Epidemiological and clinical characteristics of patients with COVID-19 in Islamic Republic of Iran

Background: Coronavirus disease 2019 (COVID-19) is a worldwide public health emergency. Aims: This study aimed to investigate the epidemiological and clinical characteristics of patients with COVID-19 in Saveh city, Islamic Republic of Iran in 2020. Methods: In this descriptive analytical research, 3181 patients suspected of having COVID-19 who visited Saveh med- ical centres were investigated. Patients were confirmed with COVID-19 using polymerase chain reaction testing. Data on sociodemographic, epidemiological and clinical characteristics of the patients were collected using a validated form through interviews and medical records. The chi-squared, t and Fisher exact tests were used to assess differences in socio- demographic, epidemiological and clinical characteristics between patients with positive and negative polymerase chain reaction results. Logistic regression analysis was used to examine the association between independent variables and death from COVID-19. Results: About half the patients (48.3%) had a history of chronic disease. Diabetes (16.2%), high blood pressure (14.8%) and cardiovascular disease (12.4%) were the most prevalent chronic diseases among patients who were confirmed positive for COVID-19. Risk factors for death among confirmed COVID-19 patients were: intubation (odds ratio (OR) = 8.97; 95% con- fidence interval (CI): 5.15–15.63), age ≥ 80 years (OR = 5.81; 95% CI: 1.91–17.60), oxygen saturation < 93% (OR = 2.48; 95% CI: 1.51–4.08), diabetes (OR = 1.88; 95% CI: 1.00–3.54) and shortness of breath (OR = 1.70; 95% CI: 1.02–2.82). Conclusion: Given the greater risks of contracting and dying from COVID-19 in certain groups of patients, health educa- tion programmes targeting these groups are recommended.

Exposure to the COVID-19 News on Social Media: Psychological and Self-reported Behavioural Responses Among Iranian Adults (preprint)

Background: Exposure to news on coronavirus disease 2019 (COVID-19) pandemic is inevitable. This study aimed to explore associations between exposure to COVID-19 news on social media and psychological and behavioral consequences among Iranians.Methods: This was a telephone-based survey carried out in April 2020 in Iran. Iranian adults aged 18 and over were randomly selected from the postal codes and using their mobile phones. A self-designed questionnaire was administered to collect data on participants’ characteristics and questions to address their psychological and behavioral responses regarding the COVID-19 pandemic. A multivariate logistic regression model was performed to assess the relationship between anxiety, fear, and behavioral responses and independent variables including exposure to news.Results: In all 1563 adults participated in the study. The mean age of respondents was 39.17±13.5 years. Moderate to high-level anxiety was reported by 55.4% of participants, while fear of being affected by coronavirus was reported by 54.1%. Overall 88% reported that they changed their behaviors to some extent. Exposure to the COVID-19 news on social media was by far the most influencing variable on anxiety (OR= 2.21, 95% CI: 1.62-3.04; P < 0.0001), fear (OR = 1.95, 95% CI: 1.49-2.56; P < 0.0001), and change in health behaviors (OR = 2.02, 95% CI: 1.28-3.19; P = 0.003) in the regression model. While independent variables did not show significant associations with anxiety and behavior change, the fear of being infected by the COVID19 was associated with the female gender and some socio-economic characteristics of the participants.Conclusion: Although exposure to the COVID-19 news on social media seemed to be associated with excessive anxiety and fear among people, it also, to some extent, positively has changed people’s health behaviors towards preventive measures.

Risk perception related to COVID-19 among the Iranian general population: An application of the extended parallel process model (preprint)

Background: The novel coronavirus disease 2019 (COVID-19) has emerged as a major global public health challenge. This study aimed to investigate on how people perceive the COVID-19 outbreak using the components of the Extended Parallel Process Model (EPPM) and to find out how this might contribute to possible behavioral responses to the prevention and control of the disease. Methods: : This cross-sectional study was conducted in Iran during March and April 2020. Participants were recruited via online applications using a number of platforms such as Telegram, WhatsApp, and Instagram asking people to take part in the study. To collect data an electronic self-designed questionnaire based on the EPPM was used in order to measure the risk perception (efficacy, defensive responses, perceived treat) related to the COVID-19. Descriptive statistics, chi-square, t-test and analysis of variance (ANOVA), were used to explore the data. Results: : A total of 3,727 individuals with a mean age (SD) of 37.0 (11.1) years participated in the study. The results revealed significant differences in efficacy, defensive responses and perceived treat among different population groups particularly among those aged 60 and over. Women had significantly higher scores than men on some aspects such as self-efficacy, reactance, and avoidance but men had higher perceived susceptibility scores compared to women. Overall 56.4% of participants were engaged in danger control (preventive behavior) while the remaining 43.6% were engaged in fear control (non-preventive behavior) process. Conclusion: More than half of all participants motivated by danger control. This indicated that more than half of participants had high perceived efficacy (i.e., self-efficacy and response efficacy). Self-efficacy scores were significantly higher among participants who were older, female, single, lived in rural areas, and had good economic status. The results suggest that socioeconomic and demographic factors are the main determinants of the COVID-19 risk perception. Indeed, targeted interventions are essential for controlling the pandemic.

Developing and validating the risk perceptions questionnaire for COVID-19 (Risk Precept COVID-19): an application of the extended parallel process model (preprint)

Background In order to understand how people perceive, process, and respond to COVID-19 risk information, a valid and reliable instrument is needed. This study aimed to develop an instrument to measure the risk perceptions of people about COVID-19 based on the Extended Parallel Process Model (EPPM). Methods This cross-sectional study was conducted in Tabriz, Iran. First, a comprehensive literature review was conducted to develop the initial draft of Risk-percept COVID-19. Then, in order to obtain a pre-final version of the instrument, face and content validity were conducted. After that, construct validity (exploratory and confirmatory), internal consistency using test-retest reliability and Cronbach’s alpha of the instrument were measured. Results Forty two item were initially generated. During the content validity, it was reduced to 29 items. The exploratory factor analysis (EFA) revealed four factors (perceived response efficacy, perceived threats (severity and susceptibility), perceived self-efficacy, and defensive responses (denial, avoidance and reactance) that accounted for 49.97 of the observed variance. The confirmatory factor analysis (CFA) designated a model with appropriate fitness for the data. Cronbach’s alpha coefficient for the dimensions ranged from .697 to .793, and the Intraclass Correlation Coefficient (ICC) ranged from .71 to .80 within acceptable ranges. Conclusion the current findings show that the Risk-percept COVID-19 is a valid and reliable instrument to assess the cognitions and perceptions of adults.