Assessment of Risk Factors for Severe Coronavirus Disease 2019 among Iranian Patients

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Iranian Red Crescent Medical Journal
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Keywords

COVID-19
Coronavirus disease 2019
Pneumonia
SARS-Cov-2
Vulnerable

How to Cite

Mirsoleymani, S., Nekooghadam, S. M., Ahmadi Marzaleh, M., Peyravi, M., Soltani, A., Sharififar, S., Rezaee, R., Ahmadi, M., & Akbarialiabad, H. (2020). Assessment of Risk Factors for Severe Coronavirus Disease 2019 among Iranian Patients. Iranian Red Crescent Medical Journal, 22(9). https://doi.org/10.32592/ircmj.2020.22.9.72

Abstract

Background: The outbreak of Coronavirus Disease 2019 (COVID-19) has led to a major concern for those who are more vulnerable to infections.

Objectives: This study aimed to evaluate the most important risk factors for severe COVID-19 pneumonia.

Methods: This retrospective study included information on clinical and epidemiological features of 105 patients with severe COVID-19 pneumonia hospitalized in Tajrish Hospital, Tehran, Iran. Initially, the medical records of the patients were investigated, and an interview was conducted based on a pre-prepared checklist to seek information about symptoms, past medical history, medication history, and behavior before hospitalization.   

Results: Out of 105 participants, 76 (72.5%) cases were male, and 54 (51.4%) patients were older than 54 years old. The majority of the patients (n=18; 17.1%) had both hypertension and diabetes (n=12; 11.4%). Metformin (n=36; 34.3%) was the most used medication amongst the studied patient. In addition, 24 (22.9%) patients were recreational hookah smokers, and the majority (75%) of them were under the age of 46 years old. Eventually, 19 patients were excluded from the study, of whom 11 individuals had diabetes, and 10 cases were using metformin. 

Conclusion: Apparently, hookah smoking played a critical role in the spread of COVID-19 in Iran and has made younger people more susceptible. In addition to older age, the immunosuppressive effects of Metformin seem to make diabetic patients with an impaired immune system more vulnerable to severe COVID-19 pneumonia. More studies on the immune system of vulnerable individuals by identifying their differences can help to protect them.

https://doi.org/10.32592/ircmj.2020.22.9.72
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References

  1. COVID-19 National Incident Room Surveillance Team. Covid-19, australia: epidemiology report 6 (reporting week ending 19: 00 aedt 7 march 2020). Commun Dis Intell (2018). 2020;44:21. doi: 10.33321/cdi.2020.44.21. [PubMed: 32156224].
  2. Lippi G, Plebani MJCC. Laboratory abnormalities in patients with covid-2019 infection. Clin Chem Lab Med. 2020;58(7):1131-4 doi: 10.1515/cclm-2020-0198. [PubMed: 32119647].
  3. Tuite AR, Bogoch I, Sherbo R, Watts A, Fisman DN, Khan KJ. Estimation of covid-2019 burden and potential for international dissemination of infection from Iran. Ann Intern Med. 2020;172(10):699-701. doi: 10.7326/M20-0696. [PubMed: 32176272].
  4. Xiao-Wei X, Xiao-Xin W, Xian-Gao J, Kai-Jin X, Ling-Jun Y, Chun-Lian M, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series.BMJ. 2020;368:m606. doi: 10.1136/bmj.m606. [PubMed: 32075786].
  5. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records.Lancet. 2020;395(10226):809-15. doi: 10.1016/S0140-6736(20)30360-3. [PubMed: 32151335].
  6. World Health Organization. Coronavirus disease (COVID-19) outbreak. Geneva: World Health Organization; 2020.
  7. Wu Y, Guo W, Liu H, Qi B, Liang K, Xu B, et al. Clinical outcomes of 402 patients with COVID-2019 from a single center in Wuhan, China. J Med Virol. 2020;In Press. doi: 10.1002/jmv.26168. [PubMed: 32530494].
  8. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China.Radiology. 2020;296(2):E15-25. doi: 10.1148/radiol.2020200490. [PubMed: 32083985].
  9. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020;296(2):E32-40. doi: 10.1148/radiol.2020200642. [PubMed: 32101510].
  10. Depoux A, Martin S, Karafillakis E, Bsd RP, Wilder-Smith A, Larson H. The pandemic of social media panic travels faster than the COVID-19 outbreak.J Travel Med. 2020;27(3):taaa031. doi: 10.1093/jtm/taaa031. [PubMed: 32125413].
  11. Wang LS, Wang YR, Ye DW, Liu QQ. A review of the 2019 Novel Coronavirus (COVID-19) based on current evidence. Int J Antimicrob Agents. 2020;55(6):105948. doi: 10.1016/j.ijantimicag.2020.105 948.
  12. Huang M, Zhan F, Wang J, Yi Q, Zhu F, Yang H, et al. Epidemiological and clinical features of 197 patients infected with 2019 novel coronavirus in Chongqing, China: a single center descriptive study. Lancet Microbe. 2020;In Press. doi: 10.2139/ssrn.3539687.
  13. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): the epidemic and the challenges.Int J Antimicrob Agents. 2020;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924.
  14. Morewitz SJ, Goldstein ML. Aging and chronic disorders. Boston, MA: Springer; 2007. P. 1-14. doi: 10.1007/978-0-387-70857-7 .
  15. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi: 10.1056/NEJMoa2002032.
  16. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-5. doi: 10.1016/j.ijid.2020.03.017.
  17. Li X, Hu Y, Zhu S, Li Y, Huang L, Li Y, et al. Epidemiological feature and outcome of 292 hospitalized patients with COVID-19 under adequate medical resource condition. Lancet. 2020;In Press. doi: 10.2139/ssrn.3550016.
  18. Orzeck EA, Shi N, Blumentals WA. Oseltamivir and the risk of influenza-related complications and hospitalizations in patients with diabetes. Clin Ther. 2007;29(10):2246-55. doi: 10.1016/j.clinthera.2007.10.001. [PubMed: 18042482].
  19. Allard R, Leclerc P, Tremblay C, Tannenbaum TN. Diabetes and the severity of pandemic influenza A (H1N1) infection. Diabetes Care. 2010;33(7):1491-3. doi: 10.2337/dc09-2215.
  20. Pollak MJD. The effects of metformin on gut microbiota and the immune system as research frontiers. Diabetologia. 2017;60(9):1662-7. doi: 10.1007/s00125-017-4352-x. [PubMed: 28770326].
  21. Karin M, Lin A. NF-kappaB at the crossroads of life and death. Nat Immunol. 2002;3(3):221-7. doi: 10.1038/ni0302-221. [PubMed: 11875461].
  22. 22. Xu X, Du C, Zheng Q, Peng L, Sun Y. Effect of metformin on serum interleukin-6 levels in polycystic ovary syndrome: a systematic review. BMC Womens Health. 2014;14(1):93. doi: 10.1186/1472-6874-14-93. [PubMed: 25096410].
  23. 23. Scheller J, Chalaris A, Schmidt-Arras D, Rose-John S. The pro-and anti-inflammatory properties of the cytokine interleukin-6.Biochim Biophys Acta. 2011;1813(5):878-88. doi: 10.1016/j.bbamcr.2011.01.034. [PubMed: 21296109].
  24. 24. Martinasek MP, McDermott RJ, Martini L. Waterpipe (hookah) tobacco smoking among youth. Curr Probl Pediatr Adolesc Health Care. 2011;41(2):34-57. doi: 10.1016/j.cppeds.2010.10.001. [PubMed: 21232693].
  25. Blachman-Braun R, Del Mazo-Rodríguez RL, López-Sámano G, Buendía-Roldán IJ. Hookah, is it really harmless?Respir Med. 2014;108(5):661-7. doi: 10.1016/j.rmed.2014.01.013. [PubMed: 24582881].