Epidemiological and Clinical Risk Factors Related to Severe COVID-19 in Iran: A multi-center study

Abstract

Background Iran was one of the first countries to be affected by COVID-19. Identifying factors associated with the severity of COVID-19 is useful in disease management. This study investigated the epidemiological and clinical features and factors related to severe COVID-19 in Iran's less-privileged area.MethodsIn a multicenter study, all patients admitted to Zahedan University of Medical Sciences hospitals located in southeastern Iran were investigated from February 29 to April 31, 2020. The demographic, epidemiological, and clinical data of patients were extracted from medical records. To explore the risk factors associated with the severity of COVID-19, bivariate and multivariate logistic regression models were used. ResultsAmong the 413 patients, 55.5% were male, and 145 (35.10%) were in severe condition at admission time. Multivariate analysis showed that the adjusted odds of the disease severity increased in patients with older age (OR 3.51; 95% CI, 2.28-5.40), substance abuse (OR 2.22; 95% CI, 2.05-5.78), and at least one underlying disease (OR 3.45; 95% CI, 1.01-1.32).Conclusions COVID-19 was more severe in older patients, patients with a history of substance abuse, and patients with at least one underlying disease. Understanding the factors affecting the disease severity can help for the clinical management of COVID-19, especially in less privileged areas where fewer resources are available.

Acute kidney injury in hospitalized COVID-19 patients in Iran; a systematic review and meta-analysis

“…The summary of characteristics extracted from studies is presented in Table 1. From 22 included studies, 9 were cohort (17,(19)(20)(21)(23)(24)(25)33,36), 8 were cross-sectional (26,(30)(31)(32)34,35,37,38), one was case-control (28), and 4 were trials (18,22,27,29). Nineteen studies had completed peer-review processes and were published from June to November 2020; while three studies (21,24,32) were not granted publication and peer-review at the time of inclusion.…”

“…While 12 articles reported results from more than 7 hospitals located in various districts of Tehran, Iran's capital and the most populous city (17-20, 23,26,27,30,33,34,36,37), other studies were carried out in Zahedan (the Southeast) (21,35), Abadan (the Southwest) ( 22), Qom (the center) (24), Urmia and Tabriz (the northwest) (25,29,31), Mazandaran and Rasht (the north) (28,38), and Nahavand (the west) (32). Three studies were conducted in a multi-center fashion (21,25,30), (17,20,23,24,27,36,38) which is an increase in serum creatinine by 0.3 mg/ dL within 48 hours or a 50% increase in serum creatinine from baseline within 7 days (39). One study outlined AKI as >30% decrease in eGFR estimated by MDRD equation (37), while AKI was defined roughly by serum creatinine cut-off if specified in other studies.…”

Clinical features, therapeutic outcomes, and recovery period of long COVID

“…Then, a smoking habit was an independent risk factor for slowing the duration of recovery from long COVID (Table 5), suggesting a need for increased attention to smoking during the whole clinical course of COVID‐19. On the other hand, sex (female), older age, and the presence of comorbidities were not independent risk factors for prolonged recovery in the analysis (Table 5), although several previous studies presented their negative effects on COVID‐19 10,12,26,36,40–43 . Of course, this finding must be confirmed in further studies; however, a prominent result was that smoking exerts a crucial effect on these infectious problems.…”

“…On the other hand, sex (female), older age, and the presence of comorbidities were not independent risk factors for prolonged recovery in the analysis (Table 5), although several previous studies presented their negative effects on COVID-19. 10,12,26,36,[40][41][42][43] Of course, this finding must be confirmed in further studies; however, a prominent result was that smoking exerts a crucial effect on these infectious problems.…”