Frailty and Mental Health Disorders Before and During COVID-19 Occurrence in Older Population in Iran: A Longitudinal Repeated-Measures Study.

PURPOSE: Iranians' worry over the number of older patients negatively impacted by COVID-19 surged dramatically throughout the 5 waves of the COVID-19 pandemic, which lasted from January 2020 to September 2021. The goal of this research was to assess the physical and mental health of Iranian older persons throughout the COVID-19 pandemic's major waves. METHODS: The health condition of 507 older persons with a positive examination for COVID-19 illness was assessed before and throughout the 5 waves of coronavirus in south Iran in analytical and hybrid longitudinal research. RESULTS: The primary consequences of COVID-19 incidence on frailty and mental health issues were revealed in this investigation. Using a linear mixed model, we found a reduction of 0.33 in loneliness (ß = -.33, 95% CI -0.39 to -0.26) during the COVID-19 pandemic. The probabilities of becoming depressed, anxious, or frail rose 4.61 (95% CI: 3.77-5.63), 1.85 (95% CI: 1.52-2.24), as well as 1.42 (95% CI: 1.17-1.42) time, subsequently, with COVID-19 occurrence, according to the mixed logistic models. Furthermore, the influence of COVID-19 incidence on loneliness result differs by gender; for depression, it varies by education; and for anxiety, it changes by comorbidities and living independently. CONCLUSION: The COVID-19 pandemic significantly impacts the mental health and frailty of older persons with the positive COVID-19 situation, and this scenario is gender-based too.

Unemployment and COVID-19-related mortality: a historical cohort study of 50,000 COVID-19 patients in Fars, Iran.

OBJECTIVES: Previous studies have estimated the risk of death associated with unemployment in the coronavirus disease 2019 (COVID-19) pandemic, but no studies have examined unemployment before COVID-19 infection as a risk factor for COVID-19-related mortality. Thus, this study aimed to investigate COVID-19 mortality among this population. METHODS: Data on 50,038 people aged 25-59 years were collected from 38 agencies in Fars Province, Iran, from February 2020 to July 2021. Follow-up lasted from participants' diagnosis with COVID-19 based on the results of a reverse transcription-polymerase chain reaction test to participants' death or the end of the study period. The association between unemployment and COVID-19-related mortality was estimated using the Poisson regression method, and a sensitivity analysis was conducted to calculate the E-value. RESULTS: Unemployment was associated with a 2.41-fold (95% confidence interval [CI], 2.01 to 2.90) higher age-adjusted and sex-adjusted risk of COVID-19-related mortality. The adjusted Poisson regression analysis showed 8.82 (95% CI, 6.42 to 12.11), 2.84 (95% CI, 1.90 to 4.24), and 1.58 (95% CI, 1.24 to 2.01) times higher risks of COVID-19-related mortality among unemployed people aged 25-39 years, 40-49 years, and 50-59 years, respectively, than among their employed counterparts. Unemployment increased the risk of COVID-19 mortality by 3.31 (95% CI, 2.31 to 4.74) and 2.30 (95% CI, 1.86 to 2.84) times in female and male, respectively. The E-value was 3.43, reflecting the minimum strength of confounding required to shift the association between unemployment and COVID-19-related mortality toward the null. CONCLUSIONS: Unemployment prior to COVID-19 infection increased the risk of COVID-19-related mortality. COVID-19-related mortality disproportionately impacted unemployed women and younger unemployed people.