Gastroenterology Ward, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran.
Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2020 Nov 1;23(11):766-775. doi: 10.34172/aim.2020.102.
We studied the clinical characteristics and outcomes of 905 hospitalized coronavirus disease 2019 (COVID-19) patients admitted to Imam Khomeini Hospital Complex (IKHC), Tehran, Iran.
COVID-19 patients were recruited based on clinical symptoms and patterns of computed tomography (CT) imaging between February 20 and March 19. All patients were tested for the presence of COVID-19 RNA. The Poisson regression model estimated the incidence rate ratio (IRR) for different parameters.
The average age (± standard deviation) was 56.9 (±15.7) years and 61.77% were male. The most common symptoms were fever (93.59%), dry cough (79.78%), and dyspnea (75.69%). Only 43.76% of patients were positive for the RT-PCR COVID-19 test. Prevalence of lymphopenia was 42.9% and more than 90% had elevated lactate dehydrogenase (LDH) or C-reactive protein (CRP). About 11% were severe cases, and 13.7% died in the hospital. The median length of stay (LOS) was 3 days. We found higher risks of mortality in patients who were older than 70 years (IRR = 11.77, 95% CI 3.63-38.18), underwent mechanical ventilation (IRR = 7.36, 95% CI 5.06-10.7), were admitted to the intensive care unit (ICU) (IRR = 5.47, 95% CI 4.00-8.38), tested positive on the COVID-19 test (IRR = 2.80, 95% CI 1.64-3.55), and reported a history of comorbidity (IRR = 1.76, 95% CI 1.07-2.89) compared to their corresponding reference groups. Hydroxychloroquine therapy was not associated with mortality in our study.
Older age, experiencing a severe form of the disease, and having a comorbidity were the most important prognostic factors for COVID-19 infection. Larger studies are needed to perform further subgroup analyses and verify high-risk groups.
我们研究了伊朗德黑兰伊玛目霍梅尼综合医院(IKHC)收治的 905 例住院的 2019 年冠状病毒病(COVID-19)患者的临床特征和结局。
COVID-19 患者根据临床症状和计算机断层扫描(CT)成像模式于 2020 年 2 月 20 日至 3 月 19 日之间招募。所有患者均接受 COVID-19 RNA 检测。泊松回归模型估计了不同参数的发病率比(IRR)。
平均年龄(±标准差)为 56.9(±15.7)岁,61.77%为男性。最常见的症状是发热(93.59%)、干咳(79.78%)和呼吸困难(75.69%)。仅 43.76%的患者 RT-PCR COVID-19 检测呈阳性。淋巴细胞减少症的发生率为 42.9%,超过 90%的患者乳酸脱氢酶(LDH)或 C 反应蛋白(CRP)升高。约 11%为重症病例,住院期间有 13.7%的患者死亡。中位住院时间(LOS)为 3 天。我们发现,年龄大于 70 岁的患者(IRR=11.77,95%CI 3.63-38.18)、接受机械通气的患者(IRR=7.36,95%CI 5.06-10.7)、入住重症监护病房(IRR=5.47,95%CI 4.00-8.38)、COVID-19 检测呈阳性的患者(IRR=2.80,95%CI 1.64-3.55)和有合并症的患者(IRR=1.76,95%CI 1.07-2.89)的死亡率较高,与相应的参考组相比。在我们的研究中,羟氯喹治疗与死亡率无关。
年龄较大、出现严重疾病形式和存在合并症是 COVID-19 感染的最重要预后因素。需要更大的研究来进行进一步的亚组分析和验证高危人群。