Document Type : Original article
Authors
- Alireza Sedaghat 1
- Amene Raouf-Rahmati 2
- Katayoun Samadi 3
- Farida Daneshvar Mozaffari 4
- Ahmad Nemati 5
- Benyamin Fazli 6
1 Lung disease research center, Faculty of Medicine, Mashhad university of Medical Sciences, Mashhad, Iran
2 Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Kidney Transplantation Complications Research Center, Department of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
4 Anesthesiologist, Department of aneshthesiology, Faculty of Medicine, Mashhad university of Medical Sciences, Mashhad, Iran
5 MD , Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
6 Assistant professor of Intensive Care medicine, Department of aneshthesiology, Faculty of Medicine, Mashhad university of Medical Sciences, Mashhad, Iran
Abstract
Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.
Methods: This retrospective study included a total of 191 confirmed COVID-19 patients aged ≥18 who were admitted to an intensive care unit in the northeast of Iran in 2020. Clinical, therapeutic, and laboratory findings were recruited. The data were analyzed using SPSS software (version 23) through the Mann-Whitney U test, Chi-Square test, independent sample t-test, as well as a single variable and multivariable logistic regression.
Results: Out of a total of 191 hospitalized patients, 137 (71.7%) survived and 54 (28.2%) expired. The mean age of non-survived patients was 17 years higher than that of survived patients (P<0.0001). Hypertension, diabetes, and coronary and pulmonary diseases were significantly related to mortality (OR: 3, 2.8, 21.4, and 5.4, respectively; P<0.05). Respiratory rate >24/min, heart rate>125/min, platelet count <100*109/L, creatinine >133 μmol/L, LDH >245 U/L, WBC count >10*109/L, lymphocyte count <0.8*109/L and D-dimer >1 μg/mL were frequently observed in non-survivor patients (P<0.05). Most of the patients had an abnormality on chest radiographs, and bilateral pulmonary infiltration was the dominant chest radiograph abnormality in these patients. Moreover, consolidation and ground-glass opacification were observed more frequently in non-survived patients (P<0.05). More than 57% of severe cases required non-invasive and invasive mechanical ventilation before they died, while it was 1% in survived cases (P<0.05).
Conclusion: Older age, previous comorbidities such as diabetes, hypertension, coronary and pulmonary diseases, lymphopenia, leukocytosis, increased respiratory rate, creatinine, LDH, and D-dimer levels were related to a poor prognosis and mortality in patients with SARS-CoV-2 infection.
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