Volume 12, Issue 3 (12-2024)
Jorjani Biomed J 2024, 12(3): 22-24 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Alizadeh Barzian K, Noorbakhsh N, Jamshidi M, Sabaghan M, Daneshi N, Shajirat Z, et al . Clinical and epidemiological features of covid-19 deaths in Behbahan county, southwestern Iran, in 2020-2022. Jorjani Biomed J 2024; 12 (3) :22-24
URL: http://goums.ac.ir/jorjanijournal/article-1-992-en.html
URL: http://goums.ac.ir/jorjanijournal/article-1-992-en.html
Kazem Alizadeh Barzian1 
, Negar Noorbakhsh1 , Mehdi Jamshidi1 , Mohamad Sabaghan1 , Nima Daneshi1 , Zainab Shajirat1 , Abolhasan Difrakhsh1 , Afsaneh Waysi1 , Hamid Behrouj1 , Zahra Nikkhoy1 , Ali Jamshidi2
, Negar Noorbakhsh1 , Mehdi Jamshidi1 , Mohamad Sabaghan1 , Nima Daneshi1 , Zainab Shajirat1 , Abolhasan Difrakhsh1 , Afsaneh Waysi1 , Hamid Behrouj1 , Zahra Nikkhoy1 , Ali Jamshidi2
1- Behbahan Faculty of Medical Science, Behbahan, Iran
2- Behbahan Faculty of Medical Science, Behbahan, Iran ,ajamshidi@behums.ac.ir
2- Behbahan Faculty of Medical Science, Behbahan, Iran ,
Full-Text [PDF 426 kb]
(289 Downloads)
| Abstract (HTML) (1218 Views)
Discussion
Based on the results of the survey in the 2 years from the beginning of the COVID-19 pandemic, i.e., 2020 to 2022, from the total number of patients referred to all the hospitals in Behbahan City, just 1.2% died as a result of COVID-19. The mortality rate varies in different studies. In the study by Sheikhi et al. (2021), about 13% of patients died from COVID-19 (13). In 2020, Mousavi Jazayeri reported that the death rate of COVID-19 was 6% in Bandar-e Abbas (14). Talebi et al. showed in 2020 that in Sabzevar, the mortality rate among hospitalized patients was approximately 15% (15). Gozidehkar et al. reported that the mortality rate was 12.9% among patients admitted to Shahada Shahr Hospital in Qain (16). In the studies of Huang et al., Chen et al., and Wang et al., the mortality rate in hospitalized patients was 15%, 14.1%, and 4.3%, respectively (17-19). This difference in the death rates of patients infected with COVID-19 is likely because of the differences in people's physiological status and immune systems, timely referral of patients, hospital facilities, special medical care, underlying diseases, etc. (20).
The findings of the present research showed that the mortality rate is higher among men than women, which is compatible with most of the published studies, including the studies of Ghazidekar et al., Sheikhi et al., and Chen et al. (13,16,18). However, in Liu et al.'s study in China, the mortality rate is higher in women, contrary to the findings of the present study (21). This can be due to the more exposure and contact of men compared to women because of their occupation and the presence of underlying and chronic diseases in men (22). In the study of Sheikhi et al., Akhvizadegan et al., and Liu et al., the mortality rate in patients with cardiovascular diseases, high blood pressure, or chronic respiratory and kidney diseases was higher than in other people who did not have a history of underlying disease, and these results were aligned with the present study (13,23,24). Note that about 85% of the deceased people in the current study had at least 1 or 2 underlying diseases. On the other hand, viral diseases themselves may be the cause of secondary fungal and bacterial diseases, kidney failure, increases or decreases in the levels of other fluids and hormones in the body, hepatitis, cancer, etc., due to the suppression of the immune system and increased mortality. The effect of this disease is caused during hospitalization or treatment in people.
Conclusion
There was a significant correlation between the age of the patients, the history of at least one chronic disease, and the mortality rate in infected patients. For this reason, it is crucial to implement precautionary procedures to reduce the number of deaths among infected people. Thus, the results of the present study can depict a better picture of the patients' condition in Behbahan and provide insight into future approaches.
Acknowledgement
We would like to express our sincere gratitude to all the patients' families who participated in this study and generously provided us with clinical and demographic information. We also thank the staff at the Behbahan County Health Center for their support in data collection. We are grateful to the Behbahan Faculty of Medical Sciences for providing us with the necessary resources and financial support. We would like to acknowledge the support and guidance provided by our colleagues and collaborators throughout this project. Finally, the authors appreciate Shahidzadeh Hospital, Valiasr Hospital, and Tamin Hospital for supporting this study.
Funding sources
The research was financially supported by the Behbahan Faculty of Medical Sciences.
Ethical statement
This study was supported and approved by the Ethics Committee of the Behbahan Faculty of Medical Sciences (Code: IR.BHN.REC.1401.010). Patient data were de-identified to protect their privacy and confidentiality of information. Additionally, the study was conducted with the utmost respect for the cultural norms and traditions of the participants. Any potential conflict of interest was disclosed and managed appropriately. The results of the study will be disseminated in a manner that respects the dignity and privacy of the participants and without identifying any individual participants.
Conflicts of interest
None
Author contributions
The research was designed by AJ and KAB, DN, ZS, AD, AW, and ZN conducted the data collection. The statistical analysis of the data was performed by MS, HB, and MJ. The manuscript was edited by NN.
Full-Text: (138 Views)
Introduction
The novel SARS-CoV-2 virus is a single-strand, positive-sense RNA virus belonging to the Beta coronavirus genus of the Coronaviridae family (1). SARS-CoV-2 originally emerged in Wuhan, China, in late 2019 (2). This virus has a different spectrum of symptoms, from a simple cold to a dangerous and chronic infection like COVID-19, which is the most contagious pandemic in the last century (3). The coronavirus disease has drawn a lot of attention from clinical researchers in pathogenies, pathology, treatment, and vaccine production areas (4). COVID-19, in most cases, causes problems for the upper respiratory tract; however, this virus can also affect the inner respiratory tract (5,6). Current evidence suggests that the new coronavirus is transmitted through contact, droplets, airborne, oral-fecal, and mother-to-child routes. Moreover, patients can transmit the virus to others during incubation. Infection with SARS-CoV-2 primarily causes fever, cough, tiredness, loss of taste or smell, bone and muscle pain, and shortness of breath (7,8). According to the World Health Organization, COVID-19 has infected more than 634 million and killed more than 6 million people worldwide. Regarding Iran, it is reported that the number of infected people was about 7.5 million, and 146 000 died as a result of this infection (9). Due to the epidemic of COVID-19 and the speed of its spread in the world, genetic changes, and the creation of different strains, researchers have started many studies on different aspects of the disease and, so far, many studies in the fields of epidemiology, pathogenesis, diagnosis, treatment, and vaccination have been conducted (10). Still, these studies seem insufficient due to the mysterious nature of the disease, and it is necessary to conduct more studies to investigate the clinical and epidemiological characteristics of the disease. The present study aimed to present the demographic, epidemiological, and clinical characteristics of the deaths related to COVID-19 in Behbahan, a city located in the southwest of Khuzestan Province (Iran) with a population of over 200 000 in 2020 to 2022. It is expected to show an accurate picture of the condition of the disease, and the results can be used to help health and treatment institutions for future planning.
Methods
Study area
Behbahan is one of the 27 counties of Khuzestan Province in southwestern Iran. The capital of the county is Behbahan. The county is subdivided into 3 districts: Central, Tashan, and Zeydun. Also, it consists of 4 cities: Behbahan, Mansuriyeh, Tashan, and Sardasht. Behbahan has a land area of around 3,195 km2 and is in the southeast of Khuzestan Province at approximately 30° 35′ 45′′N and 50° 14′ 30′′E. The population of this county is estimated at 300 000 (11,12).
Patient data collection
In this cross-sectional study, data from all patients who died of COVID-19 were obtained from all hospitals in Behbahan County (Khuzestan Province, Iran) between March 2020 and March 2022. In the next step, demographic data (Age, sex, etc.) and epidemiological and clinical information (The history of chronic diseases) were collected from patients. Finally, the obtained data were analyzed with SPSS v. 21 (IBM Corp., Armonk, NY, USA) to assess the factors contributing to mortality.
Results
The findings showed that 437 deaths occurred during the entire study period due to COVID-19, of which 379 cases (91%) were in Behbahan and 40 cases (9%) were in Aghajari. Moreover, out of 437 cases of death, 267 patients (61%) were men and 170 patients (39%) were women. The highest number of deaths was seen in patients aged 71-80 years (24%), and the lowest number was among the 1-10 and 11-20 age groups, which was below 1% (Figure 1). According to the age grouping of the Ministry of Health and Medical Education of the Islamic Republic of Iran, middle-aged patients had the highest mortality rate (52%), and children and adolescents had the lowest mortality rate (Below 1%). In addition, there were 3 underlying risk factors, namely diabetes with 167 cases (28%), heart disease with 149 cases (25%), and high blood pressure with 103 cases (17%), which had the greatest effect on death (Figure 2). It was obvious that one of the chronic diseases was linked with the mortality rate (65%). The highest number of deaths was recorded in July 2021, with 69 cases (15.7% of all reported deaths), and the lowest number was in February 2020 and November and December 2021, with just 2 cases (0.4%). Furthermore, there were just 2 cases of death from COVID-19 in 2018, 185 cases in 2020, 250 in 2021, and 250 cases in 2022. Most of the deaths were among homemakers, with 106 cases (24%). Most of the cases (35 patients) died just 1 day after hospitalization.
The novel SARS-CoV-2 virus is a single-strand, positive-sense RNA virus belonging to the Beta coronavirus genus of the Coronaviridae family (1). SARS-CoV-2 originally emerged in Wuhan, China, in late 2019 (2). This virus has a different spectrum of symptoms, from a simple cold to a dangerous and chronic infection like COVID-19, which is the most contagious pandemic in the last century (3). The coronavirus disease has drawn a lot of attention from clinical researchers in pathogenies, pathology, treatment, and vaccine production areas (4). COVID-19, in most cases, causes problems for the upper respiratory tract; however, this virus can also affect the inner respiratory tract (5,6). Current evidence suggests that the new coronavirus is transmitted through contact, droplets, airborne, oral-fecal, and mother-to-child routes. Moreover, patients can transmit the virus to others during incubation. Infection with SARS-CoV-2 primarily causes fever, cough, tiredness, loss of taste or smell, bone and muscle pain, and shortness of breath (7,8). According to the World Health Organization, COVID-19 has infected more than 634 million and killed more than 6 million people worldwide. Regarding Iran, it is reported that the number of infected people was about 7.5 million, and 146 000 died as a result of this infection (9). Due to the epidemic of COVID-19 and the speed of its spread in the world, genetic changes, and the creation of different strains, researchers have started many studies on different aspects of the disease and, so far, many studies in the fields of epidemiology, pathogenesis, diagnosis, treatment, and vaccination have been conducted (10). Still, these studies seem insufficient due to the mysterious nature of the disease, and it is necessary to conduct more studies to investigate the clinical and epidemiological characteristics of the disease. The present study aimed to present the demographic, epidemiological, and clinical characteristics of the deaths related to COVID-19 in Behbahan, a city located in the southwest of Khuzestan Province (Iran) with a population of over 200 000 in 2020 to 2022. It is expected to show an accurate picture of the condition of the disease, and the results can be used to help health and treatment institutions for future planning.
Methods
Study area
Behbahan is one of the 27 counties of Khuzestan Province in southwestern Iran. The capital of the county is Behbahan. The county is subdivided into 3 districts: Central, Tashan, and Zeydun. Also, it consists of 4 cities: Behbahan, Mansuriyeh, Tashan, and Sardasht. Behbahan has a land area of around 3,195 km2 and is in the southeast of Khuzestan Province at approximately 30° 35′ 45′′N and 50° 14′ 30′′E. The population of this county is estimated at 300 000 (11,12).
Patient data collection
In this cross-sectional study, data from all patients who died of COVID-19 were obtained from all hospitals in Behbahan County (Khuzestan Province, Iran) between March 2020 and March 2022. In the next step, demographic data (Age, sex, etc.) and epidemiological and clinical information (The history of chronic diseases) were collected from patients. Finally, the obtained data were analyzed with SPSS v. 21 (IBM Corp., Armonk, NY, USA) to assess the factors contributing to mortality.
Results
The findings showed that 437 deaths occurred during the entire study period due to COVID-19, of which 379 cases (91%) were in Behbahan and 40 cases (9%) were in Aghajari. Moreover, out of 437 cases of death, 267 patients (61%) were men and 170 patients (39%) were women. The highest number of deaths was seen in patients aged 71-80 years (24%), and the lowest number was among the 1-10 and 11-20 age groups, which was below 1% (Figure 1). According to the age grouping of the Ministry of Health and Medical Education of the Islamic Republic of Iran, middle-aged patients had the highest mortality rate (52%), and children and adolescents had the lowest mortality rate (Below 1%). In addition, there were 3 underlying risk factors, namely diabetes with 167 cases (28%), heart disease with 149 cases (25%), and high blood pressure with 103 cases (17%), which had the greatest effect on death (Figure 2). It was obvious that one of the chronic diseases was linked with the mortality rate (65%). The highest number of deaths was recorded in July 2021, with 69 cases (15.7% of all reported deaths), and the lowest number was in February 2020 and November and December 2021, with just 2 cases (0.4%). Furthermore, there were just 2 cases of death from COVID-19 in 2018, 185 cases in 2020, 250 in 2021, and 250 cases in 2022. Most of the deaths were among homemakers, with 106 cases (24%). Most of the cases (35 patients) died just 1 day after hospitalization.
Discussion
Based on the results of the survey in the 2 years from the beginning of the COVID-19 pandemic, i.e., 2020 to 2022, from the total number of patients referred to all the hospitals in Behbahan City, just 1.2% died as a result of COVID-19. The mortality rate varies in different studies. In the study by Sheikhi et al. (2021), about 13% of patients died from COVID-19 (13). In 2020, Mousavi Jazayeri reported that the death rate of COVID-19 was 6% in Bandar-e Abbas (14). Talebi et al. showed in 2020 that in Sabzevar, the mortality rate among hospitalized patients was approximately 15% (15). Gozidehkar et al. reported that the mortality rate was 12.9% among patients admitted to Shahada Shahr Hospital in Qain (16). In the studies of Huang et al., Chen et al., and Wang et al., the mortality rate in hospitalized patients was 15%, 14.1%, and 4.3%, respectively (17-19). This difference in the death rates of patients infected with COVID-19 is likely because of the differences in people's physiological status and immune systems, timely referral of patients, hospital facilities, special medical care, underlying diseases, etc. (20).
The findings of the present research showed that the mortality rate is higher among men than women, which is compatible with most of the published studies, including the studies of Ghazidekar et al., Sheikhi et al., and Chen et al. (13,16,18). However, in Liu et al.'s study in China, the mortality rate is higher in women, contrary to the findings of the present study (21). This can be due to the more exposure and contact of men compared to women because of their occupation and the presence of underlying and chronic diseases in men (22). In the study of Sheikhi et al., Akhvizadegan et al., and Liu et al., the mortality rate in patients with cardiovascular diseases, high blood pressure, or chronic respiratory and kidney diseases was higher than in other people who did not have a history of underlying disease, and these results were aligned with the present study (13,23,24). Note that about 85% of the deceased people in the current study had at least 1 or 2 underlying diseases. On the other hand, viral diseases themselves may be the cause of secondary fungal and bacterial diseases, kidney failure, increases or decreases in the levels of other fluids and hormones in the body, hepatitis, cancer, etc., due to the suppression of the immune system and increased mortality. The effect of this disease is caused during hospitalization or treatment in people.
Conclusion
There was a significant correlation between the age of the patients, the history of at least one chronic disease, and the mortality rate in infected patients. For this reason, it is crucial to implement precautionary procedures to reduce the number of deaths among infected people. Thus, the results of the present study can depict a better picture of the patients' condition in Behbahan and provide insight into future approaches.
Acknowledgement
We would like to express our sincere gratitude to all the patients' families who participated in this study and generously provided us with clinical and demographic information. We also thank the staff at the Behbahan County Health Center for their support in data collection. We are grateful to the Behbahan Faculty of Medical Sciences for providing us with the necessary resources and financial support. We would like to acknowledge the support and guidance provided by our colleagues and collaborators throughout this project. Finally, the authors appreciate Shahidzadeh Hospital, Valiasr Hospital, and Tamin Hospital for supporting this study.
Funding sources
The research was financially supported by the Behbahan Faculty of Medical Sciences.
Ethical statement
This study was supported and approved by the Ethics Committee of the Behbahan Faculty of Medical Sciences (Code: IR.BHN.REC.1401.010). Patient data were de-identified to protect their privacy and confidentiality of information. Additionally, the study was conducted with the utmost respect for the cultural norms and traditions of the participants. Any potential conflict of interest was disclosed and managed appropriately. The results of the study will be disseminated in a manner that respects the dignity and privacy of the participants and without identifying any individual participants.
Conflicts of interest
None
Author contributions
The research was designed by AJ and KAB, DN, ZS, AD, AW, and ZN conducted the data collection. The statistical analysis of the data was performed by MS, HB, and MJ. The manuscript was edited by NN.
Type of Article: Brief Report |
Subject:
Health
Received: 2023/10/20 | Accepted: 2023/12/3 | Published: 2024/07/1
Received: 2023/10/20 | Accepted: 2023/12/3 | Published: 2024/07/1
References
1. Alinejad T, Zareh D, Hao Z, Zhou T, Chen CS. SARS-CoV-2 Mutation Mechanism, Features, and Future Perspective. SARS-CoV-2 Variants-Two Years After: IntechOpen; 2022. [View at Publisher] [DOI] [Google scholar]
2. Li J, Lai S, Gao GF, Shi WJN. The emergence, genomic diversity and global spread of SARS-CoV-2. Nature. 2021;600(7889):408-18. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Shirani K, Sheikhbahaei E, Torkpour Z, Nejad MG, Moghadas BK, Ghasemi M, et al. A narrative review of COVID-19: the new pandemic disease. Iran J Med Sci. 2020;45(4):233-49. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Adhikari G. Intuition on virology, epidemiology, pathogenesis, and control of COVID-19. Nov Res Microb J. 2020;4(5):955-67. [View at Publisher] [DOI] [Google Scholar]
5. Hassanipour S, Azadbakht O, Dehnavi Z, Shafiee M, Badeenezhad A, Nikbakht HA, et al. Meta-analysis: COVID-19 diagnosis in chest CT-master key for radiologists. Egypt J Radiol Nucl Med. 2021;52(1):1-13. [View at Publisher] [DOI] [Google Scholar]
6. Ahmadi A, Ardeshiri S, Nezhadi VR, Pajoohesh A, Moghadam TN, Sabaghan M, et al. Risk Factors for Mortality in Hospitalized Patients with COVID-19: A Cross-Sectional Study in Southwestern Iran. Iranian Red Crescent Med J. 2021;23(9). [View at Publisher] [Google Scholar]
7. Lovato A, de Filippis C, Marioni GJAjoO. Upper airway symptoms in coronavirus disease 2019 (COVID-19). Am J Otolaryngol. 2020:102474. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Matsunaga N, Hayakawa K, Terada M, Ohtsu H, Asai Y, Tsuzuki S, et al. Clinical epidemiology of hospitalized patients with coronavirus disease 2019 (COVID-19) in Japan: Report of the COVID-19 Registry Japan. Clin Infect Dis. 2021;73(11):e3677-89. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Sedighi I, Fahimzad A, Pak N, Khalili M, Shokrollahi MR, Heydari H, et al. A multicenter retrospective study of clinical features, laboratory characteristics, and outcomes of 166 hospitalized children with coronavirus disease 2019 (COVID‐19): A preliminary report from Iranian Network for Research in Viral Diseases (INRVD). Pediatric Pulmonology. 2022;57(2):498-507. [View at Publisher] [DOI] [PMID] [Google Scholar]
10. Madhi SA, Baillie V, Cutland CL, Voysey M, Koen AL, Fairlie L, et al. Efficacy of the ChAdOx1 nCoV-19 Covid-19 vaccine against the B. 1.351 variant. N Engl J Med. 2021;384(20):1885-98. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Jamshidi A, Haniloo A, Fazaeli A, Ghatee M. Effects of geographical and climatic factors on cystic echinococcosis in south-western Iran. Journal of Helminthology. 2020;94:e175. [View at Publisher] [DOI] [PMID] [Google Scholar]
12. Ghatee MA, Malek Hosseini SAA, Marashifard M, Karamian M, Taylor WR, Jamshidi A, et al. Phylogenetic analysis of Trichostrongylus vitrinus isolates from southwest Iran. Parasit Vectors. 2020;13(1):553. [View at Publisher] [DOI] [PMID] [Google Scholar]
13. Sheikhi F, Mirkazehi Rigi Z, Azarkish F, Kalkali S, Seid Abadi M, Mirbaloochzehi AJJoMM. Clinical and Demographic Characteristics of Patients with COVID-19 in Iranshahr Hospitals, Southeastern Iran in 2020. J Mar Med. 2021;3(1):46-52. [View at Publisher] [DOI] [Google Scholar]
14. Mousavi Jazayeri SAJJMM. Shahid Fatemi Field Hospital Services for Patients with COVID-19 in Bandar Abbas, Iran. Journal of Military Medicine. 2020;22(10):991-2. [View at Publisher] [Google Scholar]
15. Talebi S, Nematshahi M, Tajabadi A, Khosrogerdi AJJMM. Comparison of clinical and epidemiological characteristics of deceased and recovered patients with COVID-19 in Sabzevar, Iran. Journal of Military Medicine. 2020;22(6):509-16. [View at Publisher] [DOI] [Google Scholar]
16. Gozidehkar Z, Gahani H, Davary A, Borna HJJBUMS. Prevalence and factors related to infection and mortality due to COVID-19 among patients of Shohada Ghaen Hospital, Ghaen, Iran, 2020. J Birjand Univ Med Sci. 2021;28(4):375-84. [View at Publisher] [DOI] [Google Scholar]
17. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. [View at Publisher] [DOI] [PMID] [Google Scholar]
18. Chen J, Qi T, Liu L, Ling Y, Qian Z, Li T, et al. Clinical progression of patients with COVID-19 in Shanghai, China. J Infect. 2020;80(5):e1-6. [View at Publisher] [DOI] [PMID] [Google Scholar]
19. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729. [View at Publisher] [DOI] [PMID] [Google Scholar]
20. Dananché C, Elias C, Hénaff L, Amour S, Kuczewski E, Gustin M-P, et al. Baseline clinical features of COVID-19 patients, delay of hospital admission and clinical outcome: A complex relationship. Plos One. 2022;17(1):e0261428. [View at Publisher] [DOI] [PMID] [Google Scholar]
21. Liu L, Lei X, Xiao X, Yang J, Li J, Ji M, et al. Epidemiological and clinical characteristics of patients with coronavirus disease-2019 in Shiyan City, China Front Cell Infect Microbiol. 2020;10:284. [View at Publisher] [DOI] [PMID] [Google Scholar]
22. Mahboob S, Johora F, Abbasy AA, Jeenia FT, Ali M, Naharin NE, et al. Demographic Characteristics and Clinical Features of COVID-19 Patients Admitted in a Combined Military Hospital of Bangladesh. medRxiv. 2022. [View at Publisher] [DOI] [Google Scholar]
23. Akhavizadegan H, Aghaziarati M, Roshanfekr Balalemi MG, Arman Broujeni Z, Taghizadeh F, Akbarzadeh Arab I, et al. Relationship between comorbidity, chronic diseases, icu hospitalization, and death rate in the elderly with coronavirus infection. Iranian Journal of Ageing. 2021;16(1):86-101. [View at Publisher] [DOI] [Google Scholar]
24. Liu L, Ni SY, Yan W, Lu QD, Zhao YM, Xu YY, et al. Mental and neurological disorders and risk of COVID-19 susceptibility, illness severity and mortality: a systematic review, meta-analysis and call for action. E Clinical Medicine. 2021:1;40. [View at Publisher] [DOI] [PMID] [Google Scholar]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
