Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic has killed many people worldwide since December 2019, and Iran has been among the most affected countries. In this retrospective study, we aimed to determine the prognostic factors associated with mortality in COVID-19 patients by analyzing 396 survived and 63 non-survived patients in Shahid Modarres Hospital, Tehran, Iran, from January 30 th until April 5 th , 2020. As the results, the BMI > 35 (p = 0.0003), lung cancer (p = 0.007), chronic kidney disease (p = 0.002), Immunocompromised condition (p = 0.003), and diabetes (p = 0.018) were more frequently observed in the expired group. The history of statins use was more common in the discharged group (p = 0.002), while there was no significant difference in the drug history of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, nonsteroidal anti-inflammatory drugs, aspirin, and/or steroids, and in the past-year influenza vaccination. Multivariable regression demonstrated rising odds of in-hospital death related with age (odds ratio (OR) = 1.055, p = 0.002), levels of C-reactive protein (CRP) (OR = 2.915, p < 0.001), creatinine (OR = 1.740, p = 0.023), lymphocyte count (OR = 0.999, p = 0.008), and magnesium level (OR = 0.032, p < 0.001) on admission. In conclusion, the patients with older age and higher BMI with lymphopenia, hypomagnesemia, elevated CRP and/or raised creatinine on admission are at higher risk of mortality due to the COVID-19 infection, which requires the physicians to use timely and strong therapeutic measures for such patients.

Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis

“…27 28 Likewise, statins use has been found to be associated with a reduced risk of adverse outcomes in patients with COVID-19. [4][5][6][7][8][9] The data are, however, limited and contradictory with some studies reporting no difference while others showing adverse outcomes in statin users compared with non-users. [10][11][12][13] In the present meta-analysis, we found that statin use was associated with improved clinical outcomes in patients with COVID-19.…”

“…[1][2][3] Multiple observational studies have shown that prior use of statins is associated with a reduced risk of adverse outcomes in patients with COVID-19. [4][5][6][7][8][9] On the contrary, other studies showed either no differences in outcomes [10][11][12] or even adverse outcomes in statin users. 13 There exist two metaanalyses in this regard; while one showed that statin use did not improve the in-hospital outcomes, 14 the other reported a 30% reduction in fatal or severe disease.…”

Mortality and pre‐hospitalization use of low‐dose aspirin in COVID‐19 patients with coronary artery disease

“…11 A recent study showed there was no difference of aspirin usage between the survival and non-survival of COVID-19 patients. 12 To our knowledge, no study reported the relationship between low-dose aspirin and COVID-19 patients with CAD. As an important drug for secondary prevention of coronary artery disease, it is important to explore the relationship between the baseline use of low-dose aspirin and the clinical prognosis of COVID-19 patients.…”

“…Paul Little, professor of primary care research at the University of Southampton suggested that patients on low‐dose aspirin for secondary prevention of cardiovascular disease should be advised to continue, noting that aspirin has anti‐inflammatory effects only at much higher doses 11 . A recent study showed there was no difference of aspirin usage between the survival and non‐survival of COVID‐19 patients 12 . To our knowledge, no study reported the relationship between low‐dose aspirin and COVID‐19 patients with CAD.…”

Probabilities of ICU Admission and Hospital Discharge According to Patient Characteristics in the Designated COVID-19 Hospital of Kuwait

“…Most studies in the Middle East region focused on risk factors of mortality [16,17,18,19] among COVID-19 patients and, to our knowledge, very little (including a few papers from subsequent parts of the Jaber Hospital cohort) has been published on factors associated with the risk of ICU admission. More globally, an international meta-analysis showed that higher mortality was strongly associated with increasing age, male gender and the presence of obesity, HT, DM, CVD, and cancer, and with some excess mortality associated with several other comorbidities [20].…”