Risk Factors for In-Hospital Mortality among Patients with Coronavirus-19 in Isfahan City, Iran
Roya Riahi1, Marziye Ghasemi2, Zahra Montazeri Shatouri3
1Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Older age, COPD history, high white blood cell counts, low hemoglobin, bilateral pulmonary infiltrates, ARDS, and ICU admission are key risk factors for COVID-19 mortality in hospitalized patients.
Area of Science:
- Epidemiology
- Clinical Medicine
- Infectious Diseases
Background:
- The COVID-19 pandemic has led to significant in-hospital mortality.
- Identifying risk factors for mortality is crucial for patient management and resource allocation.
Purpose of the Study:
- To investigate the risk factors associated with mortality among hospitalized COVID-19 patients in Isfahan province.
- To provide data that can inform clinical decision-making and public health strategies.
Main Methods:
- Retrospective cohort study of 1044 COVID-19 patients admitted to three hospitals in Isfahan province.
- Data extracted from medical records included demographics, clinical, laboratory, and outcome information.
- Analysis focused on identifying factors predicting in-hospital mortality.
Main Results:
- Older age (≥65 years), history of chronic obstructive pulmonary disease (COPD), elevated white blood cell (WBC) counts, and low hemoglobin (Hb) levels were significant risk factors.
- Bilateral pulmonary infiltrates on admission, development of acute respiratory distress syndrome (ARDS), and intensive care unit (ICU) admission also increased mortality risk.
- Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were calculated for each identified risk factor.
Conclusions:
- Several factors, including older age, pre-existing conditions like COPD, specific laboratory findings (WBC, Hb), and disease severity indicators (pulmonary infiltrates, ARDS, ICU admission), are linked to higher mortality in COVID-19 patients.
- These findings underscore the importance of close monitoring and tailored interventions for high-risk individuals.
- Further research is recommended to explore these risk factors more deeply.
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.
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