Document Type : Original Article
Authors
- Abbas Edalatkhah 1
- Fateme Samadi Khorshidi 1
- Hamidreza Mohammadi 2
- Razieh Hassannejad 3
- Faezeh Jafari 1
- Mohammad Lame 1
- Amirhossein Zarepur 2
- Ehsan Zarepur 4
1 Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Student Research Committee, Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
4 Isfahan Cardiovascular Research Institute Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Objective: An outbreak of coronavirus disease 2019 (COVID-19) occurred in late 2019. A better understanding of this disease will help us in preventing and managing it. This study evaluated the risk factors and clinical and laboratory characteristics of patients admitted to Shahid Sadoughi hospital in Yazd with a diagnosis of COVID-19.
Methods: This cross-sectional study was conducted on patients with the diagnosis of COVID-19 admitted to Shahid Sadoughi hospital in Yazd in May 2020, Iran. Patients’ clinical information, including their symptoms at admission, history of smoking or drug/ alcohol abuse, history of Td (tetanus, diphtheria) vaccine, radiographic/computed tomography (CT) scan findings, and blood oxygen saturation, was recorded. The patients were also asked about their previous history of diabetes, hypertension, autoimmune disorder, and cancer or history of diseases in heart, lung, liver, and thyroid. Laboratory findings, height, weight and body mass index of the patients were also recorded. Statistical analyses were performed using SPSS 21.
Results: The mean age of 86 patients enrolled in the study was 61.40±17.37 years, of which 56 (65.11%) had mild pulmonary involvement and 30 (34.89%) had severe pulmonary involvement, according to CT scan results. Also, 26 (30.2%) of all patients had diabetes and about 30 (36%) had high blood pressure, but current smokers (6%) were rare. In patients with severe pulmonary involvement, the level of neutrophil, creatinine, and lactate dehydrogenase (LDH) was higher than patients with mild pulmonary involvement. Out of 56 patients with mild pulmonary involvement, 47 patients had a history of Td vaccination in the last 5 years. Only one patient in the severe group had a history of Td vaccination.
Conclusion: A lower percentage of blood lymphocytes as well as higher levels of neutrophils, creatinine, and LDH were observed in patients with severe pulmonary involvement. Numerous factors, especially more prominent laboratory abnormalities, determine the severity of the disease, and a better understanding of these factors can help physicians know the severity of the disease and its prognosis. These findings help us to further clarify the characteristics of COVID-19. Also, the effect of Td vaccine should be investigated in future studies.
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outbreak. J Autoimmun 2020; 109: 102433. doi: 10.1016/j.jaut.2020.102433.
2. Danesh H, Rahimi Ghasabeh S, Rounasi R, Zarepur E, Abdolrazaghnejad A. Medical evaluation of test results
related to COVID-19 in Iranian hospitals using QUADAS-2 to evaluate the quality of studies and meta-analysis using
Stata/MP v.16 Software. J Med Chem Sci 2022; 5(2): 227-38.doi: 10.26655/jmchemsci.2022.2.10.
3. Zhong NS, Zheng BJ, Li YM, Poon, Xie ZH, Chan KH, et al. Epidemiology and cause of severe acute respiratory
syndrome (SARS) in Guangdong, People’s Republic of China, in February, 2003. Lancet 2003; 362(9393): 1353-8.
doi: 10.1016/s0140-6736(03)14630-2.
4. Sasannejad P, Rezaei F, Bidaki R, Zarepur E. Rare presentation of moyamoya disease with sub acute presentation in Iran. Iran J Child Neurol 2018; 12(1): 89-93.
5. Taebi M, Tajik A, Zarepur A, Zarepur E, Tavakolimoghadam R, Danesh H. Rhabdomyolysis in severe COVID-19: a mini
review study. J Med Chem Sci 2022; 5(1): 82-8.
6. WHO. Novel Coronavirus – China. January 12, 2020. Available from: https://www.who.int/csr/don/12-january-
2020-novel-coronavirus-china.
7. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed asymptomatic carrier transmission of COVID-19. JAMA
2020; 323(14): 1406-7. doi: 10.1001/jama.2020.2565.
8. The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of
an outbreak of 2019 novel coronavirus diseases (COVID-19)- China, 2020. China CDC Wkly 2020; 2(8): 113-22.
9. Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol 2020; 92(6): 568-76. doi: 10.1002/
jmv.25748.
10. Adhikari SP, Meng S, Wu YJ, Mao YP, Ye RX, Wang QZ, et al. Epidemiology, causes, clinical manifestation and
diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping
review. Infect Dis Poverty 2020; 9(1): 29. doi: 10.1186/s40249-020-00646-x.
11. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus
in Wuhan, China. Lancet 2020; 395(10223): 497-506. doi:10.1016/s0140-6736(20)30183-5.
12. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of
2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395(10223): 507-13. doi:
10.1016/s0140-6736(20)30211-7.
13. Li K, Fang Y, Li W, Pan C, Qin P, Zhong Y, et al. CT image visual quantitative evaluation and clinical classification of
coronavirus disease (COVID-19). Eur Radiol 2020; 30(8): 4407-16. doi: 10.1007/s00330-020-06817-6.
14. Abrishami A, Dalili N, Mohammadi Torbati P, Asgari R, Arab-Ahmadi M, Behnam B, et al. Possible association of
vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study. Eur J Nutr
2021; 60(4): 2249-57. doi: 10.1007/s00394-020-02411-0.
15. Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest CT features associated with severe and critical
COVID-19 pneumonia. Invest Radiol 2020; 55(6): 327-31.doi: 10.1097/rli.0000000000000672.
16. Mertz D, Kim TH, Johnstone J, Lam PP, Science M, Kuster SP, et al. Populations at risk for severe or complicated
influenza illness: systematic review and meta-analysis. BMJ 2013; 347: f5061. doi: 10.1136/bmj.f5061.
17. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with
COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395(10229): 1054-62. doi: 10.1016/s0140-
6736(20)30566-3.
18. Shi Y, Yu X, Zhao H, Wang H, Zhao R, Sheng J. Host susceptibility to severe COVID-19 and establishment of a
host risk score: findings of 487 cases outside Wuhan. Crit Care 2020; 24(1): 108. doi: 10.1186/s13054-020-2833-7.
19. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and
death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 2020; 180(7): 934-43.
doi: 10.1001/jamainternmed.2020.0994.
20. Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients
with COVID-19 in Wuhan, China. JAMA Cardiol 2020; 5(7): 802-10. doi: 10.1001/jamacardio.2020.0950.
21. Nabavi S, Javidarabshahi Z, Allahyari A, Ramezani M, Seddigh-Shamsi M, Ravanshad S, et al. Clinical features
and disease severity in an Iranian population of inpatients with COVID-19. Sci Rep 2021; 11(1): 8731. doi: 10.1038/
s41598-021-87917-1.
22. Hodges G, Pallisgaard J, Schjerning Olsen AM, McGettigan P, Andersen M, Krogager M, et al. Association between
biomarkers and COVID-19 severity and mortality: a nationwide Danish cohort study. BMJ Open 2020; 10(12):
e041295. doi: 10.1136/bmjopen-2020-041295.
23. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with
SARS-CoV-2 in Wuhan, China. Allergy 2020; 75(7): 1730-41. doi: 10.1111/all.14238.
24. Mohapatra PR, Mishra B, Behera B. BCG vaccination induced protection from COVID-19. Indian J Tuberc 2021;
68(1): 119-24. doi: 10.1016/j.ijtb.2020.08.004.
25. Ietto G. SARS - CoV-2: Reasons of epidemiology of severe ill disease cases and therapeutic approach using trivalent
vaccine (tetanus, diphtheria and Bordetella pertussis).Med Hypotheses 2020; 141: 109779. doi: 10.1016/j.mehy.2020.109779.
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