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Epidemiological and clinical risk factors related to severe COVID-19 in Iran: a multi-center study
Seyed Mohammad Hashemi-Shahri1, Seyed Mohammad Nasiraldin Tabatabaei2, Alireza Ansari-Moghaddam3
1Research Center for Infectious Diseases and Tropical Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
Insights
Older age, substance abuse, and underlying diseases significantly increase the risk of severe COVID-19. Understanding these factors is crucial for managing the pandemic, especially in resource-limited regions.
Area of Science:
- Epidemiology
- Clinical Medicine
- Public Health
Background:
- COVID-19 significantly impacted Iran early in the pandemic.
- Identifying COVID-19 severity factors aids disease management.
- This study focused on a less privileged region in Iran.
Purpose of the Study:
- To investigate epidemiological and clinical features of COVID-19.
- To identify factors associated with COVID-19 severity.
- To inform disease management strategies in underserved areas.
Main Methods:
- Multi-center study of patients admitted to Zahedan University of Medical Sciences hospitals (February-April 2020).
- Extracted demographic, epidemiological, and clinical data from medical records.
- Utilized bivariate and multivariate logistic regression to identify risk factors for severity.
Main Results:
- Out of 413 patients, 35.10% presented with severe COVID-19.
- Older age was associated with increased odds of severe disease (OR 2.27).
- Substance abuse (OR 2.49) and multiple underlying diseases (OR 1.52-2.60) were significant risk factors for severity.
Conclusions:
- COVID-19 severity is notably higher in older individuals, those with substance abuse history, and patients with comorbidities.
- These findings are vital for optimizing clinical management of COVID-19.
- Understanding risk factors is particularly important for resource-constrained settings.
Background:
Iran was one of the first countries to be affected by COVID-19. Identifying factors associated with the severity of COVID-19 is effective in disease management. This study investigated the epidemiological and clinical features and factors related to the severity of COVID-19 in one of the less privileged areas in Iran.
Methods:
In a multi-center study, all patients admitted to Zahedan University of Medical Sciences hospitals in southeastern Iran were investigated from February 29 to April 31, 2020. Demographic, epidemiological, and clinical data of patients were extracted from medical records. Bivariate and multivariate logistic regression models were used to explore the risk factors associated with the severity of COVID-19.
Results:
Among the 413 patients, 55.5% were male, and 145 (35.10%) were in a severe condition at admission time. Multivariate analysis showed that the adjusted odds of the disease severity increased in patients with older age (OR 2.27; 95% CI 1.41-3.65), substance abuse (OR 2.49; 95% CI 1.14-5.43), having one underlying disease (OR 1.52; 95% CI 0.90-2.55), having two underlying disease (OR 2.31; 95% CI 1.19-4.50), and having three or more underlying disease (OR 2.60; 95% CI 1.19-5.66).
Conclusions:
COVID-19 was more severe in older patients, patients with a history of substance abuse, and patients with the underlying disease. Understanding the factors affecting the disease severity can help the clinical management of COVID-19, especially in less privileged areas where fewer resources are available.
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