Demographic and clinical characteristics of severe Covid-19 infections: a cross-sectional study from Mashhad University of Medical Sciences, Iran

  1. Ladan Goshayeshi
  2. Mina Akbari Rad
  3. Robert Bergquist
  4. Abolghasem Allahyari
  5. Kamila Hashemzadeh
  6. MUMS Covid-19 Research Team
  7. Nasrin Milani
  8. Mahdi Gholian-Aval
  9. Fariba Rezaeitalab
  10. Mohammad Jafar Sadeghi Quchani
  11. Zahra Nahbandani
  12. Mandana Khodashahi
  13. Zahra Javid
  14. Mahnaz Mozdourian
  15. Mohammad Ali Yaghoubi
  16. Zahra Mozaheb
  17. Mohsen Seddigh-Shamsi
  18. Mohammad Moeini Nodeh
  19. Shima Nabavi
  20. Hooman Mosannen Mozaffari
  21. Mohammadreza Farzanehfar
  22. Zahra Lotfi
  23. Alireza Shariati
  24. Shekoofe Bonakdaran
  25. Zahra Rezaieyazdi
  26. Zahra Mirfeizi
  27. Maryam Miri
  28. Reza Bassiri
  29. Sajjad Ataei Azimi
  30. Benyamin Hoseini

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Abstract

Background

Coronavirus Disease 2019 (Covid-19) is expanding worldwide. The characteristics of this infection in patients varies from country to country. To move forward, clinical data on infected patients are needed. Here, we report a comparison between fatalities and recovery of patients with severe Covid-19, based on demographic and clinical characteristics.

Methods

Between 5 March and 12 May 2020 in Mashhad, Iran, 1278 of 4000 suspected Covid-19 patients were confirmed positive by real-time reverse-transcriptase–polymerase-chain-reaction assay of upper respiratory specimens. We compared the demographic, exposure history and clinical symptoms of 925 survivors and 353 fatal cases with confirmed disease.

Results

Mean (SD) age for all confirmed patients was 56.9 (18.7) years, 67.1 (15.9) years in fatal cases and 53.0 (18.3) years in survivors. Multivariate logistic regression analysis showed that the outcome of patients was associated with age (odds ratio = 1.049, P  = 0.0001, 95% CI = 1.040–1.057). Despite a high burden of Covid-19 infections in the 30–39 and 40–49 year age groups, most of these (89.6 and 87.2%, respectively) recovered. The median (IQR) duration of hospitalization was 9.0 (6.0–14.0) days. The most prevalent co-morbidities were cardiovascular disorders (21%) and diabetes (16.3%). Dyspnoea (72.7%), cough (68.1%) and fever (63.8%) were the most frequent clinical symptoms. Healthcare workers, of whom two (3%) died, comprised 5.2% of infected cases. Combination antiviral and antibiotic therapy was used in 43.0% of cases.

Conclusions

The characteristics of severe Covid-19 varied substantially between fatal cases and survivors, with diabetes and cardiovascular disorders the most prevalent co-morbidities. In contrast to other studies, there were a higher number of fatalities in younger patients in our setting.

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  1. Version published to 10.1186/s12879-021-06363-6
  2. Version published to 10.1101/2020.05.20.20108068v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2020.05.20.20108068: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, it has limitations, chiefly in that the RT-PCR testing approach focused on cases with severe symptoms, most of which were hospitalized. We analysed data from patients treated in facilities served by the Mashhad University of Medical Sciences, and so did not cover all areas of Razavi Khorasan, although most patients requiring hospitalization are routinely referred to this city. Despite the above-mentioned limitations, we feel that our findings are instructive and will inform future research, both in Iran and internationally. In summary, the frequency of Covid-19 fatalities rose considerably from 30-39 years, with a higher number of fatalities in younger patients than in international studies. Fever, cough, and dyspnoea were common symptoms among hospitalized patients with Covid-19. Diabetes and cardiovascular disorders were the most prevalent co-morbidities, as observed in other studies.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  4. Version published to 10.1101/2020.05.20.20108068v1 on medRxiv