Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran.
Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2020 Dec 1;23(12):864-869. doi: 10.34172/aim.2020.115.
The coronavirus disease 2019 (COVID-19) has become a pandemic health problem worldwide. In this study, we attempted to explain the clinical and laboratories characteristics of non-surviving patients, to identify the probable factors affecting disease progression.
In a retrospective study, we assessed the data from dead adult patients who were hospitalized and laboratory diagnosed with COVID-19 during March 2020. The data were obtained from electronic medical records. Moreover, a checklist including demographic, clinical, laboratorial, imaging, and treatment data was completed for each one of the patients. In case of lack of information, a member of the research team contacted the first-degree relatives via phone.
Totally, 50 patients were enrolled in this study. The mean age was 68.0 ± 14.1 years. Of them, 29 (58%) patients were male. Notably, the median (IQR) hospitalization time was 4.0 (2.7-6.2) days and the duration between the first symptoms to death was 10.0 (5.0-14.5) days. Also, pre-existing morbidity was reported in 42 (84%) patients, and hypertension was the most common one with 28 (54%) patients. Interestingly, body temperature more than 37.5°C was reported in only 20 (40%) patients. Nevertheless, neutrophilia (≥7109/L) and lymphopenia (<1.0 109/L) were observed in 27 (54%) and 29 (58%) patients, respectively. Also, elevated levels of creatinine, lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were common, which may be indicators of aggravation of the patients' status.
Besides age and underlying diseases, elevated creatinine level, neutrophil count, and the inflammatory indices along with the reduced lymphocyte count can be considered as indicators of disease progression. Hence, they should be considered for admission and surveillance of patients.
2019 年冠状病毒病（COVID-19）已成为全球范围内的大流行病健康问题。在这项研究中，我们试图解释死亡患者的临床和实验室特征，以确定影响疾病进展的可能因素。
在一项回顾性研究中，我们评估了 2020 年 3 月期间因 COVID-19 住院并经实验室诊断的成年死亡患者的数据。这些数据来自电子病历。此外，为每位患者完成了一份包含人口统计学、临床、实验室、影像学和治疗数据的检查表。在信息缺失的情况下，研究团队的一名成员通过电话联系患者的一级亲属。
总共有 50 名患者纳入本研究。平均年龄为 68.0 ± 14.1 岁。其中，29 名（58%）患者为男性。值得注意的是，中位（IQR）住院时间为 4.0（2.7-6.2）天，从首次症状到死亡的时间为 10.0（5.0-14.5）天。此外，42 名（84%）患者报告有预先存在的疾病，高血压是最常见的疾病，有 28 名（54%）患者。有趣的是，仅 20 名（40%）患者的体温超过 37.5°C。然而，中性粒细胞增多（≥7109/L）和淋巴细胞减少（<1.0 109/L）分别在 27 名（54%）和 29 名（58%）患者中观察到。此外，肌酐、乳酸脱氢酶（LDH）、红细胞沉降率（ESR）和 C 反应蛋白（CRP）水平升高很常见，这些可能是患者病情加重的指标。
除了年龄和基础疾病外，肌酐水平升高、中性粒细胞计数和炎症指标以及淋巴细胞计数减少可作为疾病进展的指标。因此，应考虑这些指标来入院和监测患者。
