|
Association of Mortality of Covid-19 with Demographic Characteristics and Clinical Status of the Hospitalized Patients: A Retrospective Cohort Study
|
Zhale Mollai1    , Ladan Sedighi2 , Mehrnaz Ahmadi3 , Shiva Gomarverdi4 , Shima Shirozhan5 |
1- Research Committee of Hamadan University of Medical Sciences, Hamadan, Iran.
2- Medical and surgical nursing department, school of nursing and Midwifery , shahid Beheshti university of medical sciences, Tehran, Iran
3- Medical and surgical nursing department,school of nursing and Midwifery ,nursing care research center in chronic disease, Ahvaz Jundishapur university of medical sciences, Ahvaz, Iran
4- department of medical and surgical nursing, school of nursing and midwifery, hamadan university of medical sciences, Hamadan, Iran.
5- department of nursing, university of social welfare and rehabilitation science, Tehran, Iran. , shimashirozhan@gmail.com |
|
|
Abstract: (1654 Views) |
Background and Aim: A variety of factors, such as age and underlying diseases, affect the severity of covid-19 and its mortality rate. Identification of these factors is important to manage the disease in vulnerable people. The purpose of this study was to examine the association of outcome of covid-19 with demographic characteristics, underlying diseases, serum biomarkers, and level of care for inpatients.
Materials and Methods: This retrospective cohort study was conducted in Sina Hospital in Hamadan in 1400. All adult hospitalized patients with definite diagnosis of COVID-19 were included in the study by convenience sampling method during a three-month period. Demographic and clinical status data were collected using a designed questionnaire. Using SPSS software the data were analyzed by independent t, Mann-Whitney, and multivariate logistic regression analysis tests.
Results: A total of 283 hospitalized patients with a mean age of 57.22 years participated in this study, of which 67 (23.7%) died. Among the deceased patients, 92.4% were over 50 years of age which showed a significant difference compared to the deceased patients under 50 years of age (P<0.001). People who died with any documented history of underlying diseases accounted for 83.3% of the deceased patients, and their proportion was statistically significant compared to the patients without any underlying disease (P 0.0005). Prevalence of severe acute respiratory distress syndrome (ARDS) was significantly different in the deceased patients (28.8%) compared to that in the survivors (3.9%) (P<0.001). According to the results of our study age, gender, history of underlying diseases, serum BUN level and severity of acute respiratory distress syndrome are predictors of death in the patients with Covid-19.
Conclusion: The findings of this study indicated the need to pay more attention to preventive measures in old people with underlying diseases. It can also help healthcare professionals to consider designing programs for prevention, appropriate care and treatment in relation to the predictors of mortality. |
|
| Keywords: COVID-19, Mortality, Prognosis |
|
|
Full-Text [PDF 531 kb]
(427 Downloads)
|
Type of Study: Original Research |
Subject:
Epidemiology and Biostatistics
Received: 2022/06/6 | Accepted: 2022/12/14 | Published: 2023/12/6
|
|
|
|
|
|
|
| References |
1. 1.Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531-8. [ DOI:10.1007/s00392-020-01626-9] [ PMID] [ ] 2. World Health Organization. World Health Organization (WHO) Coronavirus (COVID-19) Dashboard (2022). World Health Organization, URL: https://covid19. who. int/. (Accessed: 28 February 2022). 2022. 3. Samsami M, Mehravaran E, Tabarsi P, Javadi A, Arsang-Jang S, Komaki A, et al. Clinical and demographic characteristics of patients with COVID-19 infection: statistics from a single hospital in Iran. Hum Antibodies. 2021;29(1):49-54. [ DOI:10.3233/HAB-200428] [ PMID] 4. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P. A novel coronavirus from patients with pneumonia in China, 2019. NEJM. 2020 Jan 24. [ DOI:10.1056/NEJMoa2001017] [ PMID] [ ] 5. Goshayeshi L, Rad MA, Bergquist R, Allahyari A, Hashemzadeh K, Milani N, Gholian-Aval M, Rezaeitalab F, Quchani MJ, Nahbandani Z, Javid Z. Demographic and clinical characteristics of the severe Covid-19 infections: first report from Mashhad University of Medical Sciences, Iran. medRxiv. 2020 May 23:2020-05. [ DOI:10.1186/s12879-021-06363-6] [ PMID] [ ] 6. Cochrane COVID-19 Diagnostic Test Accuracy Group. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19. CDSR. 2022 May 20;2022(5):CD013665. [ DOI:10.1002/14651858.CD013665.pub3] [ PMID] [ ] 7. Alsofayan YM, Althunayyan SM, Khan AA, Hakawi AM, Assiri AM. Clinical characteristics of COVID-19 in Saudi Arabia: a national retrospective study. J. Infect. Public Health. 2020 Jul 1;13(7):920-5. [ DOI:10.1016/j.jiph.2020.05.026] [ PMID] [ ] 8. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. lancet. 2020 Feb 15;395(10223):497-506. [ DOI:10.1016/S0140-6736(20)30183-5] [ PMID] 9. Ssentongo P, Ssentongo AE, Heilbrunn ES, Ba DM, Chinchilli VM. Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PloS one. 2020 Aug 26;15(8):e0238215. [ DOI:10.1371/journal.pone.0238215] [ PMID] [ ] 10. Chen T, Wu DI, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, Wang T. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. bmj. 2020 Mar 26;368. [ DOI:10.1136/bmj.m1091] [ PMID] [ ] 11. Jalili M, Payandemehr P, Saghaei A, Sari HN, Safikhani H, Kolivand P. Characteristics and mortality of hospitalized patients with COVID-19 in Iran: a national retrospective cohort study. Ann Intern Med. 2021 Jan;174(1):125-7. [ DOI:10.7326/M20-2911] [ PMID] [ ] 12. Salari A, Mahdavi-Roshan M, Ghorbani Z, Mortazavi SS, Naghshbandi M, Faraghnia F, Rahbar Taramsari M, Ahmadnia Z. An investigation of risk factors of in-hospital death due to COVID-19: a case-control study in Rasht, Iran. Ir J Med Sci (1971-). 1971:1-3. 13. Martins-Filho PR, Tavares CS, Santos VS. Factors associated with mortality in patients with COVID-19. A quantitative evidence synthesis of clinical and laboratory data. Eur J Intern Med. 2020 Jun 1;76:97-9. [ DOI:10.1016/j.ejim.2020.04.043] [ PMID] [ ] 14. Polverino F, Stern DA, Ruocco G, Balestro E, Bassetti M, Candelli M, Cirillo B, Contoli M, Corsico A, D'Amico F, D'Elia E. Comorbidities, cardiovascular therapies, and COVID-19 mortality: a nationwide, Italian Observational Study (ItaliCO). Front Cardiovasc Med. 2020 Oct 9;7:585866. [ DOI:10.3389/fcvm.2020.585866] [ PMID] [ ] 15. Ferrando C, Suarez-Sipmann F, Mellado-Artigas R, Hernández M, Gea A, Arruti E, et al. Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS. Intensive Care Med. 2020;46(12):2200-11. [ DOI:10.1007/s00134-020-06192-2] [ PMID] [ ] 16. Alamdari NM, Afaghi S, Rahimi FS, Tarki FE, Tavana S, Zali A, 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. [ DOI:10.1620/tjem.252.73] [ PMID] 17. Cheng A, Hu L, Wang Y, Huang L, Zhao L, Zhang C, et al. Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients. Int J Antimicrob Agents. 2020;56(3):106110. [ DOI:10.1016/j.ijantimicag.2020.106110] [ PMID] [ ] 18. Hasan SS, Capstick T, Ahmed R, Kow CS, Mazhar F, Merchant HA, et al. Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: a systematic review and meta-analysis. Expert Rev Respir Med. 2020;14(11):1149-63. [ DOI:10.1080/17476348.2020.1804365] [ PMID] [ ] 19. Abdollahi A, Kamali Sarvestani H, Rafat Z, Ghaderkhani S, Mahmoudi‐Aliabadi M, Jafarzadeh B, et al. The association between the level of serum 25 (OH) vitamin D, obesity, and underlying diseases with the risk of developing COVID‐19 infection: A case-control study of hospitalized patients in Tehran, Iran. J Med Virol. 2021;93(4):2359-64. [ DOI:10.1002/jmv.26726] [ PMID] 20. Wiener-Kronish JP, Cohen NH, Leslie K, Gropper MA, Eriksson LI, Fleisher LA, editors. Miller's anesthesia, 2-volume set E-book. Elsevier Health Sciences; 2019 Oct 7. 21. Shapiro SS, Wilk MB. An analysis of variance test for normality (complete samples). Biometrika. 1965 Dec 1;52(3/4):591-611. [ DOI:10.1093/biomet/52.3-4.591] 22. Rosner B. Fundamentals of biostatistics: Cengage learning; 2015. 23. 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. JAMDA. 2020;21(7):915-8. [ DOI:10.1016/j.jamda.2020.05.045] [ PMID] [ ] 24. Zali A, Gholamzadeh S, Mohammadi G, Looha MA, Akrami F, Zarean E, Vafaee R, Maher A, Khodadoost M. Baseline characteristics and associated factors of mortality in COVID-19 patients; an analysis of 16000 cases in Tehran, Iran. AAEM. 2020;8(1). 25. Bhopal SS, Bhopal R. Sex differential in COVID-19 mortality varies markedly by age. Lancet. 2020 Aug 22;396(10250):532-3. [ DOI:10.1016/S0140-6736(20)31748-7] [ PMID] 26. Jin J-M, Bai P, He W, Wu F, Liu X-F, Han D-M, et al. Gender differences in patients with COVID-19: focus on severity and mortality. Front Public Health. 2020;8:152. [ DOI:10.3389/fpubh.2020.00152] [ PMID] [ ] 27. Krieger N, Chen JT, Waterman PD. Excess mortality in men and women in Massachusetts during the COVID-19 pandemic. Lancet. 2020;395(10240):1829. [ DOI:10.1016/S0140-6736(20)31234-4] [ PMID] 28. Clark A, Jit M, Warren-Gash C, Guthrie B, Wang HH, Mercer SW, et al. Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: a modelling study. Lancet Glob Health. 2020;8(8):e1003-e17. 29. Najera H, Ortega-Avila AG. Health and Institutional Risk Factors of COVID-19 Mortality in Mexico, 2020. Am J Prev Med. 2021;60(4):471-7. [ DOI:10.1016/j.amepre.2020.10.015] [ PMID] [ ] 30. Mirjalili M, Dehghani M, Raadabadi M, Dehghani A. Death risk among COVID-19 patients in Yazd, Iran: a hospital-based case-cohort study. Journal Mil Med. 2021;23(3):274-82. 31. Tzotzos SJ, Fischer B, Fischer H, Zeitlinger M. Incidence of ARDS and outcomes in hospitalized patients with COVID-19: a global literature survey. J Crit Care. 2020;24(1):1-4. [ DOI:10.1186/s13054-020-03240-7] [ PMID] [ ] 32. Fan E, Beitler JR, Brochard L, Calfee CS, Ferguson ND, Slutsky AS, Brodie D. COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted?. Lancet Respir Med. 2020 Aug 1;8(8):816-21. [ DOI:10.1016/S2213-2600(20)30304-0] [ PMID] 33. Hsu C-Y, Lai C-C, Yeh Y-P, Chang-Chuan C, Chen H-H. Progression from Pneumonia to ARDS as a Predictor for Fatal COVID-19. J Infect Public Health. 2021;14(4):504-7. [ DOI:10.1016/j.jiph.2020.12.026] [ PMID] [ ] 34. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061-9. [ DOI:10.1001/jama.2020.1585] [ PMID] [ ] 35. Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, et al. Predictors of COVID‐19 severity: a literature review. Rev Med Virol. 2021;31(1):1-10. [ DOI:10.1002/rmv.2146] [ PMID] [ ] |
|
| Send email to the article author |
|
|
|
| Add your comments about this article |
|
|
|
|
Ethics code: IR.UMSHA.REC.1399.458
Mollai Z, Sedighi L, Ahmadi M, Gomarverdi S, Shirozhan S. Association of Mortality of Covid-19 with Demographic Characteristics and Clinical Status of the Hospitalized Patients: A Retrospective Cohort Study. SJKU 2023; 28 (5) :60-74 URL: http://sjku.muk.ac.ir/article-1-7378-en.html
|
