COVID-19 is a rapidly evolving public health emergency which disrupted all aspect of humans life. The rapid spread of the COVID-19 has left the world often unprepared to combat this pandemic. Socio-clinical characteristics and mortality rate of the COVID-19 outbreak were described during current study. Mean age of COVID-19 patients was 45 years old compared with the international mean age 47–62 [4][5]. This variation in the mean age of the COVID-19 disease may be due to the difference in the inclusion criteria and the age group of patients included in the previous studies, however all age groups may be included in the COVID-19 infection, including children under 12 years of age and the elderly who reach the age of 104 as shown by our current study.
Males COVID-19 patients were affected slightly more frequently than females (53.8% vs 46.2%). As compared with other studies, a larger number of COVID-19 males patients (60%) were detected [6] and also similar to the previous studies that showed males predominant [4][7][8]. Previous studies related to previous coronavirus outbreaks, which include severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS), have shown that male patients are the most dominant
[9][10]. The reason for low susceptibility of the females to viral infection may be the strong immune response in females, which weakens the viral infection [11].
Most common three symptoms in our patients were fever (64.2%), fatigue (42.4%), and cough (42.2%). However, gastrointestinal tract manifestations were uncommon and these were consistent with a previous study [12]. These symptoms were consistent with previous studies [4][13] and it was in concordance to findings of other kinds of literature [14][15]. On the other hand, we found ear, nose, and throat symptoms as anosmia (38.5%) and aguesia (33.6%) in all cases, and these symptoms were observed in several studies [16][17]. Patients with a mild infection may show only slight fatigue and no fever and this was in agreement with a previous study [18]. Interestingly, in a prior study there were 4 COVID-19 patients (26.7%) exhibited smell and taste disorders [19]. The current result was similar with the COVID-19 patients in Italy, where 33.9% of them showed either an abnormal smell or taste [20], This means that smell and taste disorders can be a useful diagnostic guide in the COVID-19 outbreak, although it is present in many viral diseases.
The mortality rate was 5.6% during our study and this result was higher than the result of the Chinese Centers for Disease Control who showed that the mortality rate was 2.3% [3]. The difference between the two studies is due to the big difference between the numbers of patients between the two studies. Besides, the mortality rate was higher than a study from Saudi Arabia, which reported a 1% [8]. This difference may be attributed to differences in the follow-up period and there was a considerable patients (9.3%) of the Saudi Arabia study were asymptomatic while in our study all the studied patients were symptomatic. However, COVID-19 outbreak mortality rate in the world is much lower than 10% and 30% mortality rate respectively for SARS and MERS [21][22]. The mortality rate during the current study was less than the mortality rate during the previous study which showed a comparatively high COVID-19 mortality rate approximately 14.1% [23]. This is partly due to the admission of large numbers of patients with a critical condition from COVID-19, who was admitted to Tongji Hospital with limited medical resources with the onset of the COVID-19 pandemic outbreak. Our results appear to be different from another study in Beijing [24] where all of the patients recovered. Regarding the rate of critical cases and higher mortality mentioned in this previous research compared to the lower death rate in our current study, this is partly due to the admission of large numbers of patients suffering from a critical condition of COVID-19, who were admitted to China Hospital with limited medical resources at the beginning. This is an epidemic as it tends to introduce only critical cases to hospitals in China [7][14][25].
Health-care workers are exposed to COVID-19 more than other population while providing health and medical services to patients [26]. This confirms what our study and other similar studies have found that early screening of those workers to avoid transmission of the infection and preserve health-care workers [8][23]. However, the source of infection cannot determine whether it is from the community or the hospitals outbreaks [8].
Males were more predominant than females in COVID-19 patients who died compared with those who recovered and there was a significant difference in fatality rate between males and females of COVID-19 patients during our study (P-value = 0.023). This result was in agreement with the results reported by previous studies [3][14] which showed that the fatality rate for confirmed COVID-19 cases was appeared to be more frequent in male than in COVID-19 female patients, as there is an increase in the risk of death rate with age in both sexes.
Age group ≥ 59 years was more predominant than other age groups among deceased patients than recovered patients (P-value = 0.000). This result was in agreement with the results reported by Wu et al. study [27] who showed that the more frequent rate was in COVID-19 patients aged 80 and above. As the younger patients have a strong immune response and they have no risk factors. Many previous studies have shown that the COVID-19 outbreak has a more complex and deep course in elderly patients, especially those who suffer from comorbidities accompanied by a weak immune response [6][14].
To note, transmission of the infection is more in crowded (urban areas) than relatively less crowded areas. However, there was no statistically significant difference in fatality rate between urban and rural COVID-19 patients during our study (P-value = 0.162). This result was in agreement with the results reported by previous studies [3] [25].
No statistically significant difference in the death rate between health-care and non-healthcare workers of COVOD-19 patients during the current study (P-value = 0.801) and this result was in agreement with the results reported by prior study [3]. Notably, health-care workers were possible to have a better outcome, which is in agreement with previous study that showed low fatality rate (0.3%) registered in health-care workers COVID-19 patients [28].
No statistically significant difference in fatality rate between smokers and non-smokers of COVID-19 patients during the study (P-value = 0.356). This result was in agreement with the results reported by Chen et al. study [3] but in disagreement with the previous meta-analysis that showed the risk of smoking on the severity of COVID-19 infection [29].
Patients with comorbidities were more predominant than patients without history of comorbidities among deceased patients than recovered patients (P-value = 0.000). This result was in agreement with the previous studies [3][30] which reported that the comorbidities were strongly associated with the fatality of COVID-19 patients.
These results will enrich the information provided about this epidemic and this will be reflected in helping to improve recovery outcomes and reduce the mortality rate. However, the main current study limitation was the small sample size.
In conclusion, the mortality rate was 5.6%. Fever, fatigue, and cough were the main symptoms of the COVID-19 disease. Old age, males, and subjects with history of systemic diseases increase the fatality rate.