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The COVID-19 virus rapidly spread worldwide, becoming one of the major healthcare challenges. The symptoms of this disease vary widely, ranging from mild to fatal. As of May 24, 2023, over 766 million confirmed cases and 6.9 million deaths have been recorded. Comorbidities such as hypertension, obesity, and heart disease increase the risk of infection and adverse outcomes. Vaccines have been developed, but viral mutations have led to new outbreaks. Epidemiological studies are crucial for better understanding COVID-19. This research examines the epidemiology of COVID-19 and the role of comorbidities in Iran.MethodsA cohort study was conducted to report COVID-19 cases and mortality. Using checklists and telephone interviews, suspected, probable, and confirmed cases were classified. Incidence metrics included cumulative incidence and incidence rate, while mortality metrics included IFR and CFR. Case-control studies were conducted to examine factors influencing infection, hospitalization, and mortality. Multi-state Survival Analysis was used to assess the status changes in hospitalized patients.ResultsDuring the study period, 14%, 9.7%, and 6.2% of participants were in the confirmed, probable, and suspected COVID-19 groups, respectively. The cumulative incidence of confirmed cases was 14%. The frequency of suspected and probable cases from the pandemic's start to November 28, 2022, was 191 and 573, respectively. The total person-years at risk was 19,331. The incidence rates for suspected and probable cases were 0.009 and 0.029 per person-year, respectively. The IFR and CFR were 2.07% and 3.64%, respectively. Multiple logistic regression showed that residence, ethnicity, marital status, kidney stones, gallstones, and stroke history were associated with COVID-19 infection. Age increase was associated with a 1% decrease in infection odds. Type 2 diabetes, cancer, cardiovascular disease, and obesity were not associated with COVID-19 infection. Age, BMI over 25, urban living, thyroid disease, and type 2 diabetes were associated with increased hospitalization odds. Smoking was associated with decreased hospitalization odds. Hypertension and mental illness were associated with increased mortality odds, while urban living and kidney stone history were associated with decreased mortality odds.ConclusionThis study showed that various factors such as urban living, Lur ethnicity, marital status, kidney stones, gallstones, and stroke history are associated with COVID-19 infection odds. Urban living and Lur ethnicity increase infection odds, while gallstones and stroke history decrease them. Age increase was associated with decreased infection odds but increased hospitalization odds. Additionally, BMI over 25, urban living, thyroid disease, and type 2 diabetes were associated with increased hospitalization odds. Smoking was associated with decreased hospitalization odds. Hypertension and mental illness were associated with increased mortality odds, while urban living and kidney stone history were associated with decreased mortality odds. These results highlight the complex and multifactorial impact of various factors on the severity and outcomes of COVID-19, emphasizing the importance of considering these factors in disease management and prevention.
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