Disease Waves of SARS-CoV-2 in Iran Closely Mirror Global Pandemic Trends

Fattahi, Zohreh; Mohseni, Marzieh; Beheshtian, Maryam; Jafarpour, Ali; Jalalvand, Khadijeh; Keshavarzi, Fatemeh; Behravan, Hanieh; Ghodratpour, Fatemeh; Ashrafi, Farzane Zare; Kalhor, Marzieh; Azad, Maryam; Koshki, Mahdieh; Ghaziasadi, Azam; Soveyzi, Mohamad; Abdollahi, Alireza; Kiani, Seyed Jalal; Ataei‐Pirkooh, Angila; Rezaeiazhar, Iman; Bokharaei-Salim, Farah; Haghshenas, Mohammad Reza; Babamahmoodi, Farhang; Mokhames, Zakiye; Soleimani, Alireza; Elahi, Zohreh; Ziaee, Masood; Javanmard, Davod; Ghafari, Shokouh; Ezani, Akram; Moghaddam, Alireza Ansari; Shahraki-Sanavi, Fariba; Shahri, Seyed Mohammad Hashemi; Azaran, Azarakhsh; Yousefi, Farid; Moattari, Afagh; Moghadami, Mohsen; Fakhim, Hamed; Ataei, Behrooz; Nasri, Elahe; Poortahmasebi, Vahdat; Varshochi, Mojtaba; Mojtahedi, Ali; Jalilian, Farid Azizi; Khazeni, Mohammad; Moradi, Abdolvahab; Tabarraei, Alijan; Piroozmand, Ahmad; Yahyapour, Yousef; Bayani, Masoumeh; Tavangar, Fatemeh; Yaghoubi, M.; Keramat, Fariba; Tavakoli, Mahsa; Jalali, Tahmineh; Pouriayevali, Mohammad Hassan; Salehi‐Vaziri, Mostafa; Khorshid, Hamid Reza Khorram; Najafipour, Reza; Malekzadeh, Reza; Kahrizi, Kimia; Jazayeri, Seyed Mohammad; Najmabadi, Hossein

doi:10.34172/aim.2022.83

Cited by 6 publications

(10 citation statements)

References 45 publications

(65 reference statements)

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“…Babol district experienced six major waves of hospitalizations and deaths in the summer and fall compared to other provinces. In contrast to other reports from Iranian health authorities, the results of the present study also represented an increase in the total number of hospitalizations during the fifth wave, but in deaths during the first wave compared to the subsequent and later waves 11 . It is worth noting that the fifth wave was accompanied by the emergence of Delta variants of SARS-CoV-2 in our region, which are more transmissible than the first wave associated with the ancestral Wuhan strain.…”

Section: Discussioncontrasting

confidence: 99%

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Demographics, clinical characteristics, and outcomes in hospitalized patients during six waves of COVID‑19 in Northern Iran: a large cohort study

Shirafkan,

Sadeghi,

Halaji

et al. 2023

Sci Rep

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Since the first report of coronavirus disease 2019 (COVID-19) in Iran, our country has experienced several waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Northern Iran was one of the most affected regions of the country by COVID-19. In the current study, the demographic and clinical characteristics and outcomes of hospitalized patients were determined over a 2-year period (during six waves of SARS-CoV-2). This is a large cohort study investigating hospitalized patients with suspected and probable, and confirmed SARS-CoV-2 infection in Babol district, northern Iran, during the two years of COVID-19. The study population included patients admitted to four hospitals affiliated with Babol University of Medical Sciences between March 7, 2020 (start of the first wave) and March 20, 2022 (end of the sixth wave). Epidemiological and demographic characteristics, real-time PCR, cycle thresholds, clinical data and outcomes of COVID-19 were analyzed in 24,287 hospitalized patients. A total of 24,287 hospitalized patients were included in the study: 13,250 (46.6%) patients were suspected of having COVID-19, 11037(45.4%) were confirmed COVID-19 cases. The mean age of confirmed COVID-19 patients was 54.5 ± 18.9 years and 5961 (54%) were female. The median length of hospitalization for COVID-19 survivors and non-survivors was 5 (interquartile range [IQR] 4-8) and 7 (IQR 3-15) days, respectively. Of the patients with confirmed COVID-19, 714 (6.5%) died during hospitalization. In addition, the mortality rate from the first to the sixth wave was 22.9%, 8.1%, 9.9%, 6.8%, 2.7% and 3.5% in confirmed COVID-19 patients. The patients in the fifth wave were significantly younger than the others (mean age and SD of 51.1 ± 17.4 versus 59.2 ± 16.9, 54.7 ± 19.9, 58.4 ± 17.9, 53.5 ± 16.8 and 58.5 ± 25.1 years; p<0.001). The highest in-hospital mortality rate was 22.9% (126/551) in the first wave and the lowest in the fifth wave was 2.7% (96/3573) of cases. In conclusion, in the present study, the in-hospital mortality rate was 6.5% and more than half of the deceased patients were ≥65 years old. Male gender, advanced age and comorbidities significantly increased the mortality rate. The patients in the fifth wave were significantly younger than those in the other waves, and the lowest mortality rate and intensive care unit admission were also observed in the fifth wave.

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Section: Discussioncontrasting

confidence: 99%

“…Several variants of SARS-CoV-2 have emerged during the pandemic, some of which have spread worldwide, while others have quickly disappeared 11 . In Iran, the outbreak of the SARS-CoV-2 pandemic occurred in six different waves until October 2021.…”

Section: Introductionmentioning

confidence: 99%

Demographics, clinical characteristics, and outcomes in hospitalized patients during six waves of COVID‑19 in Northern Iran: a large cohort study

Shirafkan,

Sadeghi,

Halaji

et al. 2023

Sci Rep

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“…Despite the fact that Iran was one of the first and most affected countries facing the SARS-CoV-2 rapid expansion, there was no large-scale SARS-CoV-2 genome sequencing data available for monitoring the circulating SARS-CoV-2 variants throughout the country in the early days of the pandemic. 18 , 19 A considerable effort by the Genetics Research Center (GRC) of the University of Social Welfare and Rehabilitation Sciences (USWR) subjected 369 SARS-CoV-2 samples from different regions of Iran to WGS from March 2020 to May 2021. 18 , 19 …”

Section: Introductionmentioning

confidence: 99%

“… 18 , 19 A considerable effort by the Genetics Research Center (GRC) of the University of Social Welfare and Rehabilitation Sciences (USWR) subjected 369 SARS-CoV-2 samples from different regions of Iran to WGS from March 2020 to May 2021. 18 , 19 …”

Section: Introductionmentioning

confidence: 99%

Implementation of an In-House Platform for Rapid Screening of SARS-CoV-2 Genome Variations

et al. 2023

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Background: Global real-time monitoring of SARS-CoV-2 variants is crucial to controlling the COVID-19 outbreak. The purpose of this study was to set up a Sanger-based platform for massive SARS-CoV-2 variant tracking in laboratories in low-resource settings. Methods: We used nested RT-PCR assay, Sanger sequencing and lineage assignment for 930-bp of the SARS-CoV-2 spike gene, which harbors specific variants of concern (VOCs) mutations. We set up our platform by comparing its results with whole genome sequencing (WGS) data on 137 SARS-CoV-2 positive samples. Then, we applied it on 1028 samples from March-September 2021. Results: In total, 125 out of 137 samples showed 91.24% concordance in mutation detection. In lineage assignment, 123 out of 137 samples demonstrated 89.78% concordance, 65 of which were assigned as VOCs and showed 100% concordance. Of 1028 samples screened by our in-house method, 78 distinct mutations were detected. The most common mutations were: S:D614G (21.91%), S:P681R (12.19%), S:L452R (12.15%), S:T478K (12.15%), S:N501Y (8.91%), S:A570D (8.89%), S:P681H (8.89%), S:T716I (8.74%), S:L699I (3.50%) and S:S477N (0.28%). Of 1028 samples, 980 were attributed as VOCs, which include the Delta (B.1.617.2) and Alpha (B.1.1.7) variants. Conclusion: Our proposed in-house Sanger-based assay for SARS-CoV-2 lineage assignment is an accessible strategy in countries with poor infrastructure facilities. It can be applied in the rapid tracking of SARS-CoV-2 VOCs in the SARS-CoV-2 pandemic.

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“…Rapid emergence of new SARS-CoV-2 variants due to viral mutations increases its ability to escape the immune system and infect more patients, renders immunization ineffective, and affects the effectiveness of public health measures ( 5 ). In September 2020, Alpha became the dominant variant in Iran ( 6 ), which was associated with double the risk of hospitalization during 14 days of a positive molecular test in the UK and Scotland compared to previous variants ( 7 ). However, this variant predominated in Iran before starting vaccination, which made it one of the worst COVID-19 peaks so that the daily death toll exceeded 700.…”

Section: Introductionmentioning

confidence: 99%

Demographic and clinical characteristics and outcomes of COVID-19 patients admitted to a university hospital in the west of Iran: a retrospective study in the third wave

Jesmani¹,

Bozorgomid²,

Shadmani³

et al. 2023

Vacunas

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Disease Waves of SARS-CoV-2 in Iran Closely Mirror Global Pandemic Trends

Cited by 6 publications

References 45 publications

Demographics, clinical characteristics, and outcomes in hospitalized patients during six waves of COVID‑19 in Northern Iran: a large cohort study

Demographics, clinical characteristics, and outcomes in hospitalized patients during six waves of COVID‑19 in Northern Iran: a large cohort study

Implementation of an In-House Platform for Rapid Screening of SARS-CoV-2 Genome Variations

Demographic and clinical characteristics and outcomes of COVID-19 patients admitted to a university hospital in the west of Iran: a retrospective study in the third wave

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