Clinical Characteristics of Patients Infected with Coronavirus Disease 2019 (COVID-19) in Iran: A Retrospective Cohort Study

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Keywords

Acute respiratory disease
COVID-19
2019 novel coronavirus
pneumonia

How to Cite

PanahiL., Yaghubi T., AmiriM., BalouH. ali, Etebarian KhorasganiA., & pouy, somaye. (2021). Clinical Characteristics of Patients Infected with Coronavirus Disease 2019 (COVID-19) in Iran: A Retrospective Cohort Study. Iranian Red Crescent Medical Journal, 23(3). https://doi.org/10.32592/ircmj.2021.23.3.87

Abstract

Background: Coronavirus disease 2019 (COVID-19) was introduced by the World Health Organization as a pandemic and emergency for human health. This study aimed to investigate the clinical characteristics of patients infected with COVID-19 in Guilan Province, Iran.

Methods: This retrospective study was conducted on 1,000 patients with a definitive diagnosis of COVID-19 pneumonia admitted to six hospitals in Guilan Province, Iran, from April 13 to June 14, 2020. This study evaluated the patients' clinical information, demographic characteristics, laboratory results, and chest computed tomography scans.  

Findings: The mean age of the patients was obtained at 55±1.3 years, and the majority (n=800; 80%) of the cases were male. Furthermore, most patients had underlying diseases, including respiratory system disease (n=173; 17.3%), cardiovascular disease (n=711; 71.1%), and malignancy (n=146; 14.6%). The most common causes of the infection with COVID-19 included the presence in crowded places (n=733; 73.3%), close contact with the infected person (n=370; 82.2%), possession of pets (n=107; 23.2%), and family gathering (n=822; 82.2%). In addition, the most common clinical symptoms in patients included fever (n=911; 91.1%), cough (n=900; 90%), and dyspnea or shortness of breath (n=889; 88.9%). Other less common symptoms were diarrhea (n=160; 16%), vomiting (n=168; 16.8%), and headache (n=217; 21.7%). Dyspnea developed in 889 (88.9%) patients, and 660 (66%) cases had increased leucocytes.

Conclusion: COVID-19 causes mild to fatal pneumonia in patients. Therefore, early detection and treatment of these patients are of utmost importance. Timely treatment of the disease can reduce the severity of symptoms and prevent the further spread of the disease.

https://doi.org/10.32592/ircmj.2021.23.3.87

References

  1. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20(6):689-96. doi: 10.1016/S1473-3099(20)30198-5. [PubMed: 32220650].
  2. 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].
  3. 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. [PubMed: 32109013].
  4. Hemsley MS, Glass N, Watson J. Taking the eagle's view: using watson's conceptual model to investigate the extraordinary and transformative experiences of nurse healers. Holist Nurs Pract. 2006;20(2):85-94. doi: 10.1097/00004650-200603000-00009. [PubMed: 16518155].
  5. Liang Y, Liang J, Zhou Q, Li X, Lin F, Deng Z, et al. Prevalence and clinical features of 2019 novel coronavirus disease (COVID-19) in the Fever Clinic of a teaching hospital in Beijing: a single-center, retrospective study. MedRxiv. 2020;In Press. doi: 10.1101/2020.02.25.20027763.
  6. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. doi: 10.1016/S0140-6736(20)30211-7. [PubMed: 32007143].
  7. 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].
  8. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med. 2020;382(13):1199-207. doi: 10.1056/NEJMoa2001316. [PubMed: 31995857].
  9. Wang X, Zhou Z, Zhang J, Zhu F, Tang Y, Shen X. A case of 2019 Novel Coronavirus in a pregnant woman with preterm delivery. Clin Infect Dis. 2020;71(15):844-6. doi: 10.1093/cid/ciaa200. [PubMed: 32119083].
  10. Lam CM, Wong SF, Leung TN, Chow KM, Yu WC, Wong TY, et al. A case‐controlled study comparing clinical course and outcomes of pregnant and non‐pregnant women with severe acute respiratory syndrome. BJOG. 2004;111(8):771-4. doi: 10.1111/j.1471-0528.2004.00199.x. [PubMed: 15270922].
  11. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020;9(1):51-60.doi: 10.21037/tp.2020.02.06. [PubMed: 32154135].
  12. Tang A, Tong Z, Wang H, Dai Y, Li K, Liu J, et al. Detection of novel coronavirus by RT-PCR in stool specimen from asymptomatic child, China. Emerg Infect Dis. 2020;26(6):1337-9. doi: 10.3201/eid2606.20.0301. [PubMed: 32150527].
  13. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi: 10.1371/journal.pmed.1000097. [PubMed: 19621072].
  14. Lizarondo L, Stern C, Carrier J, Godfrey C, Rieger K, Salmond S, et al. Joanna briggs institute reviewer's manual. California: SAGE Publications; 2017. doi: 10.46658/JBIMES-20-09.
  15. Liu W, Zhang Q, Chen J, Xiang R, Song H, Shu S, et al. Detection of Covid-19 in children in early January 2020 in Wuhan, China. N Engl J Med. 2020;382(14):1370-1. doi: 10.1056/NEJMc2003717. [PubMed: 32163697].
  16. Jiehao C, Jin X, Daojiong L, Zhi Y, Lei X, Zhenghai Q, et al. A Case series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 2020;71(6):1547-51. doi: 10.1093/cid/ciaa198. [PubMed: 32112072].
  17. Kam KQ, Yung CF, Cui L, Lin Tzer Pin R, Mak TM, Maiwald M, et al. A well infant with coronavirus disease 2019 (COVID-19) with high viral load. Clin Infect Dis. 2020;71(15):847-9. doi: 10.1093/cid/ciaa201. [PubMed: 32112082].
  18. Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease 2019. Clin Chem Lab Med. 2020;58(7):1135-8. doi: 10.1515/cclm-2020-0272. [PubMed: 32172227].
  19. Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Science. 2020;368(6490):489-93. doi: 10.1101/2020.02.14.20023127. [PubMed: 32179701].
  20. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: interim guidance. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: Interim guidance. Geneva: World Health Organization; 2020. P. 21.
  21. Panahi L, Amiri M, Pouy S. Risks of novel coronavirus disease (COVID-19) in pregnancy; a narrative review. Arch Acad Emerg Med. 2020;8(1):e34. [PubMed: 32232217].
  22. Song HD, Tu CC, Zhang GW, Wang SY, Zheng K, Lei LC, et al. Cross-host evolution of severe acute respiratory syndrome coronavirus in palm civet and human. Proc Natl Acad Sci. 2005;102(7):2430-5. doi: 10.1073/pnas.0409608102. [PubMed: 15695582].
  23. Haagmans BL, Al Dhahiry SH, Reusken CB, Raj VS, Galiano M, Myers R, et al. Middle East respiratory syndrome coronavirus in dromedary camels: an outbreak investigation. Lancet Infect Dis. 2014;14(2):140-5. doi: 10.1016/S1473-3099(13)70690-X. [PubMed: 24355866].
  24. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. [PubMed: 31986264].
  25. Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J. 2020;133(9):1025-31. doi: 10.1097/CM9.0000000000000744. [PubMed: 32044814].
  26. Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81. doi: 10.1016/S2213-2600(20)30079-5. [PubMed: 32105632].
  27. Liu WJ, Zhao M, Liu K, Xu K, Wong G, Tan W, et al. T-cell immunity of SARS-CoV: Implications for vaccine development against MERS-CoV. Antiviral Res. 2017;137:82-92. doi: 10.1016/j.antiviral.2016.11.006. [PubMed: 27840203].
  28. Xu X, Yu C, Zhang L, Luo L, Liu J. Imaging features of 2019 novel coronavirus pneumonia. Eur J Nucl Med Mol Imaging. 2020;247(5):1022-3. doi: 10.1007/s00259-020-04720-2. [PubMed: 32060619].
  29. Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013;13(9):752-61. doi: 10.1016/S1473-3099(13)70204-4. [PubMed: 23891402].
  30. Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med. 2003;348(20):1986-94. doi: 10.1056/NEJMoa030685. [PubMed: 12682352].
  31. Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol. 2020;30(6):3306-9. doi: 10.1007/s00330-020-06731-x. [PubMed: 32055945].
  32. Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020;295(1):202-7. doi: 10.1148/radiol.2020200230. [PubMed: 32017661].