Moradi Ghobad, Piroozi Bakhtiar, Mohamadi-Bolbanabad Amjad, Safari Hossein, Shokri Azad, Rahimi Ramyar
Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran.
Med J Islam Repub Iran. 2020 Mar 29;34:26. doi: 10.34171/mjiri.34.26. eCollection 2020.
The new Coronavirus disease (COVID-19) was first identified in China in 2019. Case fatality rate (CFR) indicator of the disease is one of the most important indices noticed by experts, policymakers, and managers, based on which daily evaluations and many judgments are made. CFR can change during epidemics. This study aimed to estimate the actual number of COVID-19 cases in Iran and to calculate the early CFR for the disease based on official statistics. This was a descriptive study whose data were obtained from the website of the Ministry of Health and Medical Education of Iran from February 20, 2020 until March 26, 2020. CFR has been obtained by dividing the total number of deaths by the total number of confirmed cases at one point in time. In this study, the actual number of COVID-19 cases in Iran was estimated based on the mortality model in 4 scenarios. Excel 2013 software was used to analyze the data. According to the findings of this study, In Iran, until March 26, 2020, a total of 27 017 people have been infected by COVID-19 and 2077 died of it. However, CFR indicator had a descending trend in Iran: 100%, 18.6%, 8.8%, 3.3%, 6.9%, and 7.7% on days 1, 5, 10, 20, 30, and 35, respectively. The actual number of COVID-19 cases in Iran was estimated to be 4 789 454, 2 873 673, 1 436 836, and 718418 as of March 26, 2020 according to the 4 scenarios, respectively. In emerging epidemics, CFR indicator must not be used as a basis to judge the performance of a health system unless that epidemic condition has been clarified. Moreover, it is suggested that in the outbreak of an epidemic, specifically emerging diseases, CFR must not be the base of judgment. Making judgments, specifically in the outbreak of emerging epidemics, based on fatality rate can lead to information bias. It is also possible to estimate the total number of patients based on the CFR in circumstances where little information is available on the disease.
新型冠状病毒病（COVID-19）于2019年在中国首次被发现。该疾病的病死率（CFR）指标是专家、政策制定者和管理人员关注的最重要指标之一，基于此进行每日评估并做出许多判断。病死率在疫情期间可能会发生变化。本研究旨在根据官方统计数据估算伊朗COVID-19病例的实际数量，并计算该疾病的早期病死率。这是一项描述性研究，其数据来自伊朗卫生和医学教育部网站，时间跨度为2020年2月20日至2020年3月26日。病死率通过某一时刻的死亡总数除以确诊病例总数得出。在本研究中，基于4种情景下的死亡率模型估算了伊朗COVID-19病例的实际数量。使用Excel 2013软件对数据进行分析。根据本研究的结果，在伊朗，截至2020年3月26日，共有27017人感染了COVID-19，其中2077人死亡。然而，伊朗的病死率指标呈下降趋势：在第1天、第5天、第10天、第20天、第30天和第35天分别为100%、18.6%、8.8%、3.3%、6.9%和7.7%。根据4种情景，截至2020年3月26日，伊朗COVID-19病例的实际数量分别估计为4789454、2873673、1436836和718418例。在新发疫情中，除非疫情情况已明确，否则病死率指标不得用作评判卫生系统绩效的依据。此外，建议在疫情爆发时，特别是新发疾病，病死率不得作为判断依据。基于病死率进行判断，特别是在新发疫情爆发时，可能会导致信息偏差。在对该疾病了解甚少的情况下，也可以根据病死率估算患者总数。
