Clinical and Epidemiological Features of Hospitalized Patients with COVID-19 in Hospitals of Tehran University of Medical Sciences

Abstract

Introduction: Since the start of COVID-19 pandemic in December 2019, until mid-April 2020 the total number of cases worldwide exceeded two millions and the death toll exceeded 130000 cases.
 Objective: The current study conducted to explore the clinical and epidemiological characteristics of COVID-19 patients, fatality of this disease and its mortality risk factors in major hospitals affiliated with Tehran University of Medical Sciences (TUMS).
 Methods: The data were collected in four major teaching hospitals affiliated with TUMS for all the patients that were admitted between Feb 19th and Apr 15th 2020 and were diagnosed as COVID-19 using reverse transcription polymerase chain reaction (RT-PCR), clinical diagnosis and/or lung computed tomography (CT) scan. The case fatality rate of the disease was estimated by age, sex, symptoms, comorbidities, and type of diagnosis. Logistic regression model was used to examine the associations between different factors and in-hospital deaths.
 Results: By Apr 15th 2020, a total of 4377 patients were admitted with COVID-19 diagnosis in four selected hospitals and 496 (11.3%) of these patients died in hospital. The case fatality rate of this disease was 28.8% in the ≥80-year age group, which was the highest compared to the other age groups. The case fatality rates were 12.5% and 9.8% among men and women, respectively. The results of multiple logistic regression on the outcome of death indicated that age, sex, cough, myalgia, reduced consciousness at arrival and past history of cancer were significantly associated with in-hospital death. Adjusting the effect of other variables, for each 10-year increase in age, the odds of death due to COVID-19 was 1.61 times greater (adjusted OR 1.61, 95% CI: 1.51 to 1.72, p<0.001).
 Conclusions: Older age, the male gender, past history of comorbidities (particularly cancer) and reduced consciousness at arrival are among the factors that can significantly increase the odds of in-hospital death in COVID 19 patients. These factors might be helpful in detecting and managing patients with poorer prognosis.

Direct Inpatient Cost and Payments of COVID-19 in Iran: Quantile Regression Analysis

“…82.35% of COVID-19 cases admitted to the teaching hospital recovered and the case fatality rate was 12.58% (it means that from every 100 admitted cases, 12.58 people died). Baigi et al ( 22 ) explored the epidemiological characteristics of COVID-19 in a major hospital in Tehran, Iran. They estimated the case fatality rate as 12.5% and 9.8% for men and women respectively.…”

The Comparison of Clinical Epidemiology of Hospitalized Patients with COVID-19 during the Third and Fourth Waves of the Pandemic in Gorgan

“…These results can be attributed to early hospitalization and early start of drug therapy, which reduced the number of patients with severe diseases. Similarly, in a study that compared the patients in the first and second waves in Babol City, the number of severe cases of the disease was significantly larger in the first wave than in the second one, and it was suggested that this happened probably because the mean age of the patients in the first wave was higher, and hence, the number of severe cases of the disease was larger compared to the second one [ 7 , 10 ]. However, in this research, although the mean age of the patients in the third wave was somewhat higher than the fourth one, this difference was not statistically significant and could be due to changes in hospitalization criteria and the treatment received by the patients in the fourth wave (i.e., the patients were hospitalized earlier and received drug treatment, and hence, the disease progression towards severity was slower in the fourth wave).…”

“…More than 50% of the hospitalized patients had not been screened by the health system, and the screening had no effect on the length of stay (LOS) and outcomes of the disease [ 6 ]. In addition, Baigi et al reported that older age, being male, history of comorbidities (especially cancer), and decreased consciousness at arrival were among the factors that could considerably increase the risk of death in hospitalized COVID-19 patients in Iran [ 7 ].…”

Risk Factors for Mortality in Hospitalized Patients with COVID-19, Southwestern of Iran; a cross-sectional study

“…The results of recently performed meta-analyses in this regard have shown that underlying diseases, such as diabetes, coronary heart disease, and hypertension are the main prognostic factors of high mortality in patients with COVID-19 (5,6). Some studies conducted in Iran and the United States also confirmed age, gender, and underlying diseases as the main prognostic factors responsible for death risk (4,(7)(8)(9). Another meta-analysis indicated a relationship between tobacco use and high mortality rate among patients with COVID-19 (10).…”