Decomposition of socioeconomic inequality in COVID‐19 mortality in Iran: A retrospective cohort study

Nemati, Saeed; Saeedi, Elnaz; Abdi, Sepideh; Qandian, Ali; Kalhor, Esmaeil; Moradi, Shima; Joshang, Narges; Eftekharzadeh, Anita; Khanghahi, Masoud Hatamzadeh; Fattahi, Pedram; Rajabpour, Mojtaba Vand; Najari, Hamid Reza

doi:10.1111/hsc.13627

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…During the first emergence of the COVID-19 pandemic, the mortality rate among all hospitalized patients and particularly critically ill patients was pretty high [ 3–5 ]. Age, male gender, co-exciting disorders and lower socioeconomic status have already been identified as the factors associated with higher COVID-19 mortality in this period [ 6 , 7 ]. Multiple studies have shown considerable improvement in the survival of these patients after the first disease surge [ 8–10 ].…”

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confidence: 99%

Trends of in-hospital and ICU mortality in COVID-19 patients over the fourth and fifth COVID-19 surges in Iran: a retrospective cohort study from Iran

Abdi

Nemati

Darbaghshahi

et al. 2022

International Journal for Quality in Health Care

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Background The current study aimed to investigate the temporal trend of in-hospital and ICU mortality of COVID-19 patients over 6 months in the spring and summer of 2021 in Iran. Methods We performed an observational retrospective cohort study on 14,355 patients who were hospitalized with confirmed COVID-19 for six months from April to September 2021 in Qazvin province, Iran. The trend of overall in-hospital mortality and ICU mortality were the main outcome of interest. We obtained crude and adjusted in-hospital and ICU mortality rates for each month of admission and over surge and lull periods of the disease. Results The overall in-hospital mortality, early mortality, and ICU mortality were 8.8%, 3.2%, and 67.6%, respectively. The trend for overall mortality was almost plateau ranging from 6.5% in July to 10.7% in April. The lowest ICU mortality was 60.0% observed in April, whereas it reached a peak in August (ICU-mortality= 75.7%). Admission on surge days of COVID-19 was associated with an increased risk of overall mortality (OR=1.3, 95% CI= 1.1, 1.5). The comparison of surge and lull status showed that the odds of ICU mortality in the surge of COVID-19 was 1.7 higher than in the lull period (P-value<0.001). Conclusion We found that the risk of both overall in-hospital and ICU mortality increased over the surge period and fourth and fifth waves of SARS-CoV-2 infection in Iran. Lack of hospital resources and particularly ICU capacities to respond to the crisis during the surge period is assumed to be the main culprit.

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Section: Introductionmentioning

confidence: 99%

Trends of in-hospital and ICU mortality in COVID-19 patients over the fourth and fifth COVID-19 surges in Iran: a retrospective cohort study from Iran

Abdi

Nemati

Darbaghshahi

et al. 2022

International Journal for Quality in Health Care

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“…This database covers demographic, epidemiological, and clinical characteristics of patients hospitalized due to COVID-19. Please see [ 23 , 24 ] for more detailed information about this database.…”

Section: Methodsmentioning

confidence: 99%

In-hospital mortality of COVID-19 in Iranian children and youth: A multi-centre retrospective cohort study

et al. 2022

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Background COVID-19 presents as a mild and less severe respiratory disease among children. However, it is still lethal and could lead to death in paediatric cases. The current study aimed to investigate the clinical characteristics of children and young people hospitalized due to COVID-19 in Qazvin-Iran. We also investigated the risk factors of death due to COVID-19 in paediatric cases. Methods We performed a retrospective cohort study on 645 children and young people (ages 0-17) hospitalized since the beginning of the COVID-19 pandemic. The cases were confirmed with positive results of reverse transcription-polymerase chain reaction (RT-PCR). The data were retrieved from an electronic database of demographic, epidemiological, and clinical characteristics. Results The median age of the admitted patients was 4.0 years, 33.6% were under 12 months old, and 53.0% were female. Fever, cough, nausea/vomiting, dyspnoea, and myalgia were the most common symptoms presented by 50.5%, 47.6%, 24.2%, and 23.0% of the patients, respectively. Overall, we observed 16 cases of death and the in-hospital fatality rate was 2.5%. We also found comorbidity as an independent risk factor of death (odds ratio (OR) = 3.8, 95% confidence interval (CI) = 1.2-12.1, P -value = 0.022). Finally, we observed an increased risk of death in patients with dyspnoea (OR = 11.0, 95% CI = 2.8-43.7). Conclusion In-hospital mortality was relatively high in paediatric patients who were hospitalized due to COVID-19 in Iran. The risk of hospitalization, ICU admission, and death was higher among children with younger ages, underlying causes, and dyspnoea.

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Decomposition of socioeconomic inequality in COVID‐19 mortality in Iran: A retrospective cohort study

Nemati

Saeedi

Abdi

et al. 2021

Health Social Care Comm

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This study aimed to investigate the relationship between socioeconomic status and COVID‐19 mortality in Iran. We performed a retrospective cohort study on data from the hospitalised COVID‐19 patients in Qazvin. We collected data on education, self‐reported socioeconomic status, and location of residence as a proxy for socioeconomic status (SES). We applied the Blinder‐Oaxaca decomposition approach to assess the role of socioeconomic inequality in COVID‐19 mortality and determine the main contributors to the observed inequality. Overall, 941 patients (48.96%) had low SES, while only 24.87% ( n = 478) were classified in the high SES category. The mortality rate was significantly higher in the low SES group, and we spotted a 17.13% gap in COVID‐19 mortality between the high and low SES patients ( p < 0.001). Age was the main contributor to the observed inequality, responsible for 6.91% of the gap ( p < 0.001). Having co‐morbidities (1.53%) and longer length of stay (LOS) in hospitals (0.95%) in the low SES group were other main determinants of the inequality in COVID‐19 mortality ( p < 0.05). In the unexplained part of our model, the effect of increased age (10.61%) and a positive RT‐PCR test result (3.43%) were more substantial in the low SES group compared to the high SES patients ( p < 0.05). The low SES people had an increased risk of getting COVID‐19, and the disease has been more severe and fatal among them. Increased age, co‐morbidities, and LOS were identified as the main drivers of this inequality.

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Decomposition of socioeconomic inequality in COVID‐19 mortality in Iran: A retrospective cohort study

Cited by 4 publications

References 25 publications

Trends of in-hospital and ICU mortality in COVID-19 patients over the fourth and fifth COVID-19 surges in Iran: a retrospective cohort study from Iran

Trends of in-hospital and ICU mortality in COVID-19 patients over the fourth and fifth COVID-19 surges in Iran: a retrospective cohort study from Iran

In-hospital mortality of COVID-19 in Iranian children and youth: A multi-centre retrospective cohort study

Decomposition of socioeconomic inequality in COVID‐19 mortality in Iran: A retrospective cohort study

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