Demographic and Clinical Features Association With Mortality in Patients With COVID-19: A Cross-Sectional Study in the West of Iran

  • Ebrahim Jalili Department of Emergency Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
  • Fariba Keramat Department of Infectious Diseases, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
  • Saeid Bashirian Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
  • Salman Khazaei Health Sciences Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
  • Elaheh Talebi-Ghane Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
  • Manoochehr Karami Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
  • Ali Reza Soltanian Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
Keywords: Severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2); Infectious disease; Coronavirus; Death; Epidemiology

Abstract

The coronavirus disease 2019 (COVID-19) pandemic as an emergency public health concern has caused hundreds of thousands of deaths in the world. Identifying predictors of death in COVID-19 patients is a key to improving survival and helping patients triage, better management, and assist physicians and health care. The present study was conducted on 512 positive COVID-19 patients confirmed by real-time PCR hospitalized in Sina Hospital, Hamadan, in 2020. The data of demographic characteristics, clinical manifestations, laboratory findings, chest examination, and disease outcome were collected. The logistic regression model was performed to explore the predictors of in-hospital mortality. Among 512 patients, 57 (11.1%) deaths have occurred. The adjusted odds ratios (OR) estimate of death in COVID-19 for patients with age more than 60 years versus those lower than 60 years was 3.15 (95% CI: 1.06, 9.37). The adjusted OR estimate of death in patients with hypertension comorbidity versus those with no comorbidity was 3.84 (95% CI: 1.27, 11.59). In addition, the adjusted OR estimate (95% CI) of death in patients with respiratory rate above 30 per minute, BUN >20 mg/dL, LDH >942 U/L and SGOT >45 U/L against lower than those values was respectively 10.72 (1.99, 57.68), 5.85 (2.19, 15.63), 13.42 (2.17, 83.22) and 2.86 (1.02, 8.05). The risk of death was higher among the patients with multiple comorbidity diseases, systolic BP lower than 90 mmHg, SPO2 lower than 88 and more than ten days hospitalization in comparison with COVID-19 patients with no comorbidity disease (P=0.002), systolic BP higher than 90 mmHg (P=0.002), SPO2 higher than 88 (P<0.001) and hospitalization for lower than ten days (P=0.012). Our findings suggest that older age, pre-existing hypertension and/or multiple co-morbidities, high respiratory rate, elevated BUN, LDH and SGOT, low systolic BP, and hypoxemia were independently associated with in-hospital mortality in COVID-19 patients. These results can be helpful for physicians and health care workers to improve clinical management and appropriate medical care of COVID-19 patients.

Published
2021-11-16
Section
Articles