Demographic and clinical features association with mortality in patients with COVID-19: A cross-sectional study in the West of Iran

The coronavirus disease 2019 (COVID-19) pandemic as an emergency public health concern has caused hundreds of thousands of deaths in the world. Identifying predictors of death in COVID-19 patients are a key to improve survival and help patients triage, better management, and assist physicians and  health care.

Retrospective observational study

The present study conducted on 512 positive COVID-19 patients confirmed by real-time PCR hospitalized in Sina Hospital, Hamadan in 2020. The data of demographic characteristics, clinical manifestations, laboratory findings, chest examination and disease outcome were collected. Logistic regression model was performed to explore the predictors of in-hospital mortality.

Among 512 patients 57 (11.1%) deaths were occurred. the adjusted odds ratios (OR) estimate of death in COVID-19 for patients with age more than 60 years versus  those lower than 60 years was 3.15 (95% CI: 1.06, 9.37). The adjusted OR estimate of death in patients with hypertension comorbidity versus those with no comorbidity was 3.84 (95% CI: 1.27, 11.59). In addition, the adjusted OR estimate (95% CI) of death in patients with respiratory rate above 30 per minute, BUN >  20 mg/dL, LDH >  942 U/L and SGOT > 45 U/L against lower than those values was respectively 10.72 (1.99, 57.68), 5.85 (2.19, 15.63), 13.42 (2.17, 83.22) and 2.86 (1.02, 8.05).The risk of  death  was  higher  among  the  patients  with multiple comorbidity diseases, systolic BP lower than 90 mmHg, SPO2 lower than 88 and  more than ten days hospitalization in comparison  with  COVID-19  patients  with  no comorbidity disease (P=0.002), systolic BP higher than 90 mmHg (P=0.002), SPO2 higher than 88  (P<0.001) and hospitalization for lower than ten days (P=0.012).

Our findings suggest that, older age, pre-existing hypertension and/or multiple co-morbidities, high respiratory rate, elevated BUN, LDH and SGOT, low systolic BP and hypoxemia were independently associated with in-hospital mortality in COVID-19 patients. These results can be helpful for physicians and  health care workers to improve clinical management and appropriate medical care of COVID-19 patients.