Epidemiological and Clinical Risk Factors Related to Severe COVID-19 in Iran: A multi-center study

Abstract

Background Iran was one of the first countries to be affected by COVID-19. Identifying factors associated with severity of COVID-19 is effective in disease management. This study investigated the epidemiological and clinical features and factors associated with severity of COVID-19 in one of the less privileged areas in Iran.Methods In a multi-center study, all patients admitted to hospitals of Zahedan University of Medical Sciences located in southeastern Iran were investigated from February 29 to April 31, 2020. Demographic, epidemiological and clinical data of patients were extracted from medical records. To explore the risk factors associated with severity of COVID-19, bivariate and multivariate logistic regression models were used.Results Among the 413 patients, 55.5% were male and 145 (35.10%) were in a severe condition at admission time. Multivariate analysis showed that the adjusted odds of the disease severity increased in patients with older age (OR 3.51; 95% CI, 2.28-5.40), substance abuse (OR 2.22; 95% CI, 2.05-5.78) and at least one underlying disease (OR 3.45; 95% CI, 1.01-1.32).Conclusions COVID-19 was more severe in older patients, patients with a history of substance abuse, and patients with at least one underlying disease. Understanding the factors affecting the disease severity can help for clinical management of COVID-19, especially in less privileged areas where fewer resources are available.