Clinical Manifestations of Patients with Coronavirus Disease 2019 (COVID-19) in a Referral Center in Iran

Baghaei, Parvaneh; Nadji, Seyed Alireza; Marjani, Majid; Moniri, Afshin; Hashemian, Seyed Mohammadreza; Sheikhzade, Hakimeh; Abtahian, Zahra; Heshmatnia, Jalal; Abedini, Atefeh; Jamaati, Hamidreza; Mansourafshar, Babak; Ahmadi, Zargham Hossein; Dezfuli, Mojtaba Mokhber; Seifi, Sharareh; Sadeghi, Mohsen; Mirenayat, Maryam Sadat; Yassari, Fatemeh; Lookzadeh, Somayeh; Farzanegan, Behrooz; Kiani, Arda; Vasheghani, Maryam; Dastan, Farzaneh; Eslaminejad, Alireza; Malekmohammad, Majid; Varahram, Mohammad; Zali, Alireza; Tabarsi, Payam; Velayati, Ali Akbar

Clinical Manifestations of Patients with Coronavirus Disease 2019 (COVID-19) in a Referral Center in Iran

Document Type : Original Article

Authors

Parvaneh Baghaei ¹

Seyed Alireza Nadji ²

Majid Marjani ¹

Afshin Moniri ¹

Seyed Mohammadreza Hashemian ¹

Hakimeh Sheikhzade ¹

Zahra Abtahian ¹

Jalal Heshmatnia ¹

Atefeh Abedini ³

Hamidreza Jamaati ³

Babak Mansourafshar ⁴

Zargham Hossein Ahmadi ⁵

Mojtaba Mokhber Dezfuli ⁵

Sharareh Seifi ³

Mohsen Sadeghi ³

Maryam Sadat Mirenayat ³

Fatemeh Yassari ³

Somayeh Lookzadeh ³

Behrooz Farzanegan ⁶

Arda Kiani ⁶

Maryam Vasheghani ³

Farzaneh Dastan ³

Alireza Eslaminejad ⁶

Majid Malekmohammad ⁶

Mohammad Varahram ⁷

Alireza Zali ⁸

Payam Tabarsi ¹

Ali Akbar Velayati ¹

¹ Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran,

² Virology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

³ Chronic Respiratory Disease Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

⁴ National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

⁵ Lung Transplant Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

⁶ Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

⁷ Mycobacteriology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

⁸ Research Center for Neurosurgery and Functional Nerves, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Background: Following the recent epidemic of coronavirus disease 2019 (COVID-19) in Wuhan, China, a novel betacoronavirus was isolated from two patients in Iran on February 19, 2020. In this study, we aimed to determine the clinical manifestations and outcomes of the first confirmed cases of COVID-19 infection (n=127).
Materials and Methods: This prospective study was conducted on all COVID-19-suspected cases, admitted to Masih Daneshvari Hospital (a designated hospital for COVID-19), Tehran, Iran, since February 19, 2020. All patients were tested for COVID-19, using reverse transcription-polymerase chain reaction (RT-PCR) assay. Data of confirmed cases, including demographic characteristics, clinical features, and outcomes, were collected and compared between three groups of patients, requiring different types of admission (requiring ICU admission, admission to the general ward, and transfer to ICU).
Results: Of 412 suspected cases, with the mean age of 54.1 years (SD=13.4), 127 (31%) were positive for COVID-19. Following the patients’ first visit to the clinic, 115 cases were admitted to the general ward, while ten patients required ICU admission. Due to clinical deterioration in the condition of 25 patients (out of 115 patients), ICU admission was essential. Based on the results, the baseline characteristics of the groups were similar. Patients requiring ICU admission were more likely to have multiorgan involvement (liver involvement, p <0.001; renal involvement, p <0.001; and cardiac involvement, P=0.02), low O2 saturation (p <0.001), and lymphopenia (P=0.05). During hospital admission, 21 (16.5%) patients died, while the rest (83.5%) were discharged and followed-up until March 26, 2020. Also, the survival rate of patients, who received immunoglobulin, was higher than other patients (60.87% vs. 39.13%).
Conclusion: The mortality rate of COVID-19 patients was considerable in our study. Based on the present results, this infection can cause multiorgan damage. Therefore, intensive monitoring of these patients needs to be considered.

Keywords

COVID-19

Features

ICU

Outcomes