Association of Underlying Diseases and Clinical Characteristics with Mortality in Patients with 2019 Novel Coronavirus in Iran

Abstract

Objectives: The first case of 2019 novel coronavirus disease (COVID-19) was reported in Iran in February 2020. Here, we report the epidemiological and clinical characteristics of patients with COVID-19 and factors associated with mortality in these patients. Methods: A retrospective cohort study was conducted from February 22, 2020, to March 24, 2020, in Golestan Hospital in Kermanshah, Iran. Demographic data including underlying diseases and clinical data including the presenting symptoms, chest computed tomography (CT) scan, reverse transcription polymerase chain reaction (RT-PCR) test results, and outcomes were extracted from electronic medical records. Simple and multiple logistic regression methods were used to explore the factors associated with mortality. Results: Of 245 patients admitted with COVID-19, 155 (63.30%) were male. The mean age of the subjects was 54.68 ± 19.21. Forty-five (18.48%) patients had underlying diseases. Common symptoms were dyspnea (n = 137; 55.9%), cough (n = 93; 38.0%), and fever (n = 78; 31.8%). All patients had pneumonia with abnormal findings on chest CT scan (100%), and RT-PCR test results were positive in 87 (35.50%) patients. Of the total admitted cases, 38 (15.5%) patients died during hospitalization. An old age (OR = 1.09; 95% CI: 1.02 to 1.06), history of heart disease (OR = 5.07; 95% CI: 1.46 to 17.58), hypertension (OR = 5.82; 95% CI: 1.13 to 30.04), smoking (OR = 11.44; 95% CI: 1.01 to 29.53), history of at least one underlying disease (OR = 3.31; 95%CI: 1.54 to 7.09), and symptoms of decreased consciousness at the time of admission (OR = 24.23; 95% CI: 2.62 to 223.39) were associated with mortality. Also, the symptoms of cough (OR = 0.383; 95% CI: 0.17 to 0.88) and fever (OR = 0.278; 95% CI: 0.10 to 0.74) had a negative association with mortality. Conclusions: In the current study, factors including old age, smoking, symptoms of decreased consciousness, and underlying diseases such as heart disease, hypertension, and history of at least one underlying disease were associated with mortality. Factors associated with mortality should be considered so that we can better manage patients with COVID-19.

Evaluation of High Resolution Computed Tomography Findings and its Relationship with the Clinical Course of Patients with Covid-19 

“…In another similar study in Iran, dyspnea was the most common symptom in patients [16], Our results showed that 32.60 % of patients had a history of an underlying disease which this rate was 18.48 % [16] and 34.9% [10] in other studies. In contrast, /diabetic disease was the most contributor to disease in the present study, but study [16] declared cardiovascular disease was the most. Six out of 92 patients (6.52%) required mechanical ventilation, in contrast, whit other study results which this rate was 13(10.83%) [8].…”

“…However, in other studies fever was the most common symptom [10,14,15]. In another similar study in Iran, dyspnea was the most common symptom in patients [16], Our results showed that 32.60 % of patients had a history of an underlying disease which this rate was 18.48 % [16] and 34.9% [10] in other studies. In contrast, /diabetic disease was the most contributor to disease in the present study, but study [16] declared cardiovascular disease was the most.…”

Risk Factors Associated with Severity and Death from COVID-19 in Iran: A Systematic Review and Meta-Analysis Study

“…After deleting duplicates, we identified 2463 studies from four databases and then screened articles by title and full text according to the study's objectives. Finally, 69 studies were included in the meta-analysis (Figure 1), of which 62 studies had assessed risk factors for death from COVID 28–89 ); 13 studies determined risk factors for severity (( 41,50,53–55,65,…”