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.
Tohoku J Exp Med. 2020 Sep;252(1):73-84. doi: 10.1620/tjem.252.73.
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 until April 5, 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.
自 2019 年 12 月以来,全球范围内已有许多人死于 2019 年冠状病毒病(COVID-19)大流行,伊朗也是受影响最严重的国家之一。在这项回顾性研究中,我们旨在通过分析 2020 年 1 月 30 日至 4 月 5 日在伊朗德黑兰沙希德·莫达雷斯医院的 396 名存活和 63 名未存活的 COVID-19 患者,确定与死亡率相关的预后因素。结果表明,在死亡组中,BMI>35(p=0.0003)、肺癌(p=0.007)、慢性肾脏病(p=0.002)、免疫功能低下状态(p=0.003)和糖尿病(p=0.018)更为常见。在出院组中,使用他汀类药物的病史更为常见(p=0.002),而在血管紧张素转换酶抑制剂、血管紧张素 II 受体阻滞剂、非甾体抗炎药、阿司匹林和/或类固醇的药物史以及过去一年的流感疫苗接种方面无显著差异。多变量回归显示,住院期间死亡的风险与年龄(比值比(OR)=1.055,p=0.002)、C 反应蛋白(CRP)水平(OR=2.915,p<0.001)、肌酐(OR=1.740,p=0.023)、淋巴细胞计数(OR=0.999,p=0.008)和镁水平(OR=0.032,p<0.001)升高有关。总之,对于因 COVID-19 感染而导致死亡率增加的患者,年龄较大、BMI 较高、淋巴细胞减少、低镁血症、CRP 和/或肌酐升高的患者,需要医生及时采取强有力的治疗措施。