Research Article

Epidemiological Study of Patients with COVID-19 in Iran (Markazi Province)

Abstract

Background: The increasing prevalence of SARS-COV-2 infection necessitates further epidemiological studies in the field of this epidemic.
Methods: during 66 days (20/02/2020 to 01/06/2020) all patients diagnosed with SARS-COV-2 infection referred to Valiasr Hospital in Arak were monitored. Thus, based on the pre-prepared questionnaire, the information of the mentioned patients was extracted from the Hospital Information System (HIS) by the required formats and after eliminating the incomplete cases, it was aggregated based on coding (to preserve the patients' information). The results were evaluated using spss. v25 software.
Results: Out of 535 patients with SARS-COV-2 included in the study, 295 (55%) were male and 240 (45%) were female. Women with a mean age of 61.03 years were significantly (p = 0.009) at a higher age than men with a mean age of 56.59 years. Nearly 60% (304 patients) of patients had a history of underlying disease. Gender comparison of patients with a history of underlying disease infected with SARS-COV-2 infection did not show any significant difference between male and female patients. Comparison of the mean age of the improved and dead patients shows that the mean age of the dead patients with a significant difference (P <0.001) was higher than the improved subjects. This result is also true for people with a history of underlying disease (p<0.0001). The number of patients with arterial oxygen saturation <93% was significantly higher in the group of patients with a history of at least one chronic underlying disease than who did not have any chronic disease (P <0.0001). The mortality rate in ICU patients was significantly higher than those admitted to the normal ward (p < 0.0001).
Conclusion: Aging, gender, underlying diseases and arterial oxygen saturation (<93%) at the time of admission have important role in the hospitalization rate, severity of the disease and mortality in patients with COVID-19.

[1] Patel A, Jernigan DB. Initial public health response and interim clinical guidance for the 2019 novel coronavirus outbreak-United States, December 31, 2019–February 4, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(5):140-6.
[2] High KP, Bradley SF, Gravenstein S, Mehr DR, Quagliarello VJ, Richards C, et al. Clinical practice guideline for the evaluation of fever and infection in older adult residents of long-term care facilities: 2008 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009; 48(2):149-71.
[3] Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID‐19) implicate special control measures. J Med Virol. 2020; 92(6):568-76.
[4] Licciardi F, Giani T, Baldini L, Favalli EG, Caporali R, Cimaz R. COVID-19 and what pediatric rheumatologists should know: a review from a highly affected country. Pediatr Rheumatol Online J. 2020; 18(1):35.
[5] Robson B. COVID-19 Coronavirus spike protein analysis for synthetic vaccines, a peptidomimetic antagonist, and therapeutic drugs, and analysis of a proposed achilles’ heel conserved region to minimize probability of escape mutations and drug resistance. Comput Biol Med. 2020; 121:103749.
[6] Gorbea C, Mosbruger T, Cazalla D. A viral Sm-class RNA base-pairs with mRNAs and recruits microRNAs to inhibit apoptosis. Nature. 2017; 550(7675):275-9.
[7] Kreutz R, Algharably EA, Azizi M, Dobrowolski P, Guzik T, Januszewicz A, et al. Hypertension, the renin–angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19. Cardiovasc Res. 2020; 116(10):1688-1699.
[8] Mondal R, Lahiri D, Deb S, Bandyopadhyay D, Shome G, Sarkar S, et al. COVID-19: Are we dealing with a multisystem vasculopathy in disguise of a viral infection?. J Thromb Thrombolysis. 2020; 50(3):567-79.
[9] Abedini A, Mirtajani SB, Karimzadeh M, Jahangirifard A, Kiani A. Can Hesperidin be the Key to the Treatment of Severe Acute Respiratory Syndrome COV-2?. Biomedical and Biotechnology Research Journal (BBRJ). 2020; 4(5):108.
[10] Gavriatopoulou M, Korompoki E, Fotiou D, Ntanasis-Stathopoulos I, Psaltopoulou T, Kastritis E, et al. Organ-specific manifestations of COVID-19 infection. Clin Exp Med. 2020; 20(4):493-506.
[11] Gupta AK, Jneid H, Addison D, Ardehali H, Boehme AK, Borgaonkar S, et al. Current perspectives on Coronavirus 2019 (COVID‐19) and cardiovascular disease: A white paper by the JAHA editors. J Am Heart Assoc. 2020; 9(12):e017013.
[12] Jamshidi M, Lalbakhsh A, Talla J, Peroutka Z, Hadjilooei F, Lalbakhsh P, et al. Artificial intelligence and COVID-19: deep learning approaches for diagnosis and treatment. IEEE Access. 2020; 8:109581-95.
[13] Sethi V. CoronaVirus: medical management in a developed country ie China versus a developing country ie India. Authorea Preprints. 2020.
[14] Amawi H, Abu Deiab GA, A Aljabali AA, Dua K, Tambuwala MM. COVID-19 pandemic: an overview of epidemiology, pathogenesis, diagnostics and potential vaccines and therapeutics. Ther Deliv. 2020; 11(4):245-68.
[15] Molenberghs G, Buyse M, Abrams S, Hens N, Beutels P, Faes C, et al. Infectious diseases epidemiology, quantitative methodology, and clinical research in the midst of the COVID-19 pandemic: Perspective from a European country. Contemp Clin Trials. 2020; 99:106189.
[16] Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J. 2020; 39(5):355.
[17] Noor R, Maniha SM. A brief outline of respiratory viral disease outbreaks: 1889–till date on the public health perspectives. Virusdisease. 2020; 31(4):441-9.
[18] Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020; 80(6):e14-e18.
[19] Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its Impact on Patients with COVID-19. SN comprehensive clinical medicine. 2020; 25:1-8.
[20] Diaz JH. Hypothesis: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19. J Travel Med. 2020; 27(3):taaa041.
[21] Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, et al. Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes care. 2020; 43(7):1392-8.
[22] Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontology 2000. 2013; 62(1):59-94.
[23] Jin JM, Bai P, He W, Wu F, Liu XF, Han DM, et al. Gender differences in patients with COVID-19: Focus on severity and mortality. Front Public Health. 2020; 8:152.
[24] Jamaati H, Fadaizadeh L, Khoundabi B, Hashemian SM, Monjazabi F, Jahangirifard A, et al. COVID-19-Related severe heterogeneous acute respiratory distress syndrome: A therapeutic challenge. Biomedical and Biotechnology Research Journal (BBRJ). 2020; 4(5):75.
[25] Hikmet F, Méar L, Edvinsson Å, Micke P, Uhlén M, Lindskog C. The protein expression profile of ACE2 in human tissues. Mol Syst Biol. 2020; 16(7):e9610.
[26] Datta PK, Liu F, Fischer T, Rappaport J, Qin X. SARS-CoV-2 pandemic and research gaps: understanding SARS-CoV-2 interaction with the ACE2 receptor and implications for therapy. Theranostics. 2020; 10(16):7448.
[27] Soro-Paavonen A, Gordin D, Forsblom C, Rosengard-Barlund M, Waden J, Thorn L, et al. Circulating ACE2 activity is increased in patients with type 1 diabetes and vascular complications. J Hypertens. 2012; 30(2):375-83.
[28] Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020; 55(5):2000547.
[29] Wu C, Chen X, Cai Y, Zhou X, Xu S, Huang H, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020; 180(7):934-943.
[30] Polak SB, Van Gool IC, Cohen D, Jan H, van Paassen J. A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression. Mod Pathol. 2020; 33(11):2128-2138.
[31] Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia–a systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020; 14(4):395-403.
[32] Cornejo-Pareja IM, Gómez-Pérez AM, Fernández-García JC, Barahona San Millan R, Aguilera Luque A, de Hollanda A, et al. Coronavirus disease 2019 (COVID‐19) and obesity. Impact of obesity and its main comorbidities in the evolution of the disease. Eur Eat Disord Rev. 2020; 28(6):799-815.
[33] Gupta R, Hussain A, Misra A. Diabetes and COVID-19: evidence, current status and unanswered research questions. Eur J Clin Nutr. 2020; 74(6):864-870.
[34] Pranata R, Permana H, Huang I, Lim MA, Soetedjo NN, Supriyadi R, Soeroto AY, Alkatiri AA, Firman D, Lukito AA. The use of renin angiotensin system inhibitor on mortality in patients with coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. Diabetes Metab Syndr. 2020; 14(5):983-90.
[35] Gan R, Rosoman NP, Henshaw DJ, Noble EP, Georgius P, Sommerfeld N. COVID-19 as a viral functional ACE2 deficiency disorder with ACE2 related multi-organ disease. Medical hypotheses. 2020; 144:110024.
[36] Zhu L, She ZG, Cheng X, Qin JJ, Zhang XJ, Cai J, et al. Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes. Cell metabolism. 2020; 31(6):1068-1077.
[37] Rajaei M, Bosarge PL, Griffin RL, McGwin G, Jansen JO, Kerby JD. Impact of glycemic control on risk of mortality and complications in trauma patients. Shock. 2020; 54(1):30-4.
[38] Mackman N, Antoniak S, Wolberg AS, Kasthuri R, Key NS. Coagulation abnormalities and thrombosis in patients infected with SARS-CoV-2 and other pandemic viruses. Arterioscler Thromb Vasc Biol. 2020; 40(9):2033-44.
[39] Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging (Albany NY). 2020; 12(7):6049.
[40] Xu L, Mao Y, Chen G. Risk factors for 2019 novel coronavirus disease (COVID-19) patients progressing to critical illness: a systematic review and meta-analysis. Aging (Albany NY). 2020; 12(12):12410-21.
[41] Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, et al. Association between hypoxemia and mortality in patients with COVID-19. Mayo Clin Proc. 2020; 2020; 95(6):1138-1147.
[42] Mikami T, Miyashita H, Yamada T, Harrington M, Steinberg D, Dunn A, et al. Risk factors for mortality in patients with COVID-19 in New York City. J Gen Intern Med. 2021; 36(1):17-26.
[43] Zhang J, Wang X, Jia X, Li J, Hu K, Chen G, et al. Risk factors for disease severity, unimprovement, and mortality of COVID-19 patients in Wuhan, China. Clin Microbiol Infect. 2020; 26(6):767-772.
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IssueVol 7 No 3 (2021): Summer QRcode
SectionResearch Article(s)
Published2021-07-31
DOI https://doi.org/10.18502/aacc.v7i3.6901
Keywords
Covid-19 Epidemiology Underlying disease Mortality

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How to Cite
1.
Kamali A, Mahmoodieh B, Jamalian M, Amani A, Jahangirifard A. Epidemiological Study of Patients with COVID-19 in Iran (Markazi Province). Arch Anesth & Crit Care. 2021;7(3):138-143.