Epidemiological and clinical features of 2019 novel coronavirus diseases (COVID-19) in the South of Iran

Abstract

Background: In March 2020, the WHO declared the novel coronavirus (COVID-19) outbreak a global pandemic. Although the number of infected cases is increasing, information about its clinical characteristics in the Middle East, especially in Iran, a country which is considered to be one of the most important focal points of the disease in the world, is lacking. To date, there is no available literature on the clinical data on COVID-19 patients in Iran.

Methods: In this multicenter retrospective study, 113 hospitalized confirmed cases of COVID-19 admitted to university affiliated hospitals in Shiraz, Iran from February 20 to March 20 were entered in the study.

Results: The mean age was 53.75 years and 71 (62.8%) were males. The most common symptoms at onset were fatigue (75: 66.4%), cough (73: 64.6%), and fever (67: 59.3%). Laboratory data revealed significant correlation between lymphocyte count (P value = 0.003), partial thromboplastin time (P value = 0.000), international normalized ratio (P value = 0.000) with the severity of the disease. The most common abnormality in chest CT scans was ground-glass opacity (77: 93.9%), followed by consolidation (48: 58.5%). Our results revealed an overall 8% (9 out of 113 cases) mortality rate among patients, in which the majority was among patients admitted to the ICU (5: 55.6%).

Conclusion: Evaluating the clinical data of COVID-19 patients and finding the source of infection and studying the behavior of the disease is crucial for understanding the pandemic.

Keywords: COVID-19; Clinical characteristics; Iran.

Fig. 1

(a) Axial CT scans from an above 60 year-old male; Selected cut from non-contrast chest CT of lung window. Sub pleural crescent-shaped Ground-glass opacities as well as smooth interlobular septal thickening can be seen in both lungs, involving mostly peripheral zone; (b) Axial CT scans from an above 60 year-old male; selected image from non-contrast chest CT scans, lung window. Extensive consolidation with can be seen in both lower lobes with air bronchograms; (c) and (d) Axial CT scans from an above 50 year-old male at the level of carina; (C) Day 5 after symptom onset: patchy consolidation affecting the bilateral, peripheral lung parenchyma and (d) Day 7: expansion of consolidation in both lungs, as well as ground glass opacities in right side; (e) Axial CT scans from an above 60 year-old male; selected image from non-contrast chest CT scans, lung window. Mixed consolidation and ground glass opacities can be seen in both lower lobes, right middle lobe and lingula of left upper lobe; (f) and (g) Axial CT scans from an above 50 year-old male; selected image from non-contrast chest CT scans, lung window, (f) Day 3 after symptom onset: ground glass opacities in both lower lobe associated with mal focus of consolidation and (g) Day 7: expansion of consolidation in both lungs, as well as GGO in right middle lobe (black arrow); Mild pleural effusion is seen bilaterally (yellow arrows); (h) Axial CT scans from an above 50-year old female; selected image from non-contrast chest CT scans, lung window. Multiple patchy consolidation in both lower lobe; (i) Axial CT scans from an under 50 year-old male; selected image from non-contrast chest CT scans, lung window. Crazy-paving pattern (GGO with superimposed inter- and intralobular septal thickening) are seen bilaterally; (j) Axial CT scans from an above 50 year-old male; selected image from non-contrast chest CT scans, lung window. Ground-glass opacities affecting the bilateral lung field, reverse halo sign (ground-glass opacity surrounded by denser consolidation of crescentic shape) in left lower lobe (arrow), Pleural effusion is seen bilaterally