ABSTRACT
BackgroundTo prevent infectious diseases, it is necessary to understand how they are spread and their clinical features. Early identification of risk factors and clinical features is needed to identify critically ill patients, provide suitable treatments, and prevent mortality. MethodsWe conducted a prospective study on COVID-19 patients referred to a tertiary hospital in Iran between March and November 2020. Of the 3008 patients (mean age 59.3{+/-}18.7 years, range 1 to 100 years), 1324 were women. We investigated COVID-19 related mortality and its association with clinical features including headache, chest pain, symptoms on CT, hospitalization, time to infection, history of neurological disorders, having a single or multiple risk factors, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia. FindingsThere was a significant association between COVID-19 mortality and old age, headache, chest pain, respiratory distress, low respiratory rate, oxygen saturation less than 93%, need for a mechanical ventilator, having symptoms on CT, hospitalization, time to infection, history of hypertension, neurological disorders, cardiovascular diseases and having a risk factor or multiple risk factors. In contrast, there was no significant association between mortality and gender, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia. InterpretationOur results might help identify early symptoms related to COVID-19 and better manage patients clinically.
ABSTRACT
BackgroundPreventing communicable diseases requires understanding the spread, epidemiology, clinical features, progression, and prognosis of the disease. Early identification of risk factors and clinical outcomes might help to identify critically ill patients, provide proper treatment and prevent mortality. MethodsWe conducted a prospective study in patients with flu-like symptoms referred to the imaging department of a tertiary hospital in IRAN between 3 March 2020 and 8 April 2020. Patients with COVID- 19 were followed up to check their health condition after two months. The categorical data between groups were analyzed by Fishers exact test and continuous data by Wilcoxon Rank-Sum Test. Findings319 patients (mean age 45.48{+/-}18.50 years, 177 women) were enrolled. Fever, dyspnea, weakness, shivering, C-reactive protein (CRP), fatigue, dry cough, anorexia, anosmia, ageusia, dizziness, sweating and age were the most important symptoms of COVID-19 infection. Traveling in past three months, asthma, taking corticosteroids, liver disease, rheumatological disease, cough with sputum, eczema, conjunctivitis, tobacco use, and chest pain did not have any relationship with COVID-19. O_TEXTBOXResearch in contextO_ST_ABSEvidence before this studyC_ST_ABSWe searched Google scholar, PUBMED and Scopus for articles that investigated the recent epidemic of COVID-19, especially those that investigate effective risk factors. We found that there is not enough research in this field, especially the risk factor that is effective in finding the rate of mortality of this disease. Added value of this studyWe determined some of the most important effective risk factors on prediction, clinical outcome and mortality rate of COVID-19 infection. To the best of our knowledge, some of these risk factors are investigated in this work for the first time. Our findings could provide good insight into the early prediction of the disease, its clinical outcomes, and suggest a cost-effective method for mortality prediction. Implication of all the available evidenceCOVID-19 can transmit human-to-human and lead to severe symptoms and high mortality. Early prediction of this disease and the risk of mortality can help the physicians to better manage this worldwide health problem. C_TEXTBOX InterpretationFinding clinical symptoms for early diagnosis of COVID-19 is a critical part of prevention. These symptoms can help in the assessment of disease progression. To the best of our knowledge, some of the effective features on the mortality due to COVID-19 are investigated for the first time in this research. FundingNone
