Covid-19 pandemic: in-depth analysis of cases and deaths in Zahedan University of Medical Sciences a year since the time the first case emerged in China
As of 27 February 2021, globally more than 114,035,478 cases have been reported with more than 2,530,385 deaths, and the figures keep increasing every day. As of the same date, about 1,615,184 confirmed cases have also been reported from Islamic Republic of Iran, with 59,899 reported deaths of Covid 19 .
Report from: Dr Majid Sartipi, Director of Diseases Control & Prevention Department, Vice Chancellery for Health, ZAUMS
Published on: 27 February 2021
Authors:
Dr. Majid Sartipi
Dr. Seyed Mehdi Tabatabaei
Please click the following link for the details:
ZAUMS Coronavirus Disease (COVID-19) Situation Updates
Coronaviruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19.
It has been one year since reports first emerged that a viral "pneumonia of unknown cause" infecting dozens in China had been identified as a novel coronavirus. That novel coronavirus, SARS-CoV-2, is now known to cause COVID-19. The outbreak of coronavirus first detected in December 2019 in Wuhan, China, wreaked havoc on the planet, upended normal life, and confirmed our shared global vulnerability to the appearance of new pathogens, in particular airborne viruses that spread easily through travel and social proximity.
As of 27 February 2021, globally more than 114,035,478 cases have been reported with more than 2,530,385 deaths, and the figures keep increasing every day. As of the same date, about 1,615,184 confirmed cases have also been reported from Islamic Republic of Iran, with 59,899 reported deaths of Covid 19 (worldmeter: Coronavirus update (live) .
This Epidemiological Update provides an overview of the COVID-19 cases and deaths, in the areas covered by Zahedan University of Medical Sciences, highlighting key data and trends; as well as other pertinent epidemiological information concerning the COVID-19 pandemic.
During the year 2020 the areas covered by Zahedan University of Medical Sciences experienced two waves of COVID 19: the first wave in June and July and the bigger and second wave in November. Deaths from COVID 19 clearly increased after each wave. The maximum number of reported COVID 19 deaths per day was eleven.
In the early days of the COVID 19 pandemic, perhaps due to less experience in disease management, the COVID 19 Case Fatality Rate (CFR) was high (about 9%), but as physicians continued to gain experience, this rate showed a significant reduction, so that it reached 5.4% in February 2021.
About 59% of all COVID-19 cases (Outpatients and Hospitalized) in the university-covered population were men.
Of all COVID-19 cases (outpatients and hospitalized), about 1% (185 patients) were non-Iranian, and all health services were provided to this population, same as the Iranian population, totally free of charge.
The age group of 16 to 45 years had the highest number of cases with a total number of 10,543 cases. The age distribution is almost the same in both sexes.
Since the beginning of the pandemic, 8975 cases of Severe Acute Respiratory Infections (SARI) have been admitted to hospitals affiliated with Zahedan University of Medical Sciences, of which 4847 cases (54%) were male and the rest were female.
Out of 8975 SARI cases that hospitalized affilliated with Zahedan University of Medical Sciences, 4086 cases (45.5%) were positive for COVID-19, of which 2282 cases (56%) were male and the rest were female.
The hospitalization rate due to Severe Acute Respiratory Infection and COVID- 19 was highest for those aged 60 years and older. The next age group was 16 to 45 years old. The age distribution of cases was almost the same in both sexes.
About 93% of hospitalized COVID-19 patients were of Iranian nationality. Six percent of cases were non-Iranian and about 1% had an unknown nationality. All hospitalized patients received full and free of charge medical services.
SARI patients were admitted to hospitals in three different wards depending on their condition: patients with stable condition in general wards, patients with more severe respiratory condition in respiratory isolation wards and critically ill patients in Intensive Care Units (ICU). About 46% of cases were admitted to the general wards, 45% to the respiratory isolation wards and 9% in Intensive Care Units.
Similar to SARI cases, patients with COVID-19 were admitted to three wards based on their disease status. The majority of the COVID-19 patients admitted to the Respiratory isolation wards (56%). The proportion of patients admitted to the Intensive Care Unit swas similar to that of patients with SARI (i.e. 9%).
Only 19 cases (0.4%) of SARI cases had a history of COVID- 19.
Out of 4086 cases of COVID-19 hospitalized, 54 cases (1.3%) reported a history of COVID-19.
A total of 83 COVID- 19cases (11%) died in general wards, which requires an in-depth investigation. It also seems that the proportion of deaths in the respiratory isolation wards was higher than in the ICU wards, which still needs to be investigated.
The average interval between the onset of symptoms and the diagnosis of the disease has been increasing since the beginning of the pandemic, perhaps due to a decrease in people"s sensitivity, fear of going to medical centers, and excessive pressure on diagnostic laboratories. With the introduction of Rapid Diagnostic Tests (RDT) into the country"s health system in early December and testing in the most remote rural areas, the average time from the onset of symptoms to diagnosis has significantly reduced.
COVID-19 had the highest incidence in November with 344.3 per 100,000 populations under the coverage of Zahedan University of Medical Sciences, followed by July (250.6) and June (212.6) per 100,000 population.
The trend of COVID-19 mortality was similar to that of the incidence of COVID-19cases, with the highest incidence occurring in November. The months of July and June are next in terms of deaths.
Five districts of Sistan and Baluchestan Province are covered by Zahedan University of Medical Sciences. The most populous city of the province, which is also the capital of this province, is Zahedan. Due to the density of the population and the greater concentration of health facilities in this city, most cases of COVID-19 occurred in the city of Zahedan (1680.5 per100, 000 population) is the Saravan district ranked second with 1108.6 in 100,000 population.
"The past year has seen rapid advances in understanding of the biology, pathogenesis, and clinical characteristics of the disease. There are still several unknowns about the mechanisms of SARS-CoV-2 biology and pathogenesis. Epidemiologists are predicting short- and long-term projections to prepare for and potentially mitigate the spread and impact of the disease."
"However, the pandemic has exposed our susceptibly to microbial pathogens and gaps in our therapeutic arsenal. COVID-19 is not the first pandemic that humanity has faced, and it will not be the last. However, it has taught us how unprepared the world was for such an outbreak, and provided us with lessons in preparing and responding to virus warnings in the future. We hope that the continued research will lead to breakthroughs and help us be better prepared for future outbreaks."
Copyright © 2021 Zahedan University of Medical Sciences. All rights reserved. Date updated: 27/02/2021
Should you have any queries please do not hesitate to contact us on: msartipi23@zaums.ac.ir
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