Epidemiological Study of Infection and Death Due to COVID-19 in Fars Province, Iran, From February to September 2020

BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has entered our lives with the fear of outbreak, death, and recurrence. Our objective in this study is to evaluate the epidemiological features of Coronavirus Disease 2019 (COVID-19) infection and death in Fars province, Iran. METHODS: A cross-sectional study was conducted from February 18(th) to September 30(th), 2020, where age, history of underlying diseases, sex, community-wide quarantine, nationality, close contact, pregnancy, medical staff job, traveling , and residency were compared between alive and deceased groups. Data were analyzed using IBM SPSS software, version 22.0, and the significance level was set at 0.05. RESULTS: Regarding 57958 new cases of COVID-19, the basic reproduction number (R(0)) was estimated as 2.8, requiring a minimum of 65% immunization to reach herd immunity. Moreover, an R(0)=0.36 was required to reach the endemic state in the region. The incidence, mortality, fatality, and recurrence rates of COVID-19 were estimated as 1347.9 per 100,000 dwellers, 209.5 per 1000,000 dwellers, 1.6 %, and 3.1 per 100,000 dwellers, respectively. Age, history of underlying diseases, urban residency, and the male sex were significantly higher in the deceased group (OR=1.09, 5.48, 1.24, and 1.32; All Ps<0.001, <0.001, 0.005, and <0.001, respectively). In addition, the recurrence rate among positive cases was estimated as 0.23% with a median±inter-quartile range equal to 84±46.25 days. Community-wide quarantine was shown to be a protective factor for death due to COVID-19 (OR=0.58, P=0.005). CONCLUSION: Community-wide quarantine blocks the transmission of COVID-19 effectively. COVID-19 enjoys no solid immunity. History of underlying diseases, the male sex, urban residency, and age were among the most significant causes of death due to COVID-19. Further investigations are recommended on the genetic structure of SARS-CoV-2, treatments, and vaccination.