Document Type : Research articles
Authors
- Alireza Ahmadi 1
- Soroush Ardeshiri 1
- Vahid Rajab Nezhadi 1
- Aida Pajoohesh 1
- Touba Narimani Moghadam 2
- Mohamad Sabaghan 1
- Jaffar Fatahi Asl 3
- Javad Zarei
- Kambiz Ahmadi Angali 4
1 Behbahan Faculty of Medical Sciences, Behbahan, Iran
2 Behbahan Faculty of Medical Sciences
3 Medical Physics Department, Faculty of Paramedicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
4 Department of Statistic and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Abstract
Background: Coronavirus disease 2019 (COVID-19) has become a global health challenge with high transmission and mortality rates.
Objectives: This study aimed to identify the risk factors for mortality in hospitalized patients with COVID-19 in Behbahan, Southwestern of Iran.
Methods: In this cross-sectional study, information of 800 patients with COVID-19 admitted to Shahidzadeh Hospital in Behbahan, Southwest of Iran, were investigated from March 20, 2020, to January 20, 2021. Subsequently, the demographic characteristics, clinical symptoms, vital signs, pharmacotherapy, laboratory findings, and the patients' underlying diseases were extracted from their medical records. Multivariable Cox regression with proportional hazard assumption was used to investigate the risk factors of death.
Results: The present study included 800 patients with COVID-19 with a mean age of 57.51±16.83 years at the time of diagnosis. Overall, 447 (55.8%) male and 353 (44.1%) female patients were included in this study, respectively. Among the total patients, 116 (14.5%) and 684 (85.5%) cases died and recovered, respectively. Based on the multivariable Cox regression analysis, age (HR=1.04; 95% CI: 1.03-1.05; P<0.001), cardiovascular diseases (HR=2.46; 95% CI: 1.63- 3.70; P<0.001), and renal failure (HR=2.77; 95% CI: 1.43- 534; P<0.001) were found to be associated with the death hazard in patients with COVID-19.
Conclusion: According to the findings of this study, the patient's age at the time of diagnosis, cardiovascular diseases, and renal failure were indicated to be the risk factors of high mortality rate in patients with COVID-19. Identification of these risk factors can be helpful in the timely intervention of patients at high risk of death for health care providers.
Keywords
- Battistoni A, Volpe M. Might renin–angiotensin system blockers play a role in the COVID-19 pandemic? Eur Heart J Cardiovasc Pharmacother. 2020;6(4):248-51. doi: 10.1093/ehjcvp/pvaa030. [PubMed: 32286607].
- Khoshnood RJ, Ommi D, Zali A, Ashrafi F, Vahidi M, Azhide A, et al. Epidemiological characteristics, clinical features, and outcome of COVID-19 patients in northern Tehran, Iran; a cross-sectional study. Adv J Emerg Med. 2020;In Press. doi: 10.22114/ajem.v0i0.547.
- World Health Organization. Coronavirus disease (COVID-19). Geneva: World Health Organization; 2020.
- Shahbazi F, Karami M, Mirzaei M, Mohamadi Y. Survival rates and prognostic factors of COVID-19 patients: a registry-based retrospective cohort study. J Res Health Sci. 2021;21(2):e00515. doi: 10.34172/jrhs.2021.47. [PubMed: 34465638].
- Tian W, Jiang W, Yao J, Nicholson CJ, Li RH, Sigurslid HH, et al. Predictors of mortality in hospitalized COVID‐19 patients: a systematic review and meta‐analysis. J Med Virol. 2020;92(10):1875-83. doi: 10.1002/jmv.26050. [PubMed: 32441789].
- Mantovani A, Byrne CD, Zheng MH, Targher G. Diabetes as a risk factor for greater COVID-19 severity and in-hospital death: a meta-analysis of observational studies. Nutr Metab Cardiovasc Dis. 2020;30(8):1236-48. doi: 10.1016/j.numecd.2020.05.014. [PubMed: 32571616].
- Petrilli CM, Jones SA, Yang J, Rajagopalan H, O’Donnell L, Chernyak Y, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020;369:m1966. doi: 10.1136/bmj.m1966. [PubMed: 32444366].
- Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York city: a prospective cohort study. Lancet. 2020;395(10239):1763-70. doi: 10.1016/S0140-6736(20)31189-2. [PubMed: 32442528].
- Baigi V, Nedjat S, Yunesian M, Sari AA, Mirzaee M, Allameh SF. Clinical and epidemiological features of hospitalized patients with COVID-19 in hospitals of Tehran University of Medical Sciences. Front Emerg Med. 2021;5(2):e20. doi: 10.18502/fem.v5i2.5615.
- Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, et al. Risk factors of critical & mortal COVID-19 cases: a systematic literature review and meta-analysis. J Infect. 2020;81(2):e16-25. doi: 10.1016/j.jinf.2020.04.021. [PubMed: 32335169].
- Di Castelnuovo A, Bonaccio M, Costanzo S, Gialluisi A, Antinori A, Berselli N, et al. Common cardiovascular risk factors and in-hospital mortality in 3,894 patients with COVID-19: survival analysis and machine learning-based findings from the multicentre Italian CORIST Study. Nutr Metab Cardiovasc Dis. 2020;30(11):1899-913. doi: 10.1016/j.numecd.2020.07.031. [PubMed: 32912793].
- Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846-8. doi: 10.1007/s00134-020-05991-x. [PubMed: 32125452].
- Deng P, Ke Z, Ying B, Qiao B, Yuan L. The diagnostic and prognostic role of myocardial injury biomarkers in hospitalized patients with COVID-19. Clin Chim Acta. 2020;510:186-90. doi: 10.1016/j.cca.2020.07.018. [PubMed: 32681933].
- Bonanad C, García-Blas S, Tarazona-Santabalbina F, Sanchis J, Bertomeu-González V, Fácila L, et al. The effect of age on mortality in patients with COVID-19: a meta-analysis with 611,583 subjects. J Am Med Dir Assoc. 2020;21(7):915-8. doi: 10.1016/j.jamda.2020.05.045. [PubMed: 32674819].
- Gori T, Lelieveld J, Münzel T. Perspective: cardiovascular disease and the COVID-19 pandemic. Basic Res Cardiol. 2020;115(3):32. doi: 10.1007/s00395-020-0792-4. [PubMed: 32277299].
- Chen R, Liang W, Jiang M, Guan W, Zhan C, Wang T, et al. Risk factors of fatal outcome in hospitalized subjects with coronavirus disease 2019 from a nationwide analysis in China. Chest. 2020;158(1):97-105. doi: 10.1016/j.chest.2020.04.010. [PubMed: 32304772].
- Zandkarimi E, Moradi G, Mohsenpour B. The prognostic factors affecting the survival of Kurdistan Province COVID-19 patients: a cross-sectional study from February to May 2020. Int J Health Policy Manag. 2020;In Press. doi: 10.34172/ijhpm.2020.155. [PubMed: 32861230].
- Maguire D, Woods M, Richards C, Dolan R, Veitch JW, Sim WM, et al. Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection. J Transl Med. 2020;18(1):354. doi: 10.1186/s12967-020-02524-4. [PubMed: 32933530].
- Rey JR, Caro‐Codón J, Rosillo SO, Iniesta ÁM, Castrejón‐Castrejón S, Marco‐Clement I, et al. Heart failure in COVID‐19 patients: prevalence, incidence and prognostic implications. Eur J Heart Fail. 2020;22(12):2205-15. doi: 10.1002/ejhf.1990. [PubMed: 32833283].
- Stefan G, Mehedinti AM, Andreiana I, Zugravu AD, Cinca S, Busuioc R, et al. Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania. Ren Fail. 2021;43(1):49-57. doi: 10.1080/0886022X.2020.1853571. [PubMed: 33307933].
', './data/ircmj/coversheet/cover_en.jpg'))