COVID-19 in Iran: clinical presentations and outcomes in three different surges of COVID-19 infection

Abstract

Background A few studies compared the characteristics and outcomes of COVID-19 patients during the first and second surges of the disease. We aimed to describe the clinical features and outcomes of COVID-19 patients across the first, second, and third surges of the disease in Tehran, Iran. Method We conducted a retrospective cohort study of patients with COVID-19 admitted to Sina hospital in Tehran, Iran, during three surges of COVID-19 from February 16 to October 28, 2020. Result Surge 1 patients were younger with more prevalence of hypertension. They also presented with significantly higher oxygen saturation, systolic blood pressure, and respiratory rate on admission. Patients had higher levels of neutrophil to lymphocyte ratio, Urea, CRP, and ESR, in surge 2. The incidence of dyspnea, chest pain, and neurological manifestations followed a significant increasing trend from surge 1 to surge 3. There was no difference in severity and in-hospital mortality between the surges. However, the length of hospital stays and acute cardiac injury (ACI) was less in surge 1 and acute respiratory distress syndrome (ARDS) in surge 2 than in other surges. Conclusion Patients did not significantly differ in disease severity, ICU admission, and mortality between surges; however, length of hospital stay and ACI increased during surges, and the number of patients developing ARDS was significantly less in surge 2 compared to other peaks.

Variation Analysis of SARS-CoV-2 Complete Sequences from Iran

“…The third peak had the most respiratory involvement, and the fourth peak had the least respiratory involvement, but the need for special care or tracheal intubation was greater in the first wave of the disease [ 26 ]. Cough and abdominal pain were more prevalent in the first wave, decreased in the second, then resurfaced in the third [ 27 ]. The second wave of the disease also included gastrointestinal symptoms [ 24 , 26 , 27 ].…”

“…Cough and abdominal pain were more prevalent in the first wave, decreased in the second, then resurfaced in the third [ 27 ]. The second wave of the disease also included gastrointestinal symptoms [ 24 , 26 , 27 ].…”

Molecular evolutionary model based on phylogenetic and mutation analysis of SARS-CoV-2 spike protein sequences from Asian countries: A phylogenomic approach

“…The nucleotide alignment obtained was subjected to NextClade v2.1.0 tool [ 30 ]. Further, the output obtained from NextClade was used to generate a maximum likelihood (ML) in IQ-TREE multicore v1.6.12 [ 31 ] for phylogenomic analysis, using the best substitution model and other default parameters. Further, phylogenetic analysis was generated based on spike protein genomic regions.…”

Effect of COVID‐19 infection on sex hormone levels in hospitalized patients: A prospective longitudinal study in Iran

“…14 Data collection was started in July 2020 and completed in February 2021 that was coincident with the second and third surges of COVID‐19 in Iran. 15 …”