Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sci Rep. 2022 Jun 13;12(1):9741. doi: 10.1038/s41598-022-14007-1.
A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Patient data were extracted for all cases aged > 19 years with toxic alcohol poisoning during the study period from February until June 2020. A total of 795 patients were hospitalized due to methanol poisoning, of whom 84 died. Median [interquartile ratio; IQR] age was 32 [26, 40] years (range 19-91 years). Patients had generally ingested alcohol for recreational motives (653, 82.1%) while 3.1% (n = 25) had consumed alcohol-based hand sanitizers to prevent or cure COVID-19 infection. Age was significantly lower in survivors than in non-survivors (P < 0.001) and in patients without sequelae vs. with sequelae (P = 0.026). Twenty non-survivors presented with a Glasgow Coma Scale (GCS) score > 8, six of whom were completely alert on presentation to the emergency departments. The time from alcohol ingestion to hospital admission was not significantly different between provinces. In East Azerbaijan province, where hemodialysis was started within on average 60 min of admission, the rate of sequelae was 11.4% (compared to 19.6% average of other provinces)-equivalent to a reduction of the odds of sequelae by 2.1 times [95% CI 1.2, 3.7; p = 0.009]. Older patients were more prone to fatal outcome and sequelae, including visual disturbances. Early arrival at the hospital can facilitate timely diagnosis and treatment and may reduce long-term morbidity from methanol poisoning. Our data thus suggest the importance of raising public awareness of the risks and early symptoms of methanol intoxication.
2019 年冠状病毒病（COVID-19）大流行初期，伊朗发生了甲醇中毒事件。本研究旨在评估此次疫情中甲醇中毒住院和死亡的流行病学情况。本研究基于伊朗 13 家转诊毒理学中心的住院数据以及伊朗法医组织（LMO）的死亡率数据，开展了一项横断面关联性研究。从 2020 年 2 月至 6 月的研究期间，提取所有年龄大于 19 岁且因急性甲醇中毒住院的患者数据。共有 795 例甲醇中毒患者住院，其中 84 例死亡。患者年龄中位数[四分位距（IQR）]为 32[26，40]岁（范围 19-91 岁）。一般而言，患者因娱乐目的摄入酒精（653 例，82.1%），3.1%（n=25）患者为预防或治疗 COVID-19 感染而摄入含酒精的手部消毒剂。幸存者的年龄显著低于非幸存者（P<0.001）和无后遗症患者（P=0.026）。20 例非幸存者的格拉斯哥昏迷量表（GCS）评分>8 分，其中 6 例在急诊就诊时完全清醒。从饮酒到住院的时间在不同省份之间无显著差异。在东阿塞拜疆省，患者平均在入院后 60 分钟内开始血液透析，后遗症发生率为 11.4%（其他省份的平均发生率为 19.6%），相当于后遗症的几率降低了 2.1 倍[95%CI 1.2，3.7；p=0.009]。年龄较大的患者更易发生致命结局和后遗症，包括视力障碍。尽早到医院就诊有助于及时诊断和治疗，从而降低甲醇中毒的长期发病率。因此，我们的数据表明，提高公众对甲醇中毒风险和早期症状的认识至关重要。
