epidemiological and clinical characteristics of covid-19 mortality in a referral hospital in iran during 2021

Background: understanding the demographic and clinical characteristics associated with covid-19-related mortality across various regions is essential for developing targeted public health interventions and enhancing clinical care.objective: this retrospective observational study aimed to explore the epidemiological and clinical profiles of covid-19 fatalities at shahid beheshti hospital, a referral center in kashan, iran, during the year 2021.methods: we included all patients with a confirmed diagnosis of covid-19 via rt-pcr who died during their hospitalization from january to december 2021. data were extracted from the hospital’s electronic health records and encompassed demographic information, comorbidities, substance use, vaccination status, clinical symptoms, vital signs, icu admissions, treatments administered, and blood type. descriptive statistics were computed using spss version 26.results: out of 950 recorded covid-19 deaths, complete records were available for 507 patients. the mean age of the deceased patients was 70.6 ± 11.0 years, with females constituting 53.5% of the sample. a majority of patients were married (74.9%) and resided in urban areas (81.3%). the most prevalent comorbidities included hypertension (18.3%), diabetes (16.0%), and cardiovascular disease (9.1%). substance use was documented in 27.8% of cases, while only 4.7% had received two doses of the vaccine; 61.1% were unvaccinated. the predominant clinical symptoms were cough (88.7%) and fever (81.1%). the mean oxygen saturation at admission was 90.9 ± 3.7%. icu admission occurred in 80.5% of cases, and intubation was necessary for 86.0%. corticosteroids were administered to 96.2% of patients, remdesivir to 68.8%, and tocilizumab to 25.8%. blood group a was the most frequently observed blood type (45.7%).conclusion: the findings indicate that covid-19 mortality in this population was significantly associated with advanced age, pre-existing comorbidities, and low vaccination rates. these results highlight the urgent need for targeted vaccination initiatives, early identification of high-risk individuals, and improved access to critical care services in middle-income countries.