Jundishapur Scientific Medical Journal

Jundishapur Scientific Medical Journal

‏Epidemiologic and Clinical Characteristics of Hospitalized Patients with COVID-19: A Case-control Study

Document Type : Original Article

Authors
1 Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran
2 Assistant Professor of Biostatistics Department of Public Health, School of Health Research Center for Environmental.
3 Assistant Professor of Internal Medicine School of Medicine Ayatollah Taleghani Hospital Abadan University of Medical Sciences, Abadan, Iran.
4 Associate Professor of Healthcare Services Management, Department of Public Health, School of Health, Abadan, University of Medical Sciences, Abadan, Iran.
10.32592/JSMJ.23.2.123
Abstract
Background and Objectives COVID-19 is a new disease, and there is limited information about its risk factors. This study aimed to determine epidemiologic and clinical characteristics of hospitalized COVID-19 patients in Abadan.
Subjects and Methods This research employed a case-control design, wherein deceased patients with confirmed COVID-19 diagnoses served as the case group. The control group comprised hospitalized patients at Taleghani Hospital who had recovered from COVID-19 and were discharged in good health. Data were extracted from patient records. Logistic regression and generalized estimating equation (GEE) analyses were used to determine the risk factors for COVID-19 mortality. All statistical analyses were performed using SPSS software version 27 at a significance level of 0.05.
Results Demographic, clinical and laboratory data of 221 discharged and 221 deceased patients were assessed. The composition of the study participants included females in both the control and case groups (47.5% and 40.89%, respectively). Compared to controls, cases exhibited characteristics associated with greater disease severity. These included a higher mean age, a greater prevalence of underlying medical conditions, and lower oxygen saturation levels. Interestingly, the control group experienced a higher incidence of diarrhea. Conclusion While the study observed an association between diarrhea and lower mortality among the investigated patients, a cautious interpretation is warranted due to the potential presence of unmeasured confounding variables.
Keywords
Subjects

[1] Director W. General’s opening remarks at the Mission briefing on COVID-19. Tedros Adhanom Ghebreyesus: Geneva, Switzerland. 2020 .
[2] Control CfD, Prevention. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID 19 . 2020
[3] Ong EZ, Chan YFZ, Leong WY, Lee NMY, Kalimuddin S, Mohideen SMH, et al. A dynamic immune response shapes COVID-19 progression. Cell host & microbe. 2020;27(6):879 -
82. e2 . [10.1016/j.chom.2020.03.021] [PMID]
[4] Cao Y, Li L, Feng Z, Wan S, Huang P, Sun X, et al. Comparative genetic analysis of the novel coronavirus (2019-nCoV/SARS-CoV-2) receptor ACE2 in different populations. Cell discovery. 2020;6(1):1 - 4 . [10.1038/s41421-020-0147-1 ] [PMID]
[5] Wenzhong L, Hualan L. COVID-19: attacks the 1-beta chain of hemoglobin and captures the porphyrin to inhibit human heme metabolism. 2020 .
[6] Zhao J, Yang Y, Huang H, Li D, Gu D, Lu X, Zhang Z, Liu L, Liu T, Liu Y, He Y. Relationship between the ABO blood group and the coronavirus disease 2019 (COVID-19) susceptibility. Clinical Infectious Diseases. 2021 Jul 15;73(2):328-31. [10.1093/ cid/ciaa1150] [PMID]
[7] Taghizadeh F, Taghizadeh H. Naso-pharyngeal discharge: The first symptom of COVID-19 infection: Report two cases from Iran. Clinical case reports. 2020 Dec;8(12):2536-7 [10.1002/ ccr3.3214] [PMID]
[8] Shirani K, Sheikhbahaei E, Torkpour Z, Nejad MG, Moghadas BK, Ghasemi M, Aghdam HA, Ehsani A, Saber-Samandari S, Khandan A. A narrative review of COVID-19: the new pandemic disease. Iranian Journal of Medical Sciences. 2020 Jul;45(4): 233. [10.30476/ijms.2020.85869.1549] [PMID]
[9] Li T. Diagnosis and clinical management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: an operational recommendation of Peking Union Medical College Hospital (V2. 0) working group of 2019 novel coronavirus, Peking union medical college hospital. Emerging microbes & infections. 2020 Jan 1;9(1):582-5. [10.1080/22221751.2020. 1735265] [PMID]
[10] Zali A, Gholamzadeh S, Mohammadi G, Looha MA, Akrami F, Zarean E, Vafaee R, Maher A, Khodadoost M. Baseline characteristics and associated factors of mortality in COVID-19 patients; an analysis of 16000 cases in Tehran, Iran. Archives of academic emergency medicine. 2020;8(1). [PMID]
[11] Semenzato L, Botton J, Drouin J, Cuenot F, Dray-Spira R, Weill A, Zureik M. Chronic diseases, health conditions and risk of COVID-19-related hospitalization and in-hospital mortality during the first wave of the epidemic in France: a cohort study of 66 million people. The Lancet Regional Health–Europe. 2021 Sep 1;8. [10.1016/j.lanepe.2021.100158] [PMID]
[12] Gimeno-Miguel A, Bliek-Bueno K, Poblador-Plou B, Carmona-Pírez J, Poncel-Falcó A, González-Rubio F, et al. Chronic diseases associated with increased likelihood of hospitalization and mortality in 68,913 COVID-19 confirmed cases in Spain: A population-based cohort study. Plos one. 2021;16(11): e0259822. [10.1371/journal.pone.0259822 ] [PMID]
[13] Huang K, Zhang J, Wu W, Huang D, He C, Yang Y, Zeng X, Jiang Z, Li B, Liu H. A retrospective analysis of the epidemiology,
clinical manifestations, and imaging characteristics of familial cluster-onset COVID-19. Annals of Translational Medicine. 2020 Jun;8(12). [10.21037/atm-20-3759] [PMID]
[14] Tian S, Hu N, Lou J, Chen K, Kang X, Xiang Z, Chen H, Wang D, Liu N, Liu D, Chen G. Characteristics of COVID-19 infection in Beijing. Journal of infection. 2020 Apr 1;80(4):401-6. [10. 1016/j.jinf.2020.02.018] [PMID]
[15] Bazargan M, Amirfakhriyan M. Geographical analysis of COVID-19 epidemiology in Iran with exploratory spatial data analysis approach (ESDA). Journal of Military Medicine. 2022 Oct 26;22(6):542-52.
[16] Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, Hu Y, Tao ZW, Tian JH, Pei YY, Yuan ML. A new coronavirus associated with human respiratory disease in China. Nature. 2020 Mar;579 (7798):265-9. [10.1038/s41586-020-2008-3 ] [PMID]
[17] Zhang JJ, Cao YY, Tan G, Dong X, Wang BC, Lin J, Yan YQ, Liu GH, Akdis M, Akdis CA, Gao YD. Clinical, radiological, and laboratory characteristics and risk factors for severity and mortality of 289 hospitalized COVID-19 patients. Allergy. 2021 Feb;76(2):533-50. [10.1111/all.14496] [PMID]
[18] Zhang J, Wang Z, Wang X, Hu Z, Yang C, Lei P. Risk factors for mortality of COVID-19 patient based on clinical course: a single center retrospective case-control study. Frontiers in Immunology. 2021 Feb 16;12:581469. [10.3389/fimmu.2021. 581469] [PMID]
[19] Yu C, Lei Q, Li W, Wang X, Li W, Liu W. Epidemiological and clinical characteristics of 1663 hospitalized patients infected with COVID-19 in Wuhan, China: a single-center experience. Journal of infection and public health. 2020 Sep 1;13(9):1202-9. [10.1016/j.jiph.2020.07.002 ] [PMID]
[20] Chen J, Qi T, Liu L, Ling Y, Qian Z, Li T, Li F, Xu Q, Zhang Y, Xu S, Song Z. Clinical progression of patients with COVID-19 in Shanghai, China. Journal of infection. 2020 May 1;80(5):e1-6. [10.1016/j.jinf.2020.03.004] [PMID]
[21] Leng Y, Chen M, Dai M, Wu Y, Lei SQ, Yan K, Shao NY, Xia Z, Liu M. Minimized glycemic fluctuation decreases the risk of severe illness and death in patients with COVID-19. Journal of Medical Virology. 2021 Jul;93(7):4060. [10.1002/jmv.26584] [PMID]
[22] Dai H, Zhang X, Xia J, Zhang T, Shang Y, Huang R, Liu R, Wang D, Li M, Wu J, Xu Q. High-resolution chest CT features and clinical characteristics of patients infected with COVID-19 in Jiangsu, China. International Journal of Infectious Diseases. 2020 Jun 1;95:106-12. [10.1016/j.ijid.2020.04.003] [PMID]
[23] Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020 Feb 15; 395(10223):497-506. [10.1016/S0140-6736(20)30183-5] [PMID]
[24] Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS, Du B. Clinical characteristics of 2019 novel coronavirus infection in China. MedRxiv. 2020 Jan 1.
[25] Talebi S, Nematshahi M, Tajabadi A, Khosrogerdi A. Comparison of clinical and epidemiological characteristics of deceased and recovered patients with COVID-19 in Sabzevar, Iran. Journal of Military Medicine. 2022 Oct 26;22(6):509-16.
[26] Li JY, You Z, Wang Q, Zhou ZJ, Qiu Y, Luo R, Ge XY. The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future.
Jundishapur
Scientific Medical Journal
May & June 2024. Vol 23. No 2
Mahboubi M, et al. Characteristics of Hospitalized Patients with COVID-19. JSMJ. 2024; 23(2):123-133
133
Microbes and infection. 2020 Mar 1;22(2):80-5. [10.1016/j. micinf.2020.02.002] [PMID]
[27] Lin X, Gong Z, Xiao Z, Xiong J, Fan B, Liu J. Novel coronavirus pneumonia outbreak in 2019: computed tomographic findings in two cases. Korean journal of radiology. 2020 Mar 1;21(3): 365-8. [10.3348/kjr.2020.0078] [PMID]
[28] Rastad H, Karim H, Ejtahed HS, Tajbakhsh R, Noorisepehr M, Babaei M, Azimzadeh M, Soleimani A, Inanloo SH, Shafiabadi Hassani N, Rasanezhad F. Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease. Diabetology & metabolic syndrome. 2020 Dec;12:1-1. [10.1186/s13098-020-00565-9] [PMID]
[29] Shahriarirad R, Khodamoradi Z, Erfani A, Hosseinpour H, Ranjbar K, Emami Y, Mirahmadizadeh A, Lotfi M, Shirazi Yeganeh B, Dorrani Nejad A, Hemmati A. Epidemiological and clinical features of 2019 novel coronavirus diseases (COVID-19) in the South of Iran. BMC infectious diseases. 2020 Dec;20:1-2. [10.1186/s12879-020-05128-x] [PMID]
[30] Eshrati B, Baradaran HR, Erfanpoor S, Mohazzab A, Moradi Y. Investigating the factors affecting the survival rate in patients with COVID-19: A retrospective cohort study. Medical journal of the Islamic Republic of Iran. 2020;34:88. [10.34171/ mjiri.34.88] [PMID]
[31] Wu C, Chen X, Cai Y, Zhou X, Xu S, Huang H, Zhang L, Zhou X, Du C, Zhang Y, Song J. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA internal medicine. 2020 Jul 1;180(7):934-43 [10.1001/jama internmed.2020.0994 ][PMID]
[32] Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. jama. 2020 Mar 17;323(11): 1061-9. [10.1001/jama.2020.1585] [PMID]
[33] Du Y, Tu L, Zhu P, Mu M, Wang R, Yang P, Wang X, Hu C, Ping R, Hu P, Li T. Clinical features of 85 fatal cases of COVID-19 from Wuhan. A retrospective observational study. American journal of respiratory and critical care medicine. 2020 Jun 1;201(11): 1372-9. [10.1164/rccm.202003-0543OC ] [PMID]
[34] Carrillo-Vega MF, Salinas-Escudero G, García-Peña C, Gutiérrez-Robledo LM, Parra-Rodríguez L. Early estimation of the risk factors for hospitalization and mortality by COVID-19 in Mexico. PloS one. 2020 Sep 11;15(9):e0238905. [10.1371/ journal.pone.0238905] [PMID]
[35] Mehta HB, Li S, Goodwin JS. Risk factors associated with SARS-CoV-2 infections, hospitalization, and mortality among US nursing home residents. JAMA network open. 2021 Mar 1;4(3):e216315-. [10.1001/jamanetworkopen.2021.6315] [PMID]
[36] Bhasin A, Nam H, Yeh C, Lee J, Liebovitz D, Achenbach C. Is BMI higher in younger patients with COVID-19? Association between BMI and COVID-19 hospitalization by age. Obesity. 2020 Oct;28(10):1811-4. [10.1002/oby.22947] [PMID]
[37] Almazeedi S, Al-Youha S, Jamal MH, Al-Haddad M, Al-Muhaini A, Al-Ghimlas F, Al-Sabah S. Characteristics, risk factors and outcomes among the first consecutive 1096 patients diagnosed with COVID-19 in Kuwait. EClinicalMedicine. 2020 Jul 1;24. [10.1016/j.eclinm.2020.100448] [PMID]
[38] Berlin I, Thomas D, Le Faou AL, Cornuz J. COVID-19 and
smoking. Nicotine and Tobacco Research. 2020 Sep;22(9): 1650-2. [10.1093/ntr/ntaa059] [PMID]
[39] Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS, Du B. Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine. 2020 Apr 30;382(18):1708-20. [10.1056/NEJMoa2002032] [PMID]
[40] Killerby ME. Characteristics associated with hospitalization among patients with COVID-19—Metropolitan Atlanta, Georgia, March–April 2020. MMWR. Morbidity and mortality weekly report. 2020;69. [10.15585/mmwr.mm6925e1] [PMID]
[41] Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging (albany NY). 2020 Apr 4;12(7):6049. [10.18632/aging.103000] [PMID]
[42] Biswas M, Rahaman S, Biswas TK, Haque Z, Ibrahim B. Association of sex, age, and comorbidities with mortality in COVID-19 patients: a systematic review and meta-analysis. Intervirology. 2021 Dec 9;64(1):36-47. [10.1159/000512592] [PMID]
[43] Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, Liu XQ, Chen RC, Tang CL, Wang T, Ou CQ. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. European Respiratory Journal. 2020 May 1;55(5). [10.1183/13993003.00547-2020] [PMID]
[44] Gold MS, Sehayek D, Gabrielli S, Zhang X, McCusker C, Ben-Shoshan M. COVID-19 and comorbidities: a systematic review and meta-analysis. Postgraduate medicine. 2020 Nov 16;132(8):749-55. [10.1080/00325481.2020.1786964] [PMID]
[45] Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, Li Y, Cheng L, Li W, Jia H, Ma X. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (albany NY). 2020 Jul 7;12(13):12493. [10. 18632/aging.103579] [PMID]
[46] Chen T, Wu DI, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, Wang T. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. bmj. 2020 Mar 26;368. [10.1136/bmj.m1091 ] [PMID]
[47] Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, Gong W, Liu X, Liang J, Zhao Q, Huang H. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA cardiology. 2020 Jul 1;5(7):802-10. [10.1001/jamacardio.2020. 0950] [PMID]
[48] Wang L, He W, Yu X, Hu D, Bao M, Liu H, Zhou J, Jiang H. Coronavirus disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up. Journal of infection. 2020 Jun 1;80(6):639-45. [10.1016/j.jinf.2020.03.019] [PMID]
[49] Fallucchi F, Faravelli M, Quercia S. Fair allocation of scarce medical resources in the time of COVID-19: what do people think?. Journal of medical ethics. 2021 Jan 1;47(1):3-6. [10.1136/medethics-2020-106524] [PMID]
[50] Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. Journal of medical virology. 2020 Apr;92(4):441-7. [10.1002/jmv.25689] [PMID]
[51] Shafiei G, Barati E, Zarei AP, Hekmatnia F, Almasi M, Hekmatnia A, Shafieyoon S, Jamalipour Soufi G. The value of chest CT scan as a prognostic tool in patients with COVID-19. Sarem Journal of Medical research. 2021 Mar 10;6(1):53-60.
Volume 23, Issue 2 - Serial Number 149
May and June 2024
Pages 123-133

  • Receive Date 10 February 2024
  • Revise Date 22 March 2024
  • Accept Date 06 April 2024