Trend of COVID-19 Hospital Cases Fatality Rate in Iran: A Multicenter Study of 5318 Hospitalized COVID-19 Patients from March 2020 to March 2021
Student Research in Translational Medicine,
Vol. 5 (2023),
30 December 2023
https://doi.org/10.22037/srtm.v5.41994
Abstract
Background and Aim: Case fatality ratio (CFR) is an indicator of disease severity that can help policymakers make decisions. This study aims to evaluate the trend of CFR of hospitalized COVID-19 patients since the outset of the pandemic in Iran and identify variables that affect CFR.
Methods: 5318 confirmed COVID-19 inpatients were enrolled in this multicentric observational study. Patients admitted from March 20, 2020, to March 18, 2021, in three general hospitals were collected. The medical team gathered patients’ demographics, past medical history, and outcomes by reviewing patients’ medical records. The time trend of CFR was investigated by joinpoint regression analysis to calculate weekly percent change (WPC) and confidence interval (CI).
Results: Significant upward trend was observed in CFR of hospitalized COVID-19 patients during study weeks (WPC= 1.2, 95% CI: 0.7, 1.7; P < 0.001). The increase was more evident in men than in women (WPC: 1.4 vs. 1.1). The rise of CFR was observed in patients with cancer (WPC: 4.5), dialysis (WPC: 2.1), diabetes (WPC: 1.0), and old age (WPC: 1.0).
Conclusion: There was a significant rise in the trend of in-hospital CFR from March 2020 to March 2021 in Iran. This rise was also evident with the same rate in patients with old-age and DM. However, the rate of this rise was higher in male and cancerous patients. Worldwide variation was reported by few studies investigating the trend of hospital CFR, and further studies are warranted.
- COVID-19
- Mortality
- Hospitalization
- Comorbidity
- Interrupted Time Series Analysis
How to Cite
References
World Health Organization. WHO Timeline COVID-19 [Internet]. Who. 2020 [cited 2021 Oct 18]. p. 2020. Available from: https://www.who.int/news-room/detail/27-04-2020-who-timeline---covid-19?gclid=EAIaIQobChMI4MaewOeo6gIVyyMrCh2JRgUIEAAYASAAEgLo3_D_BwE
Iran COVID: 5,796,659 Cases and 124,256 Deaths - Worldometer [Internet]. 2021 [cited 2021 Oct 18]. Available from: https://www.worldometers.info/coronavirus/country/iran/
Cao Y, Hiyoshi A, Montgomery S. COVID-19 case-fatality rate and demographic and socioeconomic influencers: Worldwide spatial regression analysis based on country-level data. BMJ Open [Internet]. 2020;10(11). Available from: https://bmjopen.bmj.com/content/10/11/e043560
Sorci G, Faivre B, Morand S. Explaining among-country variation in COVID-19 case fatality rate. Sci Rep [Internet]. 2020;10(1):18909. Available from: https://doi.org/10.1038/s41598-020-75848-2
Ahammed T, Anjum A, Rahman MM, Haider N, Kock R, Uddin MJ. Estimation of novel coronavirus ( COVID ‐19) reproduction number and case fatality rate: A systematic review and meta‐analysis . Heal Sci Reports [Internet]. 2021 May 3;4(2):e274–e274. Available from: https://pubmed.ncbi.nlm.nih.gov/33977156
Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000 Feb;19(3):335–51.
Jassat W, Mudara C, Ozougwu L, Tempia S, Blumberg L, Davies M-A, et al. Increased mortality among individuals hospitalised with COVID-19 during the second wave in South Africa. medRxiv [Internet]. 2021 Jan 1;2021.03.09.21253184. Available from: http://medrxiv.org/content/early/2021/03/10/2021.03.09.21253184.abstract
Souris M, Gonzalez J-P. COVID-19: Spatial analysis of hospital case-fatality rate in France. PLoS One [Internet]. 2020 Dec 15;15(12):e0243606. Available from: https://doi.org/10.1371/journal.pone.0243606
Garg S, Patel K, Pham H, Whitaker M, O’Halloran A, Milucky J, et al. Clinical Trends Among U.S. Adults Hospitalized With COVID-19, March to December 2020. Ann Intern Med [Internet]. 2021 Aug 10;174(10):1409–19. Available from: https://doi.org/10.7326/M21-1991
Horwitz LI, Jones SA, Cerfolio RJ, Francois F, Greco J, Rudy B, et al. Trends in COVID-19 Risk-Adjusted Mortality Rates. J Hosp Med. 2021 Feb;16(2):90–2.
Zimmermann IR, Sanchez MN, Frio GS, Alves LC, Pereira CC de A, Lima RT de S, et al. Trends in COVID-19 case-fatality rates in Brazilian public hospitals: A longitudinal cohort of 398,063 hospital admissions from 1st March to 3rd October 2020. PLoS One [Internet]. 2021 Jul 16;16(7):e0254633. Available from: https://doi.org/10.1371/journal.pone.0254633
Hasan MN, Haider N, Stigler FL, Khan RA, McCoy D, Zumla A, et al. The Global Case-Fatality Rate of COVID-19 Has Been Declining Since May 2020. Am J Trop Med Hyg [Internet]. 2021 Apr 21;104(6):2176–84. Available from: https://pubmed.ncbi.nlm.nih.gov/33882025
Shoja E, Aghamohammadi V, Bazyar H, Moghaddam HR, Nasiri K, Dashti M, et al. Covid-19 effects on the workload of Iranian healthcare workers. BMC Public Health [Internet]. 2020;20(1):1636. Available from: https://doi.org/10.1186/s12889-020-09743-w
Khedar RS, Mittal K, Ambaliya HC, Mathur A, Gupta JB, Sharma KK, et al. Greater Covid-19 Severity and Mortality in Hospitalized Patients in Second (Delta Variant) Wave Compared to the First: Single Centre Prospective Study in India. medRxiv [Internet]. 2021 Jan 1;2021.09.03.21263091. Available from: http://medrxiv.org/content/early/2021/09/07/2021.09.03.21263091.abstract
Iran Reports Its First 2 Cases of the New Coronavirus - The New York Times [Internet]. The New York Times. 2020 [cited 2021 Nov 6]. Available from: https://archive.ph/CuAQZ
Mehta V, Goel S, Kabarriti R, Cole D, Goldfinger M, Acuna-Villaorduna A, et al. Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System. Cancer Discov [Internet]. 2020 Jul 1;10(7):935 LP – 941. Available from: http://cancerdiscovery.aacrjournals.org/content/10/7/935.abstract
Dennis JM, McGovern AP, Vollmer SJ, Mateen BA. Improving Survival of Critical Care Patients with Coronavirus Disease 2019 in England: A National Cohort Study, March to June 2020∗. Crit Care Med. 2021 Feb;49(2):209–14.
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