Noncommunicable disease, clinical course and COVID-19 prognosis: results based on I-core registry

Background:There are no data on the association between clinical course and comorbidity in Iranian patients with COVID-19.Aims:To determine noncommunicable disease (NCD), clinical characteristics and prognosis of patients hospitalized with COVID-19 in Isfahan, Islamic Republic of Iran.Methods:This multicentric retrospective observational study was performed on all patients hospitalized with COVID-19 in Isfahan from 17 February to 6 April 2020. We recruited 5055 patients. Data on clinical course and comorbid NCDs such as hypertension, coronary heart disease (CHD), diabetes mellitus (DM), cancer, chronic kidney disease (CKD) and chronic respiratory disease (CRD) were collected. Statistical analyses were done by Mann–Whitney U, χ2 and logistic regression tests using Stata version 14.Results:DM and hypertension were the most prevalent comorbidities in patients with positive and negative reverse transcription polymerase chain reaction (RT-PCR). Odds ratio (95% confidence interval) of mortality-associated factors was significant for DM [1.35 (1.07–1.70)], CHD [1.58 (1.26–1.96)], CRD [2.18 (1.58–3.0)], and cancer [3.55 (2.42–5.21)]. These results remained significant for cancer after adjustment for age, sex and clinical factors. Among patients with positive RT-PCR, death was significantly associated with CRD and cancer, while this association disappeared after adjustment for all potential confounders. There was a significant association between NCDs and higher occurrence of low oxygen saturation, mechanical ventilation requirement and intensive care unit admission after adjustment for age and sex.Conclusion:The presence of NCDs alone did not increase mortality in patients with COVID-19, after adjustment for all potential confounders including clinical factors.

The COVID-19 Pandemic, Socioeconomic Effects, and Intimate Partner Violence Against Women: A Population-Based Cohort Study in Iran (preprint)

Background: Intimate partner violence (IPV) is a significant public health challenge. IPV hotlines in high-income settings have reported rising numbers of calls in the COVID-19 pandemic era. However, no systematic studies to examine prevalence and risk factors of IPV have transpired. We investigated the prevalence, pattern, and socioeconomic risk factors of IPV pre- and six months after the onset of pandemic (hereafter post-pandemic) among a cohort of Iranian women.Methods: Our population-based IPV survey was conducted before the onset of the COVID-19 epidemic in Iran, when we interviewed 2502 partnered Iranian women aged 18-60 years. We conducted a follow-up measurement six months later (n=2116). Prevalence and first-time incidence (FTI) of psychological, physical, and sexual IPV and their 95% confidence interval (CI) were estimated. Adjusted Odds Ratio (OR) and their 95% CI were estimated.Results: The post-pandemic prevalence of IPV (65∙4%; CI: 63∙4%- 67∙4%) was higher than pre-pandemic prevalence (54∙2%; CI: 52∙2%- 56∙3%). At follow up, FTI of IPV was 25∙5% (CI: 22∙9%- 28∙4%). The highest increase of FTI was observed in cases of physical and sexual IPV. Being employed was correlated with IPV (OR: 0∙42; CI: 0∙25- 0∙68). Having the highest socioeconomic status (OR: 0∙04; CI: 0∙01- 0∙17) and a full-time employed partner (OR: 0∙02; CI: 0∙01- 0∙03) were correlated with physical IPV.Interpretation: The prevalence and severity of IPV have increased following the onset of the COVID-19 pandemic. Unemployment of women or their partners and pre-pandemic lower socioeconomic status are risk factors of IPV against women without previous experience of IPV. Monitoring programs should target these populations to prevent IPV. Guidelines for addressing IPV in the context of the COVID-19 pandemic need to be adapted for low- and middle-income countries.Funding: Vice-Chancellor for Research, Shiraz University of Medical SciencesDeclaration of Interests: The authors declare that there is no conflict of interests.Ethics Approval Statement: The study protocol was approved by the Institutional Review Board (IRB) of Shiraz University of Medical Sciences (IR.SUMS.MED.REC.1399.301).