Medical Journal of the Islamic Republic Of Iran

en Differences in the Clinical Severity Scores of Hospitalized COVID-19 Patients across Different Phases of an Epidemic Wave in Iran: a Secondary Analysis Epidemiology Epidemiology Original Research Original Research     Background: To reduce the clinical burden of COVID-19, healthcare providers, and policymakers need a clear understanding of the illness severity during epidemic waves. This study aimed to identify the clinical severity of patients with COVID-19 during different stages of an epidemic wave (pre-peak, peak, post-peak) in four provinces in Iran.    Methods: We conducted a secondary analysis of the data on COVID-19 patients admitted to hospitals (25,382 cases), which were recorded in the Medical Care Monitoring Center. Data included adult patients (≥18 years) who were hospitalized due to COVID-19 infection, confirmed by a positive SARS-CoV-2 RT-PCR test. No exclusion criteria were applied. A pairwise comparison method was used to evaluate clinical severity. Then, based on univariable and multivariable linear regression models, the severity scores of patients were compared during various stages of an epidemic wave.    Results: The findings showed that the level of severity of the disease was higher during and after the peak in the total population. The means (SD) of severity scores were 0.16 (0.25), 0.18 (0.26), and 0.19 (0.26) before, during and after the peak, respectively. Besides, age and the underlying disease had a positive and significant relationship with disease severity.    Conclusion: During the middle and late phases of the COVID-19 epidemic wave, hospitals are seeing patients with more severe illnesses than in the early stages. Enhancing hospital preparedness is essential to avert excess deaths and critical cases. Moreover, it is important to maintain ongoing monitoring of clinical symptoms during the recovery phase to support individual patients, guide public health policy, and enhance scientific understanding of epidemic recovery processes.   COVID-19, Epidemics, Clinical Severity, Hospitalization 653 658 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-8897-1&slc_lang=en&sid=1 Leila Mounesan lmmounesan@yahoo.com 200319475328460089480 200319475328460089480 No Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran Safoora Gharibzadeh safoora.gharibzadeh@gmail.com 200319475328460089481 200319475328460089481 No Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran Mahboubeh Parsaeian mahbobehparsaeian@yahoo.com 200319475328460089482 200319475328460089482 No Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Mohammad Mehdi Gouya mgouya57@gmail.com 200319475328460089483 200319475328460089483 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Sana Eybpoosh sana.eybpoosh@gmail.com 200319475328460089484 200319475328460089484 No Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran Ali Hosseini a.hosseini@ut.ac.ir 200319475328460089485 200319475328460089485 No Department of Human Geography, University of Tehran, Tehran, Iran Leila Haghjou haghjoo.leila@gmail.com 200319475328460089486 200319475328460089486 No Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran AliAkbar Haghdoost ahaghdoost@gmail.com 200319475328460089487 200319475328460089487 No HIV/STI Surveillance Research Center and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Ehsan Mostafavi mostafavi@pasteur.ac.ir 200319475328460089488 200319475328460089488 Yes Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran