One-year prevalence and the association between SARS-CoV-2 cycle threshold, comorbidity and outcomes in population of Babol, North of Iran (2020-2021)

Demographic and clinical characteristics of hospitalized children with suspected and laboratory-confirmed COVID-19 during the six waves of SARS-CoV-2 infection in northern Iran a retrospective cohort study

Introduction

Northern Iran is one of the regions of the country most affected by COVID-19. The aim of the current study was to examine the demographics, clinical characteristics, and outcomes of suspected and laboratory-confirmed patients <18 years of age hospitalized over two years (during six waves of SARS-CoV-2).

Methods

This retrospective cohort study examined hospitalized patients with suspected SARS-CoV-2 infection in Babol, northern Iran. The study included patients <18 years of age admitted to a pediatric referral hospital from March 7, 2020 to March 20, 2022. Epidemiological and demographic characteristics, real-time PCR cycle threshold (Ct), clinical data and COVID-19 results were analyzed in the hospitalized patients.

Results

Totally, 2,731 patients with suspected COVID-19 were examined from March 2020 to 2022, with a mean age of 4.6 years, and were male (54.3%). Most suspected cases occurred during the fifth (Delta) and sixth (Omicron) relapse (30% and 20%, respectively). Among them, 461 patients had comorbidities, with brain and neurological diseases (BND), malignancies and hematopoietic and blood disorders (HBDs) being the most common (6.7%, 2.6% and 2.1%, respectively). Real-time RT- PCR showed that 391 patients were positive. The mean age of the positive patients was 5.2 years. Most positive cases were in the fifth wave (30.9%), male (53.7%) and 1-5 years old (49.1%). BND (9.5%) and cardiovascular diseases (CVD) (4.3%) were common underlying conditions. A higher viral load (Ct score = 9-20) was most common in the fifth wave. Moreover, 8.7% of ICU admissions and 2.4% of deaths were due to a Ct score of 9-20. Most deaths occurred in the 1-5 age group and were associated with BND. More deaths occurred in women (73.9% overall, 71.4% real-time RT- PCR -positive), and the highest mortality was in the fifth wave. The risk ratio of mortality was higher in children with kidney disease (KD) and BND.

Conclusion

There were 27 ICU admissions (6.9%) and seven deaths (1.8%). The current study also revealed that children of any age can be susceptible to SARS-CoV-2 infection, while children aged 1-5 years are more susceptible to COVID-19. The Delta variant is associated with higher rates of hospitalization and ICU admission, and the presence of BND is associated with higher mortality rates.

Characteristics, outcome, duration of hospitalization, and cycle threshold of patients with COVID-19 referred to four hospitals in Babol City: a multicenter retrospective observational study on the fourth, fifth, and sixth waves

BACKGROUND

The aim of the present study was to compare the epidemiological patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections, hospitalizations, deaths, and duration of hospitalization during the fourth, fifth and sixth epidemic waves of coronavirus disease 2019 (COVID-19) in Iran.

METHODS

A multicenter retrospective observational study was conducted on hospitalized patients in four hospitals in the Babol district of northern Iran. The study periods were during the fourth, fifth, and sixth waves of the epidemic in Iran, (March 2021 to March 2022). A total of 13,312 patients with suspected COVID-19 were included. Patient demographics, medical history, length of hospital stay, and clinical outcomes were obtained from the hospital information system. Data on the cycle threshold (Ct) and SARS-CoV2 variant were collected for SARS-CoV2-positive cases.

RESULTS

The highest number of hospitalized patients was reported during the fifth (Delta) wave (5231; 39.3%), while the lowest number of hospitalized patients was reported during the sixth (Omicron) wave (2143; 16.1%). In total, 6459 (48.5%) out of 13,312 hospitalized patients with suspected COVID-19 had a positive rRT-PCR result. The fifth (Delta) wave had the highest number of SARS-CoV2 rRT-PCR-positive hospitalized patients (3573, 55.3%), while the sixth (Omicron) wave had the lowest number (835, 12.9%). Moreover, 238 (3.7%) patients with laboratory-confirmed COVID-19 died. The hospital mortality rate was 6.8% in the fourth (Alpha) wave, which reduced to 2.7 and 3.5% in the fifth (Delta) and sixth (Omicron) waves, respectively (p < 0.001).

CONCLUSIONS

This is the most comprehensive study evaluating the epidemiologic characteristics of laboratory-confirmed SARS-CoV2 cases in Iran during the Alpha, Delta, and Omicron waves. The highest number of SARS-CoV2-positive hospitalized patients was in the fifth wave of COVID-19 (dominance of the Delta variant), while the sixth wave (dominance of the Omicron variant) had the lowest number. Comorbidities were similar, and cardiovascular disease, diabetes, kidney disease, and hypertension were the main risk factors in all waves.

Demographics, clinical characteristics, and outcomes in hospitalized patients during six waves of COVID‑19 in Northern Iran: a large cohort study

Since the first report of coronavirus disease 2019 (COVID-19) in Iran, our country has experienced several waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Northern Iran was one of the most affected regions of the country by COVID-19. In the current study, the demographic and clinical characteristics and outcomes of hospitalized patients were determined over a 2-year period (during six waves of SARS-CoV-2). This is a large cohort study investigating hospitalized patients with suspected and probable, and confirmed SARS-CoV-2 infection in Babol district, northern Iran, during the two years of COVID-19. The study population included patients admitted to four hospitals affiliated with Babol University of Medical Sciences between March 7, 2020 (start of the first wave) and March 20, 2022 (end of the sixth wave). Epidemiological and demographic characteristics, real-time PCR, cycle thresholds, clinical data and outcomes of COVID-19 were analyzed in 24,287 hospitalized patients. A total of 24,287 hospitalized patients were included in the study: 13,250 (46.6%) patients were suspected of having COVID-19, 11037(45.4%) were confirmed COVID-19 cases. The mean age of confirmed COVID-19 patients was 54.5 ± 18.9 years and 5961 (54%) were female. The median length of hospitalization for COVID-19 survivors and non-survivors was 5 (interquartile range [IQR] 4-8) and 7 (IQR 3-15) days, respectively. Of the patients with confirmed COVID-19, 714 (6.5%) died during hospitalization. In addition, the mortality rate from the first to the sixth wave was 22.9%, 8.1%, 9.9%, 6.8%, 2.7% and 3.5% in confirmed COVID-19 patients. The patients in the fifth wave were significantly younger than the others (mean age and SD of 51.1 ± 17.4 versus 59.2 ± 16.9, 54.7 ± 19.9, 58.4 ± 17.9, 53.5 ± 16.8 and 58.5 ± 25.1 years; p<0.001). The highest in-hospital mortality rate was 22.9% (126/551) in the first wave and the lowest in the fifth wave was 2.7% (96/3573) of cases. In conclusion, in the present study, the in-hospital mortality rate was 6.5% and more than half of the deceased patients were ≥65 years old. Male gender, advanced age and comorbidities significantly increased the mortality rate. The patients in the fifth wave were significantly younger than those in the other waves, and the lowest mortality rate and intensive care unit admission were also observed in the fifth wave.

A Multiple-Center, Retrospective Study of Characteristics and Outcomes of Hospitalized COVID-19 Patients with Cardiovascular Disease in North Iran

Background

In this retrospective study, we investigated the outcomes and demographic characteristics of COVID-19 patients with and without a history of CVD.

Methods

This large retrospective, multicenter study was performed on inpatients with suspected COVID-19 pneumonia who were admitted across four hospitals in Babol, Northern Iran.Demographic data, clinical data, and cycle threshold value (Ct) results of Real Time PCR were obtained. Then, participants were divided into two groups: (1) cases with CVDs, (2) cases without CVDs.

Results

A total of 11097 suspected COVID-19 cases with a mean ± SD age of 53 ±25.3 (range: 0 to 99) years were involved in the present study. Out of whom 4599 (41.4%) had a positive RT-PCR result. Of those, 1558 (33.9%) had underlying CVD. Patients with CVD had significantly more co-morbidities such as hypertension, kidney disease, and diabetes. Moreover, 187 (12%) and 281 (9.2%) of patients with and without CVD died, respectively. Also, mortality rate was significantly high among the three groups of Ct value in patients with CVD, with the highest mortality in those with Ct between 10 and 20 (Group A = 19.9%).

Conclusions

In summary, our results highlight that CVD is a major risk factor for hospitalization and the severe consequences of COVID-19. Death in CVD group is significantly higher compared to non-CVD. In addition, the results show that age-related diseases can be a serious risk factor for the severe consequences of COVID-19.