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Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran.
Tohoku J Exp Med. 2020 09; 252(1):73-84.TJ

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 30th until April 5th, 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.

Authors+Show Affiliations

Department of General Surgery, Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Department of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Department of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Department of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Department of Pulmonary Medicine, Clinical Research and Development Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Functional Neurosurgery Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Department of Anesthesiology, Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Department of Radiology, Clinical Research and Development Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Department of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Department of Radiology, Clinical Research and Development Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences.Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences.Anesthesiology Research Center, Shahid Beheshti University of Medical Science.Hematology, Oncology, and Hematopoietic Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Science.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32908083

Citation

Alamdari, Nasser Malekpour, et al. "Mortality Risk Factors Among Hospitalized COVID-19 Patients in a Major Referral Center in Iran." The Tohoku Journal of Experimental Medicine, vol. 252, no. 1, 2020, pp. 73-84.
Alamdari NM, Afaghi S, Rahimi FS, et al. Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran. Tohoku J Exp Med. 2020;252(1):73-84.
Alamdari, N. M., Afaghi, S., Rahimi, F. S., Tarki, F. E., Tavana, S., Zali, A., Fathi, M., Besharat, S., Bagheri, L., Pourmotahari, F., Irvani, S. S. N., Dabbagh, A., & Mousavi, S. A. (2020). Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran. The Tohoku Journal of Experimental Medicine, 252(1), 73-84. https://doi.org/10.1620/tjem.252.73
Alamdari NM, et al. Mortality Risk Factors Among Hospitalized COVID-19 Patients in a Major Referral Center in Iran. Tohoku J Exp Med. 2020;252(1):73-84. PubMed PMID: 32908083.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran. AU - Alamdari,Nasser Malekpour, AU - Afaghi,Siamak, AU - Rahimi,Fatemeh Sadat, AU - Tarki,Farzad Esmaeili, AU - Tavana,Sasan, AU - Zali,Alireza, AU - Fathi,Mohammad, AU - Besharat,Sara, AU - Bagheri,Leyla, AU - Pourmotahari,Fatemeh, AU - Irvani,Seyed Sina Naghibi, AU - Dabbagh,Ali, AU - Mousavi,Seyed Ali, PY - 2020/9/10/entrez PY - 2020/9/11/pubmed PY - 2020/9/20/medline KW - COVID-19 KW - Iran KW - SARS-CoV-2 KW - prognosis KW - risk factor SP - 73 EP - 84 JF - The Tohoku journal of experimental medicine JO - Tohoku J Exp Med VL - 252 IS - 1 N2 - 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 30th until April 5th, 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. SN - 1349-3329 UR - https://www.unboundmedicine.com/medline/citation/32908083/Mortality_Risk_Factors_among_Hospitalized_COVID_19_Patients_in_a_Major_Referral_Center_in_Iran_ L2 - https://doi.org/10.1620/tjem.252.73 DB - PRIME DP - Unbound Medicine ER -