Ladan Goshayeshi1,2, Mina Akbari Rad3, Robert Bergquist4,5, Abolghasem Allahyari3, Kamila Hashemzadeh6, Benyamin Hoseini7,8. 1. Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2. Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 3. Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 4. Ingerod, SE-454 94, Brastad, Sweden. 5. Formerly UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland. 6. Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 7. Department of Health Information Technology, Neyshabur University of Medical Sciences, Neyshabur, Iran. Hoseinib1@nums.ac.ir. 8. Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Hoseinib1@nums.ac.ir.
Abstract
BACKGROUND: Coronavirus Disease 2019 (Covid-19) is expanding worldwide. The characteristics of this infection in patients varies from country to country. To move forward, clinical data on infected patients are needed. Here, we report a comparison between fatalities and recovery of patients with severe Covid-19, based on demographic and clinical characteristics. METHODS: Between 5 March and 12 May 2020 in Mashhad, Iran, 1278 of 4000 suspected Covid-19 patients were confirmed positive by real-time reverse-transcriptase-polymerase-chain-reaction assay of upper respiratory specimens. We compared the demographic, exposure history and clinical symptoms of 925 survivors and 353 fatal cases with confirmed disease. RESULTS: Mean (SD) age for all confirmed patients was 56.9 (18.7) years, 67.1 (15.9) years in fatal cases and 53.0 (18.3) years in survivors. Multivariate logistic regression analysis showed that the outcome of patients was associated with age (odds ratio = 1.049, P = 0.0001, 95% CI = 1.040-1.057). Despite a high burden of Covid-19 infections in the 30-39 and 40-49 year age groups, most of these (89.6 and 87.2%, respectively) recovered. The median (IQR) duration of hospitalization was 9.0 (6.0-14.0) days. The most prevalent co-morbidities were cardiovascular disorders (21%) and diabetes (16.3%). Dyspnoea (72.7%), cough (68.1%) and fever (63.8%) were the most frequent clinical symptoms. Healthcare workers, of whom two (3%) died, comprised 5.2% of infected cases. Combination antiviral and antibiotic therapy was used in 43.0% of cases. CONCLUSIONS: The characteristics of severe Covid-19 varied substantially between fatal cases and survivors, with diabetes and cardiovascular disorders the most prevalent co-morbidities. In contrast to other studies, there were a higher number of fatalities in younger patients in our setting.
BACKGROUND:Coronavirus Disease 2019 (Covid-19) is expanding worldwide. The characteristics of this infection in patients varies from country to country. To move forward, clinical data on infectedpatients are needed. Here, we report a comparison between fatalities and recovery of patients with severe Covid-19, based on demographic and clinical characteristics. METHODS: Between 5 March and 12 May 2020 in Mashhad, Iran, 1278 of 4000 suspected Covid-19patients were confirmed positive by real-time reverse-transcriptase-polymerase-chain-reaction assay of upper respiratory specimens. We compared the demographic, exposure history and clinical symptoms of 925 survivors and 353 fatal cases with confirmed disease. RESULTS: Mean (SD) age for all confirmed patients was 56.9 (18.7) years, 67.1 (15.9) years in fatal cases and 53.0 (18.3) years in survivors. Multivariate logistic regression analysis showed that the outcome of patients was associated with age (odds ratio = 1.049, P = 0.0001, 95% CI = 1.040-1.057). Despite a high burden of Covid-19 infections in the 30-39 and 40-49 year age groups, most of these (89.6 and 87.2%, respectively) recovered. The median (IQR) duration of hospitalization was 9.0 (6.0-14.0) days. The most prevalent co-morbidities were cardiovascular disorders (21%) and diabetes (16.3%). Dyspnoea (72.7%), cough (68.1%) and fever (63.8%) were the most frequent clinical symptoms. Healthcare workers, of whom two (3%) died, comprised 5.2% of infected cases. Combination antiviral and antibiotic therapy was used in 43.0% of cases. CONCLUSIONS: The characteristics of severe Covid-19 varied substantially between fatal cases and survivors, with diabetes and cardiovascular disorders the most prevalent co-morbidities. In contrast to other studies, there were a higher number of fatalities in younger patients in our setting.
Authors: Giacomo Grasselli; Alberto Zangrillo; Alberto Zanella; Massimo Antonelli; Luca Cabrini; Antonio Castelli; Danilo Cereda; Antonio Coluccello; Giuseppe Foti; Roberto Fumagalli; Giorgio Iotti; Nicola Latronico; Luca Lorini; Stefano Merler; Giuseppe Natalini; Alessandra Piatti; Marco Vito Ranieri; Anna Mara Scandroglio; Enrico Storti; Maurizio Cecconi; Antonio Pesenti Journal: JAMA Date: 2020-04-28 Impact factor: 56.272
Authors: Pavan K Bhatraju; Bijan J Ghassemieh; Michelle Nichols; Richard Kim; Keith R Jerome; Arun K Nalla; Alexander L Greninger; Sudhakar Pipavath; Mark M Wurfel; Laura Evans; Patricia A Kritek; T Eoin West; Andrew Luks; Anthony Gerbino; Chris R Dale; Jason D Goldman; Shane O'Mahony; Carmen Mikacenic Journal: N Engl J Med Date: 2020-03-30 Impact factor: 91.245
Authors: Temet M McMichael; Dustin W Currie; Shauna Clark; Sargis Pogosjans; Meagan Kay; Noah G Schwartz; James Lewis; Atar Baer; Vance Kawakami; Margaret D Lukoff; Jessica Ferro; Claire Brostrom-Smith; Thomas D Rea; Michael R Sayre; Francis X Riedo; Denny Russell; Brian Hiatt; Patricia Montgomery; Agam K Rao; Eric J Chow; Farrell Tobolowsky; Michael J Hughes; Ana C Bardossy; Lisa P Oakley; Jesica R Jacobs; Nimalie D Stone; Sujan C Reddy; John A Jernigan; Margaret A Honein; Thomas A Clark; Jeffrey S Duchin Journal: N Engl J Med Date: 2020-03-27 Impact factor: 91.245