Demographic and clinical characteristics of severe Covid-19 infections: a cross-sectional study from Mashhad University of Medical Sciences, Iran

BMC Infect Dis. 2021 Jul 7;21(1):656. doi: 10.1186/s12879-021-06363-6.


Background: Coronavirus Disease 2019 (Covid-19) is expanding worldwide. The characteristics of this infection in patients varies from country to country. To move forward, clinical data on infected patients are needed. Here, we report a comparison between fatalities and recovery of patients with severe Covid-19, based on demographic and clinical characteristics.

Methods: Between 5 March and 12 May 2020 in Mashhad, Iran, 1278 of 4000 suspected Covid-19 patients were confirmed positive by real-time reverse-transcriptase-polymerase-chain-reaction assay of upper respiratory specimens. We compared the demographic, exposure history and clinical symptoms of 925 survivors and 353 fatal cases with confirmed disease.

Results: Mean (SD) age for all confirmed patients was 56.9 (18.7) years, 67.1 (15.9) years in fatal cases and 53.0 (18.3) years in survivors. Multivariate logistic regression analysis showed that the outcome of patients was associated with age (odds ratio = 1.049, P = 0.0001, 95% CI = 1.040-1.057). Despite a high burden of Covid-19 infections in the 30-39 and 40-49 year age groups, most of these (89.6 and 87.2%, respectively) recovered. The median (IQR) duration of hospitalization was 9.0 (6.0-14.0) days. The most prevalent co-morbidities were cardiovascular disorders (21%) and diabetes (16.3%). Dyspnoea (72.7%), cough (68.1%) and fever (63.8%) were the most frequent clinical symptoms. Healthcare workers, of whom two (3%) died, comprised 5.2% of infected cases. Combination antiviral and antibiotic therapy was used in 43.0% of cases.

Conclusions: The characteristics of severe Covid-19 varied substantially between fatal cases and survivors, with diabetes and cardiovascular disorders the most prevalent co-morbidities. In contrast to other studies, there were a higher number of fatalities in younger patients in our setting.

Keywords: COVID-19, SARS-COV-2; Epidemiological characteristics; Symptoms, Iran.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • COVID-19 / diagnosis*
  • COVID-19 / mortality
  • COVID-19 Drug Treatment
  • Cardiovascular Diseases / epidemiology
  • Child
  • Child, Preschool
  • Comorbidity
  • Cough / etiology
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Dyspnea / etiology
  • Female
  • Fever / etiology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Iran / epidemiology
  • Male
  • Middle Aged
  • Real-Time Polymerase Chain Reaction
  • SARS-CoV-2
  • Treatment Outcome
  • Young Adult


  • Anti-Bacterial Agents
  • Antiviral Agents