Clinical and epidemiological characteristics and outcomes of Coronavirus disease-19 patients in a large longitudinal study

Muayad Aghali Merza; Serwan Mohamamed Aswad; Hushyar Musa Sulaiman; Deldar Morad Abdulah; Waleed Salih Rasheed; Nezar Ismet Taib

Clinical and epidemiological characteristics and outcomes of Coronavirus disease-19 patients in a large longitudinal study

Int J Health Sci (Qassim). 2021 Jul-Aug;15(4):29-41.

Authors

Muayad Aghali Merza¹, Serwan Mohamamed Aswad², Hushyar Musa Sulaiman³, Deldar Morad Abdulah⁴, Waleed Salih Rasheed⁵, Nezar Ismet Taib⁶

Affiliations

¹ Department of Internal Medicine, Azadi Teaching Hospital, College of Pharmacy, University of Duhok, Iraqi Kurdistan, Iraq.
² Department of Community and Family Medicine, Lecture at College of Medicine, University of Duhok, Director of Directorate of Preventive Health Affairs, Duhok, Iraqi Kurdistan, Iraq.
³ Director General Advisor, Duhok Directorate General of Health, Iraqi Kurdistan, Iraq.
⁴ Community and Maternity Health Unit, College of Nursing, University of Duhok, Iraqi Kurdistan, Iraq.
⁵ Department of Communicable Diseases, Directorate of Preventive Health Affairs, Duhok, Iraqi Kurdistan, Iraq.
⁶ Director General of Health, Duhok Directorate General of Health, Iraqi Kurdistan, Iraq.

PMID: 34285686
PMCID: PMC8265303

Abstract

Objective: This study aimed to determine the clinical and epidemiological characteristics and outcomes of Coronavirus disease (COVID)-19 patients.

Methods: In this large cohort study, 15,409 confirmed patients with the COVID-19 of different severities were followed-up from three specialized COVID-19 hospitals between March 18 and October 11, 2020 in Iraqi Kurdistan. The predictors of mortality and severity were examined in binary logistic regression analysis.

Results: The incidence rate of severe/critical status was 12.3% with a median age of 36.0 and case fatality rate (CFR) of 1.98%. The incidence rate of severe/critical conditions and CFR rose with increased age groups; except for 0-14 years (11.9%). The incidence rate of severe/critical patients and CFR was 8.3% and 0.5%, 21.1% and 4.0%, and 23.7% and 8.7% in 15-49 years, 50-64 years, and 65 and older age groups, respectively. The severity of the disease and CFR was associated with coexisting chronic diseases such as cardiovascular diseases (18.2% and 3.1%) and diabetes mellitus (19.8% and 3.4%). The asymptomatic patients (8400 and 54.5%) had statistically higher CFR; 2.3% versus 1.6% (P = 0.006). The most common symptoms on diagnosis were fever (31.9%), cough (23.5%), loss of smell/taste (16.3%), sore throat (15.7%), shortness of breath (9.8%), and headache (9.5%). The results showed that being older was the only predictor of mortality and severity in COVID-19 patients.

Conclusions: This region has a low incidence of severe-critic status and CFR. The patients with coexisting medical conditions are more likely to have severe conditions and die of COVID-19. The older age predicts severe/critic status and higher CFR.

Keywords: COVID-19; case fatality rate; outcome; severity.