Clinical Manifestations and Associated Mortality Factors of COVID-19: A Large Population-Based Study in the Northeast of Iran During 2020-2021

Background and aims: The emergence of the coronavirus disease 2019 (COVID-19) has become one of the greatest health problems of the 21st century. The current study was conducted to investigate COVID-19’s clinical manifestation, mortality factors, and their association with each other during the three devastating waves of the pandemic in Razavi-Khorasan province, Iran. Methods: This cross-sectional epidemiological population-based study was performed in Razavi-Khorasan province, Iran from January 21, 2020, to March 20, 2021. The data, including demographic characteristics and clinical presentations of the patients, were extracted from the Medical Care Monitoring System (MCMS), disease management portal in the Deputy of Health and hospital information system (HIS) of the medical universities/faculties of the province. Results: Overall, 80499 patients were admitted to all hospitals of Khorasan-Razavi with the laboratory/ clinical COVID-19 confirmed disease. The male-to-female ratio and the mean age of our COVID-19 individuals were 1.10:1 and 55.67±23.27, respectively. The most frequently reported presenting symptoms in histories provided at the admission time were respiratory distress (58.2%), fever (36.7%), and cough (34.9%), while the less common ones were abdominal pain (2.7%) and alternation in smell/ taste (0.9%). Male gender (odds ratio [OR]=1.32, P<0.001), age over 60 (OR=2.59, P<0.001), and presence of at least one comorbidity (OR=1.32, P<0.001) were significantly associated with higher mortality rates. Conclusion: Healthcare providers and public health managers can benefit from the findings of this study to detect and emphasize patients with poor prognoses.