Epidemiology of COVID-19 in Tehran, Iran: A Cohort Study of Clinical Profile, Risk Factors, and Outcomes

Abstract

Background. The outbreak of coronavirus disease 2019 (COVID-19) dates back to December 2019 in China. Iran has been among the most prone countries to the virus. The aim of this study was to report demographics, clinical data, and their association with death and CFR. Methods. This observational cohort study was performed from 20th March 2020 to 18th March 2021 in three tertiary educational hospitals in Tehran, Iran. All patients were admitted based on the WHO, CDC, and Iran’s National Guidelines. Their information was recorded in their medical files. Multivariable analysis was performed to assess demographics, clinical profile, outcomes of disease, and finding the predictors of death due to COVID-19. Results. Of all 5318 participants, the median age was 60.0 years, and 57.2% of patients were male. The most significant comorbidities were hypertension and diabetes mellitus. Cough, dyspnea, and fever were the most dominant symptoms. Results showed that ICU admission, elderly age, decreased consciousness, low BMI, HTN, IHD, CVA, dialysis, intubation, Alzheimer disease, blood injection, injection of platelets or FFP, and high number of comorbidities were associated with a higher risk of death related to COVID-19. The trend of CFR was increasing (WPC: 1.86) during weeks 25 to 51. Conclusions. Accurate detection of predictors of poor outcomes helps healthcare providers in stratifying patients, based on their risk factors and healthcare requirements to improve their survival chance.

Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort study

“…An increased risk of mortality among patients with diabetes mellitus was also showed. In line with this finding, high risk of mortality among patients with diabetes mellitus has also been reported in other studies conducted in China, Italy and New York [ 8 , 9 , 13 , 19 ]. This could be related to the fact that diabetes mellitus weakens both the innate and adaptive immune system thus patients with diabetes mellitus are prone to severe COVID-19 illness and death [ 37 ].…”

“…Coronavirus disease-2019 (COVID- 19) is caused by a novel coronavirus called severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and is associated with high morbidity and mortality [1]. On 11th March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic, after 118,000 cases and 4291 deaths were reported in 114 countries [2].…”

“…Majority of the patients have asymptomatic to mild COVID-19 disease and about 15% of the COVID-19 patients suffered severe illness which presented as need for hospitalization, supplemental oxygen or mechanical ventilation [6,7]. A number of studies conducted in mostly high income countries have revealed that the factors associated with severe COVID-19 illness and mortality are older age, male gender, and having comorbidities such as hypertension, diabetes, cardiovascular diseases and respiratory diseases [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Low-income countries could have unique factors associated with mortality.…”

Perceived Stress and Level of Uncertainty Among Hospitalized COVID-19 Patients

“…The Perceived Stress Questionnaire consists of 14 items, each rated on a five-point Likert scale (none, low, moderate, high, and very high) ( Hatamabadi et al, 2022 ). Ahmadian (2012) examined the validity and reliability of the Persian version of this tool, revealing internal consistency coefficients through Cronbach's alpha of 0.71 for the positive perception of controllability, 0.75 for the negative perception of controllability, and 0.84 for the overall questionnaire scores ( Ahmadian, 2012 ).…”

Alzheimer’s disease and COVID-19: Interactions, intrinsic linkages, and the role of immunoinflammatory responses in this process

“…According to relevant reports, people with dementia are more than three times more likely to die from COVID-19 than those without dementia and about 30% of COVID-19 deaths are in people with dementia ( 64 , 65 ). A cohort study conducted in Tehran, Iran showed that Alzheimer disease were associated with a higher risk of death related to COVID-19 ( 66 ). A cohort study conducted in England showed that COVID-19 survivors with pre-existing dementia had a higher risk of hospitalization or death (age and gender adjusted HR 2.47, 1.37 to 4.44, p = 0.002) ( 67 ).…”