ABSTRACT
COVID-19 has been considered the most important issue in the last two years. Some characteristics and factors can play a pivotal role in the survival time and mortality of COVID-19 patients. The Delta variant was one of the most important variants of COVID-19. This study aimed to investigate the risk factors of COVID-19 survival before and after the spread of the Delta variant. In this historical cohort study, 6,117 hospitalized patients with positive COVID-19 PCR tests between January and September 2021 participated. Some characteristics such as age, sex, death by COVID-19, and presence/absence of some comorbidities were registered for the patients. Log-rank test and Cox proportional hazards model were done to check the effect of the potential risk factors on the survival of COVID-19 patients by considering the onset of symptoms to death as the time variable. The mean age of patients was 47.29 (SD=18.70). 53% of patients were female, 4.6% were admitted to the ICU, and 3.6% died from COVID-19. Age (HR=9.81, p<.001), cardiovascular disease (HR=2.86, p<.001), chronic kidney disease (HR=6.21, p<.001), diabetes (HR=2.16, p=0.002), hypertension (HR=2.67, p<.001), ICU admission (HR=12.92, p<.001), pO2<93% (HR=6.75, p<.001), and intubation (HR=21.54, P<.001) were risk factors that were influential on the survival of COVD-19 patients before the spread of the Delta variant. Although the effect of some variables changed after the spread of the Delta variant, some of them, like chronic kidney disease and hypertension were no longer significant. Although the effect of some comorbidities was significant only in the crude models, they were not influential in the adjusted model. Conversely, in the presence of other risk factors, especially age, most of the comorbidities were not significant in the adjusted model. Older age, ICU admission, intubation, and pO2<93% are the most important variables which played a pivotal role in the survival of individuals infected by COVID-19. © 2023, Mahidol University - ASEAN Institute for Health Development. All rights reserved.
ABSTRACT
Background and aims: The COVID-19 pandemic caused high morbidity and mortality for humans in the 21st century. This disease can range from mild to severe, with symptoms such as fever, cough, and shortness of breath;and in more severe cases may lead to pneumonia, kidney failure, and death. As there is currently no certain treatment for this disease, it is necessary to control this epidemic through community-based programs. The preparation of emergency educational programs, especially in high-risk groups that are in contact with these patients is an important and vital priority. One of these effective educational theories, in health education, is the Protection Motivation Theory (PMT). This theory is about encouraging protective behaviors among individuals and has been accepted as a framework for predicting and intervening in health-related behaviors. One of the most at-risk groups during the COVID-19 pandemic were bank employees. Therefore, this study was conducted to investigate the predictors of protective behaviors against COVID-19 in bank employees of Sirjan, Iran. Methods: This descriptive and analytical cross-sectional study was conducted in 2020, in Sirjan. The participants in this study were 280 bank employees. Initially, a list of all banks in Sirjan was prepared, and then 10 banks were randomly selected. After visiting the selected banks, individuals who matched the inclusion criteria were found, and then participants were selected and enrolled into the study through a lottery. The inclusion criteria included, willingness to participate in the study, being a bank employee, and being a current resident of Sirjan. The exclusion criterion was people’s unwillingness to participate in the study. The data collection tool was a self-administered questionnaire which included three sections;demographic information, knowledge, and questions related to the Protection Motivation Theory. The questionnaire was first sent to eight health education academics and epidemiologists, to determine its face and content validity. After receiving their comments, some vague, confusing or irrelevant expressions were corrected or deleted. In order to determine internal reliability, 30 individuals were asked to complete the questionnaire, and the Cronbach's alpha was calculated, which was above 0.7 and acceptable. In order to evaluate the external reliability of the questionnaire, test-retest was used, and the scores of the questionnaire that had been completed twice by non-participating employees, with a two-week interval in between, were calculated. This study was approved by the ethics committee of Sirjan School of Medical Sciences (Ethics Code: IR.SIRUMS.REC.1399.002). Before commence, the purpose of the study was explained to the participants, and then their informed consent was obtained. Prior to data analysis, the normality of the data was checked by the Kolmogorov-Smirnov test. Descriptive statistics including frequencies and percentages were reported. Pearson correlation and linear regression were used to analyze the data in SPSS 23 (IBM, Armonk, NY, USA). The level of significance was considered to be p <0.05. Results: The mean age of participants was 41.6±2.16 years. The results of the correlation tests showed that there was a significant correlation between perceived susceptibility and perceived severity (r=0.586, p<0.01). Also, there were positive correlations between protection motivation with perceived susceptibility (r = 0.414, P <0.001), perceived severity (r = 0.354, P <0.001), response efficiency (r = 0.411, P <0.001), self-efficacy (r = 0.508, P <0.001), and fear (r = 0.484, P <0.001);and negative correlations with internal and external rewards (r = -0.104, P <0.05) and response cost (r = -0.237, P = 0.002). According to the linear regression test, 0.585 percent of protection motivation was predicted by perceived susceptibility and severity, response efficiency, self-efficacy, rewards, response cost and fear;among which the role of perceived fear (β = 0.28) was stronger than other variables. Conclusion: The results of this study showed the effectiveness of the application of the protection motivation theory in predicting behaviors effective for preventing COVID-19. Therefore, these structures, especially the perceived fear structure can be used in the development of educational programs and intervention techniques to change the attitude and behavior of bank employees. Therefore, it is suggested that appropriate community-based interventions be developed and implemented based on the protection motivation theory to prevent COVID - 19. © 2020 Iran University of Medical Sciences. All rights reserved.
ABSTRACT
Background and aims: COVID-19 is one of the most dangerous pandemics of the 21st century, which has caused disease in humans and has had various consequences for humans. One of the most at-risk groups are bank employees. Therefore, this study was conducted to investigate the predictors of protective behaviors against COVID-19 in bank employees of Sirjan.