Objectives: While the prevalence and severity of asthma influenced by environmental factors, the effect of parenteral smoking on asthma status of their children was examined. Methodology: 90 asthmatic children, 32 with smoker and 58 with non-smoker parents were studies in two sessions three years apart by evaluating respiratory symptoms (RS) prevalence and severity, various drugs used and pulmonary function tests (PFT) including forced vital capacity, forced volume in the first second, peak expiratory flow, and maximum expiratory low at 75, 50 and 25% of vital capacity (FVC, FEV1, PEF, MEF75, MEF50, MEF25 respectively). Results: The prevalence and severity of all RS were significantly increased in asthmatic children with smoking parents after 3 years except prevalence and severity of night wheeze and the prevalence of chest wheeze (p<0.05 to p<0.001) but PFT values were non-significantly reduced. In asthmatic children with non-smoking parents, the prevalence and severity of RS were decreased after 3 years which was significant for night and chest wheeze for prevalence and night cough and chest wheeze for severity (all, p<0.05) and PFT values were increased which were statistically significant for FVC, FEV1, MEF50 and MEF25 (p<0.05 to p<0.01). Drugs used by the group with smoking parents were increased and were significantly higher than their reduction in the groups with non-smoking parents at the end of the study (p<0.05 for fluticasone propionate 125/salmeterol and budesonide160/formoterol). Conclusion: Long-term parenteral smoking increased prevalence and severity of RS and drug used but decreased PFT values of their asthmatic children.

Introduction: COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 increasingly involves people worldwide. Probiotics can improve immune system functions via different mechanisms. We proposed that Synbiotic Lactocare® may also reduce SARS-Cov2 infection in high risk medical staff working in COVID-19 hospital wards. Method: In a randomized, controlled trial, 60 hospital staff without any history of clinical or laboratory evidence of SARS-Cov2 infection were received either once daily oral synbiotic capsule (Lactocare®) that contains 1 billion CFU/Cap of L. (Lactobacillus) casei, L. rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, L. acidophilus, Bifidobacterium infantis, L. bulgaricus, and Fructooligosacharide (Zist Takhmir, Tehran, Iran) or placebo with the same appearance for 30 days. They were followed for two months. Result: During the two month period of this study, SARS-COV-2 RT-PCR test results were positive in three participants (9.67%) in placebo group compared to zero positive test in synbiotic group. The differences were not statistically significant (p= 0.238). During the study, two persons (7 %) of placebo group had respiratory complaint such as cough, rhinorrhea and/or dyspnea, compared with one in synbiotic group (p= 0.492). Conclusion: This study showed that overall frequency of SARS-COC2 infection in participants receiving synbiotic and those receiving placebo did not differ significantly. However, 3 hospital staff in placebo group compared to no one in synbiotic group had SARS-COV2 infection. Further studies with greater power and alternative probiotic strains and mixture are warranted to determine whether Synbiotic can prevent COVID-19 in at-risk hospital staff. Keywords: COVID-19, Synbiotic, prevention, Lactocare, SARS-Cov2

Although children are less affected by Novel coronavirus disease 2019 than adults, it should not be missed, especially in those with underlying diseases. Herein, we report a patient with primary antibody deficiency, who was affected with COVID-19. This infection could be presented mildly in patients with immunodeficiency.