ABSTRACT
Background & Aims: Epidemics of human viruses began during the period of Neolithic around 12,000 years ago. Humans developed more densely population which allowed viruses to spread rapidly among communities. Also, plant and livestock viruses increased along with human viruses (2). At the January 2020, the coronavirus disease (COVID-19 7th human coronavirus) was discovered in Wuhan, Hubei province of China. COVID-19 virus caused six million deads in the world to date and cussed infection of more than seven million of cases in Iran (1). This infectious disease caused by the SARS-CoV-2 virus. This virus was contagious and fast-spread. Despite the aquarantine politics, SARS-CoV-2 virus caused many permanent economic and health damages in most countries. Coronaviruses are positive-sense, single- stranded enveloped RNA viruses with helical capsids that infect a wide range of hosts including humans, bats, other mammals, and birds (2). Coronaviruses are belonging to Nidovirales order, Coronaviridae family, Coronovirinae subfamily and four genera of alpha, beta, delta, and gamma. Alpha and beta coronaviruses are known as human infection agents. SARS-COV-2 virus abilities are including: high mortality number, short period of incubation, widespread transmission protocols, asymptomatic infection and affecting on most vital organs (heart, brain, lungs and ...) which have attracted the health system attention and caused neglect to the other chronic and non-communicable diseases (4). Therefore, the disease incidence, prevalence and prioritization around the world may change in the future. From the beginning of COVID-19 pandemic, some symptoms and risk-factors have been introduced to the world as the increase elements of morbidity and mortality. Studies have shown that having any kind of underlying diseases and risk factors will be effective in the COVID-19 disease severity and mortality (6). Some of these important risk factors are including of chronic kidney disease, hypertension, age, gender, obesity, obstructive pulmonary diseases, diabetes, lung diseases, cardiovascular diseases, cancer, and liver disease. Also, each risk factors have different impact in different geographic areas (7). Some factors, such as different viral load kinetics in each individual person, epidemiological history, therapeutic or pharmacological effects and immune response have some major impacts on the laboratory diagnostic results. Due to the successive mutations of the SARS-CoV-2 virus and the high incidence disease, it seems that the vaccination alone cannot prevent the COVID-19 (9). On the other hand, the World Health Organization has warned about the vaccination as the only pandemic control protocol. Therefore, the prevalence of morbidity and mortality have become the public health concerns in the world since the beginning of the COVID-19 epidemic and the vaccination. Recognizing of the risk-factors and symptoms on COVID-19 in different geographic areas can be a helpful source to prevent the mortality. Understanding risk factors can help the world to control of the coronaviruses pandemic period and similar situations in the future. Therefore, the aim of this study was to determine the risk-factors of mortality of COVID-19 patients in three cities of Khuzestan province, Iran. Methods: This research was an analytical cross-sectional study. Some details of 27963 COVID-19 patients such as clinical symptoms, individual characteristics and underlying diseases were gathered from hospitals in Abadan, Shadegan and Khorramshahr cities in Khuzestan province, Iran, from 20 February 2020 to November 2020. All the under-study population was previously investigated in terms of COVID-19 infection by the medical examinations and laboratory methods. This under-study population was categorized into three different groups such as hospitalized, outpatients and dead patients. Hospitalized patients have admitted in general or ICU (Intensive Care Unit) sector. Obtained database of COVID-19 patients was analyzed by IBM SPSS version 22.0 under regression, logistic model (u
ABSTRACT
Background and Objectives: This study aimed to investigate the effective factors in the survival/hazard time of Covid-19 patients in three waves of epidemic.
ABSTRACT
Background and Objectives: This study aimed to investigate the effective factors in the survival/hazard time of Covid-19 patients in three waves of epidemic. Methods: All 880 Covid-19 patients were included in this prospective cohort study using the census method. Polymerase chain reaction was used to diagnose Covid-19. The survival status of these patients was followed up for 4 months. The analysis of this study was based on the time of infection in three epidemic waves in IRAN. To analyze the data, the Kaplan-Meier nonparametric approach and Cox proportional hazards regression model were used. Survival distributions were compared in three epidemic waves using the R software (version 3.6.2) (P<0.05). Results: We diagnosed 880 positive case of Covid-19 using PCR test on 2269 susspected people who had respiratory symptomps. At the end of 1-year follow-up, cumulative incidence (risk) of Covid-19 was estimated 7%. Effective factors in the survival time of patients with Covid-19 based on Cox multivariate regression model were: 1-Age 2-Intensity of infection (Hospitalization) 3-Heart disease 4-Epidemic Wave and 5-Transmission mode of the disease (P <0.05). The Kaplan-Meier approach and log rank test (Mantel-Cox) showed a significant difference in the survival rate in three epidemic waves (P = 0.018). Conclusion: Elderly patients, especially those with a history of heart disease, are at higher risk of death than other groups. In addition to regular screening, these patients will need active monitoring, especially at the time of hospitalization. © 2021 The Authors.