Community Medicine Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Infect Dis. 2021 May 25;21(1):474. doi: 10.1186/s12879-021-06179-4.
Defining socio-demographic factors, clinical presentations and underlying diseases associated with COVID-19 severity could be helpful in its management. This study aimed to further clarify the determinants and clinical risk factors of the disease severity in patients infected with COVID-19.
A multi-centre descriptive study on all patients who have been diagnosed with COVID-19 in the province of Tehran from March 2020 up to Dec 2020 was conducted. Data on socio-demographic characteristics, clinical presentations, comorbidities, and the health outcomes of 205,654 patients were examined. Characteristics of the study population were described. To assess the association of study variables with the disease severity, the Chi-Squared test and Multiple Logistic Regression model were applied.
The mean age of the study population was 52.8 years and 93,612 (45.5%) were women. About half of the patients have presented with low levels of blood oxygen saturation. The ICU admission rate was 17.8% and the overall mortality rate was 10.0%. Older age, male sex, comorbidities including hypertension, cancer, chronic respiratory diseases other than asthma, chronic liver diseases, chronic kidney diseases, chronic neurological disorders, and HIV/AIDS infection were risk markers of poor health outcome. Clinical presentations related with worse prognosis included fever, difficulty breathing, impaired consciousness, and cutaneous manifestations.
These results might alert physicians to pay attention to determinants and risk factors associated with poor prognosis in patients with COVID-19. In addition, our findings aid decision makers to emphasise on vulnerable groups in the public health strategies that aim at preventing the spread of the disease and its mortalities.
明确与 COVID-19 严重程度相关的社会人口学因素、临床表现和基础疾病有助于对其进行管理。本研究旨在进一步阐明 COVID-19 感染患者疾病严重程度的决定因素和临床危险因素。
对 2020 年 3 月至 2020 年 12 月在德黑兰省诊断为 COVID-19 的所有患者进行了一项多中心描述性研究。检查了 205654 例患者的社会人口学特征、临床表现、合并症和健康结果数据。描述了研究人群的特征。为了评估研究变量与疾病严重程度的关联，应用了卡方检验和多因素逻辑回归模型。
研究人群的平均年龄为 52.8 岁，其中 93612 人（45.5%）为女性。约一半的患者血氧饱和度水平较低。入住 ICU 的比例为 17.8%，总死亡率为 10.0%。年龄较大、男性、合并症包括高血压、癌症、除哮喘以外的慢性呼吸系统疾病、慢性肝病、慢性肾脏病、慢性神经疾病和 HIV/AIDS 感染是不良健康结局的风险标志物。与预后不良相关的临床表现包括发热、呼吸困难、意识障碍和皮肤表现。
这些结果可能会提醒医生注意与 COVID-19 预后不良相关的决定因素和危险因素。此外，我们的研究结果还帮助决策者在旨在预防疾病传播和死亡率的公共卫生策略中强调弱势群体。
