Document Type : Original Article

Authors

• Roya Riahi ¹
• Marziye Ghasemi ²
• Zahra Montazeri Shatouri ³
• Mojgan Gharipour ⁴
• Mahboobeh Maghami ¹
• Hamid Melali ⁵
• Ramin Sami ⁶
• Aminreza Tabatabaei ⁷
• Sayed Mohsen Hosseini ¹

¹ Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran

² 2 Department of Medical Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

³ Department of Biostatistics and Epidemiology, Shahrekord University of Medical Sciences, Shahrekord, Iran

⁴ Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

⁵ Department of Surgery, Isfahan Minimally Invasive Surgery and Obesity Research Center, Amin University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

⁶ Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

⁷ Department of Education and Research, Hajj and Pilgrimage Medical Center, Tehran, Iran

Abstract

Background: The aim of the study is to explore the risk factors of mortality for hospitalized patients in three designated hospitals in Isfahan province.
Materials and Methods: This retrospective cohort study was conducted on all positive coronavirus disease (COVID)-19 patients admitted to Khorshid, Isabn Maryam, and Amin hospitals in Isfahan province. The demographic, clinical, laboratory, and outcome data of patients who were died or discharged from February 24, 2020, to April 18, 2020, were extracted from patient's medical records.
Results: Overall 1044 COVID-19 patients were included in this analysis. Based on the findings of this study, older age (≥65 years) (adjusted hazard ratio [aHR]: 2.06; 95% confidence interval [CI]: 1.13–3.76), chronic obstructive pulmonary disease (COPD) history (aHR: 2.52; 95% CI: 1.09–5.83), white blood cell (WBC) counts more than 10 × 10^3/L (aHR: 3.05; 95% CI: 1.42–6.55), Hb level <13 gr/L (aHR: 2.82; 95% CI: 1.34–5.93), bilateral pulmonary infiltrates (aHR: 2.02; 95% CI: 1.12–3.64) at admission, development of acute respiratory distress syndrome (ARDS) (aHR: 1.87; 95% CI: 1.01–3.47), and intensive care unit (ICU) admission (aHR: 2.09; 95% CI: 1.04–4.18) during hospitalization were risk factors for in-hospital mortality in patients with COVID-19.
Conclusions: Multiple factors were found related to the severity and death among COVID-19 patients. We were found that older age (≥65 years) with COPD history, high level of WBC, low level of Hb (<13 g/L), bilateral pulmonary infiltrates at admission, development of ARDS, and ICU admission during hospitalization were identified as risk factors of death among COVID-19 patients. More related studies are needed in the future.

Keywords

• Coronavirus disease 2019
• hospitalization
• risk factors