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Research article EMHJ – Vol. 28 No. 4 – 2022
Introduction
Chinese scientists isolated a new coronavirus from pa-
tients in Wuhan, China on 7 January 7 2020 (1). The
cause of the disease named coronavirus disease 2019
(COVID-19) was a new virus strain called severe acute
respiratory coronavirus 2 (SARS-CoV-2) (2). The World
Health Organization (WHO) declared the outbreak a
public health emergency of international concern on 30
January 2020 (3). The pandemic has affected high- and
low-income countries and millions of people have been
infected by SARS-CoV-2 (4–6). In March 2020, WHO de-
clared COVID-19 a pandemic (global epidemic) (7). The
high rate of virus spread have led to high rates of infec-
tion and mortality (8). Given the severity of the pandem-
ic and lack of effective treatments, efforts were made to
slow the spread of the disease to allow time to produce
and administer effective vaccines and/or treatment (8,9).
Until 2 decades ago, human coronaviruses were
only known to cause uncomplicated respiratory
infections such as the common cold. However, two
new coronaviruses, severe acute respiratory syndrome
(SARS) and Middle East respiratory syndrome (MERS),
caused severe outbreaks around the world in 2003 and
2012, respectively (10). Infection with SARS-Cov-2 is
very similar to other viral infections in terms of clinical
manifestations (7,11), and patients show a wide range of
clinical symptoms from mild and asymptomatic to very
severe including viral pneumonia, respiratory failure and
even death (12). The main symptoms of COVID-19 include
fever, cough, and fatigue. Other symptoms include
headache, haemoptysis (bloody sputum), diarrhoea,
shortness of breath and lymphopenia (12,13). Severe
cases have also been associated with heart damage and
pulmonary opacification. A high percentage of people
(about 80%) show asymptomatic infection or mild
symptoms of a cold, while about 20% experience more
severe symptoms of the disease, such as, pneumonia,
sepsis, septic shock and acute respiratory distress
syndrome (14–16). Depending on the severity of the
disease, patients may need to be assisted in breathing (e.g.
Epidemiological and clinical characteristics of patients with
COVID-19 in Islamic Republic of Iran
Marzieh Araban,
1
Mahmood Karimy,
2
Hamid Koohestani,
2
Ali Montazeri
3
and Daniel Delaney
4
1
Department of Health Education and Promotion, Social Determinants of Health Research Center, Public Health School, Ahvaz Jundishapur University
of Medical Sciences, Ahvaz, Islamic Republic of Iran.
2
Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh,
Islamic Republic of Iran.
3
Mental Health Research Group, Mother and Child Health Research Centre, Iranian Institute for Health Sciences Research,
ACECR, Tehran, Islamic Republic of Iran.
4
Department of Psychology, University of Rhode Island, Kingston, Rhode Island, United States of America.
(Correspondence to: Mahmood Karimy: karimymahmood@yahoo.com).
Abstract
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.
Keywords: coronavirus, COVID-19, risk factors, public health, Iran
Citation: Araban M; Karimy M; Koohestani H; Montazeri A; Delaney D. Epidemiological and clinical characteristics of hospitalized patients with
COVID-19 in Islamic Republic of Iran. East Mediterr Health J. 2022;28(4):249–257. https://doi.org/10.26719/emhj.22.008
Received: 21/12/20; accepted: 06/10/21
Copyright © World Health Organization (WHO) 2022. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license
(https://creativecommons.org/licenses/by-nc-sa/3.0/igo)