Risk Factors of Mortality among Hospitalized COVID-19 Patients in A Large University Hospital in Tehran, Iran

Document Type : Original Research

Authors
M. Haghighi 1
H. Hatami 2
S. Aryannezhad 3
N. Delbari 3
1 Department of Infectious Diseases, Imam Hossein Teaching and Medical Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Department of Public Health, School of Public Health and Safety and Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
10.52547/iem.7.2.141
Abstract
Backgrounds: Coronavirus disease 2019 (COVID-19) pandemic is considered as a global health challenge, and Iran is among the top ten countries with the highest mortality rate. This study aimed to analyze epidemiological, clinical, and laboratory features of hospitalized SARS-CoV-2 infected patients and identify the risk factors of mortality among them to facilitate the prioritization of resources and vaccine allocation in the population using data available in a large university hospital in Tehran, Iran.

Materials & Methods: From February 20 to May 14, 2020, a total of 684 COVID-19 confirmed cases were admitted to Imam Hossein University hospital in Tehran and enrolled in this retrospective observational study.

Findings: The mean age of the participants was 59.48±16.65 years, and 55.8% were male. Compared to survivors, non-survivors (n=127, 18.57%) were older (69.09±14.16 vs. 57.29±16.40), had higher average number of comorbidities, and more frequently suffered from dyspnea, convulsion, loss of consciousness (LOC), tachycardia, tachypnea, and hypoxia. They also had higher levels of leukocytes, neutrophil count, C-reactive protein (CRP), creatine phosphokinase (CPK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), international normalized ratio (INR), prothrombin time (PT), partial thromboplastin time (PTT), urea, and serum creatinine (p<.05). Serum potassium (K), lymphocyte count, hemoglobin, HCO3, and serum sodium (Na) were significantly lower in non-survivors. Multivariable logistic regression analysis results revealed that nine variables were positively associated with mortality.

Conclusion: Among COVID-19 patients admitted to the hospital, having more than two or three comorbidities, loss of consciousness, SpO2 < 90%, increased CRP, CPK, urea, and serum potassium, were associated with mortality.

Keywords

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Infection Epidemiology and Microbiology
Volume 7, Issue 2
May 2021
Pages 141-154