Epidemiology, clinical characteristics, and outcome of hospitalized COVID-19 patients in Kurdistan Province, Iran
DOI:
https://doi.org/10.22122/cdj.v10i2.646Keywords:
COVID-19, SARS-CoV-2, Epidemiology, Risk Factors, Mortality, IranAbstract
BACKGROUND: The present study aimed to evaluate the epidemiology, clinical characteristics, and outcome of confirmed and suspected hospitalized coronavirus disease 2019 (COVID-19) cases in Iran hospitals affiliated with the Kurdistan University of Medical Sciences, Sanandaj, Iran.
METHODS: This cross-sectional study was performed on all confirmed and suspected hospitalized COVID-19 cases in hospitals affiliated with the Kurdistan University of Medical Sciences between March and September 2020. Required data were obtained from the Hospital Intelligent Management System of hospitals. Independent t-test, chi-square test, Fisher's exact test, and one-way analysis of variance (ANOVA) were used for univariate analysis. Variables with P-value < 0.3 in univariate analysis were entered into the multivariate model, and the adjusted odds ratio (AOR) was calculated.
RESULTS: Out of 9176 cases, 3210 cases (35.03%) were confirmed with COVID-19. The mean and standard deviation (SD) of age of the cases was 56.5 ± 19.3 in the confirmed and 57.5 ± 20.6 in the suspected cases. The confirmed and suspected cases’ mortality rate was 15.0% and 10.2%, respectively. In both groups, the most common symptoms of admission to the hospital were respiratory distress, coughing, fever, and muscular pain. The variables of older age, male gender, being transferred to hospitals by ambulance, intensive care unit (ICU) hospitalization, being intubated, blood oxygen saturation level less than 93, and having an underlying disease were statistically associated with an increased chance of death.
CONCLUSION: The mortality rate among both confirmed and suspected hospitalized COVID-19 cases was significant, and this rate was higher for the confirmed cases. Death-related risk factors should be considered in resource allocation, management, and patient prioritization to reduce the outcome of death.
References
Fitzner J, Qasmieh S, Mounts AW, Alexander B, Besselaar T, Briand S, et al. Revision of clinical case definitions: Influenza-like illness and severe acute respiratory infection. Bull World Health Organ. 2018; 96(2): 122-8.
Nguyen HKL, Nguyen SV, Nguyen AP, Hoang PMV, Le TT, Nguyen TC, et al. Surveillance of severe acute respiratory infection (SARI) for hospitalized patients in Northern Vietnam, 2011-2014. Jpn J Infect Dis. 2017; 70(5): 522-7.
Yu H, Huang J, Huai Y, Guan X, Klena J, Liu S, et al. The substantial hospitalization burden of influenza in central China: Surveillance for severe, acute respiratory infection, and influenza viruses, 2010-2012. Influenza Other Respir Viruses. 2014; 8(1): 53-65.
Nair H, Simoes EA, Rudan I, Gessner BD, Azziz-Baumgartner E, Zhang JSF, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: A systematic analysis. Lancet. 2013; 381(9875): 1380-90.
Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008; 86(5): 408-16.
Piroozi B, Alinia C, Moradi G, Safari H, Hemmati P, Seroush M, et al. Incidence, mortality, and burden of severe acute respiratory infection in Iran in 2015. Iran J Public Health. 2019; 48(Suppl 1): 62-8.
Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020; 109: 102433.
World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected: interim guidance, 25 January 2020. Geneva, Switzerlans: WHO; 2020.
Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020; 91(1): 157-60.
Wolrdometer. Covid-19 Coronavirus Outbreak. WorldoMeter [Online]. [cited 2021 Jan 21]; Available from: URL: https://www.worldometers.info/coronavirus
Anastassopoulou C, Russo L, Tsakris A, Siettos C. Data-based analysis, modelling and forecasting of the COVID-19 outbreak. PLoS One. 2020; 15(3): e0230405.
Chen X, Hazra DK. Understanding the bias between the number of confirmed cases and actual number of infections in the COVID-19 pandemic. medRxiv. 2020.
Shahriarirad R, Khodamoradi Z, Erfani A, Hosseinpour H, Ranjbar K, Emami Y, et al. Epidemiological and clinical features of 2019 novel coronavirus diseases (COVID-19) in the South of Iran. BMC Infect Dis. 2020; 20(1): 427.
Grant MC, Geoghegan L, Arbyn M, Mohammed Z, McGuinness L, Clarke EL, et al. The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries. PLoS One. 2020; 15(6): e0234765.
Shankar A, Saini D, Roy S, Mosavi JA, Chakraborty A, Bharti SJ, et al. Cancer care delivery challenges amidst coronavirus disease - 19 (COVID-19) outbreak: Specific precautions for cancer patients and cancer care providers to prevent spread. Asian Pac J Cancer Prev. 2020; 21(3): 569-73.
Ssentongo P, Ssentongo AE, Heilbrunn ES, Ba DM, Chinchilli VM. Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PLoS One. 2020; 15(8): e0238215.
Suleyman G, Fadel RA, Malette KM, Hammond C, Abdulla H, Entz A, et al. Clinical characteristics and morbidity associated with coronavirus disease 2019 in a series of patients in Metropolitan Detroit. JAMA Netw Open. 2020; 3(6): e2012270.
Argenziano MG, Bruce SL, Slater CL, Tiao JR, Baldwin MR, Barr RG, et al. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ. 2020; 369: m1996.
Jalili Khoshnood R, Ommi D, Zali A, Ashrafi F, Vahidi M, Azhide A, et al. Epidemiological characteristics, clinical features, and outcome of COVID-19 patients in Northern Tehran, Iran; a Cross-Sectional Study. Front Emerg Med. 2020; 5(1): e11.
Huang X, Wei F, Hu L, Wen L, Chen K. Epidemiology and clinical characteristics of COVID-19. Arch Iran Med. 2020; 23(4): 268-271.
Zali A, Gholamzadeh S, Mohammadi G, Azizmohammad Looha M, Akrami F, Zarean E, et al. Baseline characteristics and associated factors of mortality in COVID-19 patients; an analysis of 16000 cases in Tehran, Iran. Arch Acad Emerg Med 2020; 8(1): e70.
Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382(18): 1708-20.
Li H, Wang S, Zhong F, Bao W, Li Y, Liu L, et al. Age-dependent risks of incidence and mortality of COVID-19 in Hubei Province and other parts of China. Front Med (Lausanne). 2020; 7: 190.
Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020; 146(1): 110-8.
Cheng A, Caruso D, McDougall C. Outpatient management of COVID-19: Rapid evidence review. Am Fam Physician. 2020; 102(8): 478-86.
