit these patients. Therefore, sufficient knowledge in the interpretation of the patients' lung CT scan is essential for general practitioners. CASE REPORT: A 28-year-old male patient referred to a physician at the hospital. He had only the symptoms of shortness of breath and mild chest pain during deep breathing. The general practitioner requested a CT scan of the patient; in addition, the physician diagnosed that the lungs were healthy and prescribed azithromycin and diphenhydramine syrup. Since the patient was a medical staff and was fully acquainted with CT scans, he became suspicious of the stereotype of his lung image and referred to an infectious disease specialist. Upon seeing the CT, the specialist immediately became suspicious of COVID-19 and referred the CT to a radiologist. CONCLUSION: In order to prevent misdiagnosis and spread of COVID-19 in the examinations, it is necessary to enhance the general practitioners' knowledge of the CT scan of lungs of suspected patients and patients with low lung infection, which can be difficult for general practitioners, by infectious disease specialists and radiologists.

Diagnostic and Prognostic Value of Routine Blood Tests in Patients with COVID-19 in Iran, Tehran

Background: Routine blood testing consists of Complete Blood Count (CBC) indices together with Comprehensive Metabolic Panel (CMP) which have significant roles in both diagnosis and prognosis of the novel coronavirus disease 2019 (COVID-19).&#x0D; Methods: A total number of 942 COVID-19 patients and 400 healthy persons as the control group were enrolled in this study. All patients were admitted to a single center and were divided into two groups according to disease severity (severe or non-severe). Routine laboratory findings of peripheral blood sample were collected and then analyzed.&#x0D; Results: Neutrophil-Lymphocyte Ratio (NLR) had the highest sensitivity and specificity value for COVID-19 diagnosis. Among patients with different severities of COVID-19, the amount of neutrophil, NLR, platelet, hemoglobin, Red cell Distribution Width (RDW) and total bilirubin was significantly different (p&lt;0.01).&#x0D; Conclusion: Some indices of complete blood count and comprehensive metabolic panel have diagnostic and prognostic roles in COVID-19 patients, which are helpful in early diagnosis, predicting severity and adverse outcomes of patients with COVID-19.

Digital Citizen Science for Responding to COVID-19 Crisis: Experiences from Iran.

The Coronavirus Disease 2019 (COVID-19) pandemic has so far been the most severe global public health emergency in this century. Generally, citizen science can provide a complement to authoritative scientific practices for responding to this highly complex biological threat and its adverse consequences. Several citizen science projects have been designed and operationalized for responding to COVID-19 in Iran since the infection began. However, these projects have mostly been overlooked in the existing literature on citizen science. This research sheds light on the most significant online citizen science projects to respond to the COVID-19 crisis in Iran. Furthermore, it highlights some of the opportunities and challenges associated with the strengths and weaknesses of these projects. Moreover, this study captures and discusses some considerable insights and lessons learned from the failures and successes of these projects and provides solutions to overcome some recognized challenges and weaknesses of these projects. The outcomes of this synthesis provide potentially helpful directions for current and future citizen science projects—particularly those aiming to respond to biological disasters such as the COVID-19 pandemic.

Negative Consequences of COVID-19 Pandemic on the Life of the Elderly: A Qualitative Study

Negative Consequences of COVID-19 Pandemic on the Life of the Elderly: A Qualitative Study

Impact of Non-pharmaceutical Interventions on the Control of COVID-19 in Iran: A Mathematical Modeling Study.

During the first months of the coronavirus disease 2019 (COVID-19) pandemic, Iran reported high numbers of infections and deaths. In the following months, the burden of this infection decreased significantly, possibly due to the impact of a package of interventions. We modeled the dynamics of COVID-19 infection in Iran to quantify the impacts of these interventions. We used a modified susceptible-exposed-infected-recovered (SEIR) model to model the COVID-19 epidemic in Iran, from January 21, 2020 to September 21, 2020. We estimated the 95% uncertainty intervals (UIs) using Markov chain Monte Carlo simulation. Under different scenarios, we assessed the effectiveness of non-pharmaceutical interventions (NPIs) including physical distancing measures and self-isolation. We also estimated the time-varying reproduction number (Rt ), using our mathematical model and epidemiologic data. If no NPIs were applied, there could have been a cumulative number of 51 800 000 (95% UI: 1 910 000- 77 600 000) COVID-19 infections and 266 000 (95% UI: 119 000-476 000) deaths by September 21, 2020. If physical distancing interventions, such as school/border closures and self-isolation interventions had been introduced a week earlier than they were actually launched, 30.8% and 35.2% reduction in the number of deaths and infections respectively could have been achieved by September 21, 2020. The observed daily number of deaths showed that the Rt was one or more than one almost every day during the analysis period. Our models suggest that the NPIs implemented in Iran between January 21, 2020 and September 21, 2020 had significant effects on the spread of the COVID-19 epidemic. Our study also showed that the timely implementation of NPIs showed a profound effect on further reductions in the numbers of infections and deaths. This highlights the importance of forecasting and early detection of future waves of infection and of the need for effective preparedness and response capabilities.

Prevalence of COVID-19 in Iran: results of the first survey of the Iranian COVID-19 Serological Surveillance programme

ObjectivesThis study aims to estimate the prevalence of coronavirus disease 2019 (COVID-19) in the general population of Iran. MethodsThe target population was all Iranian people aged 6 years and older in the country. A stratified random sampling design was used to select 28 314 people from among the individuals registered in the electronic health record systems used in primary health care in Iran. Venous blood was taken from each participant and tested for the IgG antibody against COVID-19. The prevalence of COVID-19 was estimated at provincial and national levels after adjusting for the measurement error of the laboratory test, non-response bias and sampling design. ResultsOf the 28 314 Iranians selected, 11 256 (39.75%) participated in the study. Of these, 5406 (48.0%) were male and 6851 (60.9%) lived in urban areas. The mean (standard deviation) participant age was 35.89 (18.61) years. The adjusted prevalence of COVID-19 until 20 August 2020 was estimated as 14.2% (95% uncertainty interval 13.3%–15.2%), which was equal to 11 958 346 (95% CI 11 211 011–12 746 776) individuals. The adjusted prevalences of infection were 14.6%, 13.8%, 16.6%, 11.7% and 19.4% among men, women, urban population, rural population and individuals aged 60 years or more, respectively. Ardabil, Golestan and Khuzestan provinces had the highest prevalence and Alborz, Hormozgan and Kerman provinces had the lowest. ConclusionsBased on the study results, a large proportion of the Iranian population had not yet been infected by COVID-19. The observance of hygienic principles and social restrictions should therefore continue until the majority of the population has been vaccinated.

Health Pandemic and Social Media: A Content Analysis of COVID-Related Posts on a Telegram Channel With More Than One Million Subscribers.

Mobile-based social media play an important role in the dissemination of information during public health emergencies. This study aimed to analyze the contents and trends of public messages posted on Telegram during Coronavirus Disease 2019 (COVID-19) pandemic. A content analysis of the 1781 messages, posted in a public Telegram channel with more than one million subscribers performed over 9-weeks. The messages were categorized into seven categories. In total, 39% (n=703) of all messages were related to COVID-19. With the official confirmation of the case of COVID-19 in Iran, the number of COVID-related massages started to rise. Overall, the most frequent messages were of joke and humor (n=292, 41.5%), followed by educational messages (n=140, 19.9%). Our study showed that the most popular messages during first weeks of COVID pandemic were satirical, indicating that people may not had taken the risks of this pandemic seriously. It is crucial for health organizations to develop strategies for dissemination of reliable health information through social media.

Challenges of Nurses in the Caring Process of Patients with Coronavirus Disease 2019 in Iran: A Qualitative Study

Background: The illness caused by the novel coronavirus is an emerging disease, and for this reason, the international community is encountered with its unknown nature, such as clinical features, treatments, and long-term complications. Experience suggests that humans are affected by the psychological and social effects of epidemics and pandemics of infectious diseases. Accordingly, it is a new experience to care for patients with this disease that has to be more explored. The present study aimed to detect the challenges with which nurses are faced in the process of caring for patients with coronavirus disease 2019 (COVID-19) in Iran using a qualitative method. Methods: This qualitative study utilized in-depth semi-structured interviews with 19 key informants selected via targeted sampling. The obtained data were analyzed by thematic analysis to identify the challenges to which the nurses have encountered in the process of caring for patients with COVID-19 in Iran. Results: Challenges of the nurses in the caring process for patients with COVID-19 are listed in five categories of stress and psychological issues, equipment-related challenges, increased events of errors, medication and treatment problems, and hospital management. It should be mentioned that at the same time, 35 other subcategories were also identified in this study. Conclusion: Since nurses are at the forefront in fighting the COVID-19, there must be plans to increase their preparedness. Deficiencies in health systems, including equipment, medicine, and personal protective gear should also be addressed so that nurses can better respond to these incidents. Psychological and mental support is a key component of the nurses’ appropriate response; therefore, along with nurses' responses, individuals, groups, and family psychological supports should be facilitated to increase performance and effectiveness in response to COVID-19.