Epidemiological Features and Hotspot of COVID-19 in Isfahan Province of Iran: Results of A Cohort Study

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background and Aim: </jats:bold>The aim of this study was to description of the epidemiological features and hotspot of COVID-19 in Isfahan province of Iran.<jats:bold>Method: </jats:bold>In this descriptive, retrospective cohort, multicenter study, all patients admitted to one of the hospitals or health networks of Isfahan province from 3<jats:sup>rd</jats:sup> February to 13<jats:sup>th</jats:sup> June 2020 due to RT-PCR (Reverse transcription-polymerase chain reaction) test were enrolled to study. Trained staff followed up participants for two weeks by a Telephone number, and the outcome was recorded.<jats:bold>Result: </jats:bold>Up to 13 June, 41,498 patients recruited and their data were analyzed; the incidence of COVID-19 was 27.5% (95% CI: 27.1, 28.2). Among the participants with the positive test, 93.2% of them, treated by outpatient basis or discharged, 2.1% were hospitalized, and the case fatality rate (CFR) was 4.8%. Khansar and Aradestan was the hotspot of COVID-19 and had the highest incidence among cities of Isfahan province. Najafabad, Khomeinishahr, and Shahinshahr&amp;Meymeh had the highest imported cases of COVID-19 to the capital of Isfahan province, Isfahan city. Also, Charmahal &amp; Bakhtiari, Khuzestan, and Fars provinces had the highest number of imported cases from other provinces to Isfahan city. We found that 77.3% of intra-province imported cases and about 83% of inter-province cases were imported after reducing lockdown.<jats:bold>conclusion:</jats:bold>The incidence and fatality of COVID-19 in Isfahan province is alarming. Inter-city and inter-provincial unnecessary travels have a high impact on the transmission and spread of the COVID-19. Applying more restrictions will prevent this from happening. It is advised to restrict the inter cities travels again by policy makers for the benefit of public health.</jats:p>

Risk Factors for In-Hospital Mortality among Patients with Coronavirus-19 in Isfahan City, Iran

“…demonstrated that in COVID-19 patients, ARDS is related to the level of troponin T. The increase in systolic pulmonary arterial pressures observed in all patients may be related to hypoxic vasoconstriction. [ 24 25 26 ] Likewise, in our study population, ARDS and acute cardiac injury were most common complications during hospitalization. Nonsurvivors were more likely to developed sepsis, ARDS acute cardiac injury, acute kidney injury, acute liver injury during hospitalization.…”

Prophylactic effects of hydroxychloroquine on the incidence of COVID-19 in patients with rheumatic arthritis: an observational cohort study

“…The abovementioned results showed rheumatic patients with at least three months of hydroxychloroquine usage could benefit from the prophylactic effect of high tissue concentration of hydroxychloroquine. This study demonstrated the prophylactic effect of hydroxychloroquine by comparing the COVID-19 incidence rate in RA patients (4.2%) and the general population (approximately 27.5%) (14).…”

“…This proportion was even higher in rheumatic patients (31.6%) (13), while this study showed that only one in nine RA-patients required admission with no need to be intubated or ICU care. Furthermore, the mortality rate in the general population of Isfahan, Iran was 4.8% until June 2020 (14), while in these patients, no mortality was observed. Therefore, it seems that hydroxychloroquine has been able to reduce the possibility of infection and reduce the severity of the disease in patients who continuously administered hydroxychloroquine for several months and its blood level has reached a steady state.…”