Eshrati Babak, Baradaran Hamid Reza, Erfanpoor Saeed, Mohazzab Arash, Moradi Yousef
Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran.
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2020 Jul 30;34:88. doi: 10.34171/mjiri.34.88. eCollection 2020.
As hospitalized patients with COVID-19, especially those who are admitted to ICU or die afterwards, generally have comorbidities, the aim of this study was to determine the factors affecting the survival rate of COVID-19 patients in Iran using a retrospective cohort. This retrospective cohort study was conducted on patients with COVID-19 who referred to medical centers under the supervision of Iran University of Medical Sciences, Tehran, Iran, from February 22 to March 25, 2020. The final date of follow-up was April 19, 2020. All consecutive inpatients with laboratory-confirmed COVID-19 were included in this study. Clinical laboratory, radiological, treatment, and demographic data were collected and analyzed. The associations among gender, immune disease, diabetes, liver disease, cardiovascular disease, kidney disease, chronic pulmonary disease, cancer, chronic nervous disease, type of treatment, and risk of death were analyzed. The Kaplan-Meier and Log-rank tests were used to estimate survival rate and compare survival rates, respectively. The total number of deaths or desired event in the study was 329 (10.3%).The risk of death in the age groups of 50-60 years, 60-70 years, and >70 years compared to the 30-40 age group was 2.17 (95% CI: 1.03, 4.55; p: 0.040); 3.72 (95 % CI: 1.80, 7.68; p: 0.001) and 5.09 (95 % CI: 2.49, 10.40; p: 0.001), respectively. The results showed men had 11.5% more risk of deaths than women (HR: 1.11; 95 % CI: 0.89, 1.39; p: 0.341). Kidney disease increased the risk of death by 52.3% in these patients, which was not statistically significant (HR: 1.78; 95 % CI: 1.04, 3.04; p: 0.035). Also, chronic pulmonary diseases and diabetes increased the risk of death in COVID-19 patients by 89.5% and 41.3% compared to COVID-19 patients without chronic pulmonary diseases and diabetes [(HR: 1.89; 95 % CI: 1.17, 3.04; p: 0.008), (HR: 1.41; 95 % CI: 1.01, 1.96; p: 0.038)]. Based on the results of this study, more attention and care should be paid to COVID-19 patients with underlying diseases, such as chronic obstructive pulmonary disease, diabetes, and kidney disease to reduce the number of deaths.
作为新冠肺炎住院患者，尤其是那些入住重症监护病房或随后死亡的患者，通常患有合并症，本研究的目的是通过回顾性队列研究确定影响伊朗新冠肺炎患者生存率的因素。这项回顾性队列研究针对2020年2月22日至3月25日转诊至伊朗德黑兰医科大学监督下的医疗中心的新冠肺炎患者进行。随访的最后日期为2020年4月19日。所有实验室确诊的新冠肺炎连续住院患者均纳入本研究。收集并分析临床实验室、放射学、治疗和人口统计学数据。分析了性别、免疫疾病、糖尿病、肝病、心血管疾病、肾病、慢性肺病、癌症、慢性神经疾病、治疗类型和死亡风险之间的关联。分别使用Kaplan-Meier法和Log-rank检验来估计生存率和比较生存率。研究中的死亡总数或期望事件数为329例（10.3%）。与30-40岁年龄组相比，50-60岁、60-70岁和>70岁年龄组的死亡风险分别为2.17（95%CI：1.03，4.55；p：0.040）；3.72（95%CI：1.80，7.68；p：0.001）和5.09（95%CI：2.49，10.40；p：0.001）。结果显示，男性死亡风险比女性高11.5%（HR：1.11；95%CI：0.89，1.39；p：0.341）。肾病使这些患者的死亡风险增加了52.3%，但无统计学意义（HR：1.78；95%CI：1.04，3.04；p：0.035）。此外，与没有慢性肺病和糖尿病的新冠肺炎患者相比，慢性肺病和糖尿病使新冠肺炎患者的死亡风险分别增加了89.5%和41.3%[（HR：1.89；95%CI：1.17，3.04；p：0.008），（HR：1.41；95%CI：1.01，1.96；p：0.038）]。基于本研究结果，应更加关注和护理患有慢性阻塞性肺病、糖尿病和肾病等基础疾病的新冠肺炎患者，以减少死亡人数。
