Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Ir J Med Sci. 2021 Nov;190(4):1321-1333. doi: 10.1007/s11845-020-02455-5. Epub 2021 Jan 15.
Identifying the non-survived patients' characteristics compared to survived subjects and introducing the critical risk factors of COVID-19 mortality would help enhance patients' prognosis and treatment.
In the current case-control study, medical records of 103 non-survived COVID-19 patients (cases) and 147 sex-matched survivors (controls) who admitted to Razi University Hospital in Rasht, Guilan, Northern Iran from April 21 to August 21, 2020, were explored. Data on demographic, anthropometric, clinical, and laboratory assessment was extracted from the electronic medical records. To estimate the association between variables of interest and mortality odds due to COVID-19 logistic regression was carried out.
The patients who died (mean age = 62.87 years) were older than the discharged patients (57.33 years; P value = 0.009). According to the results of multivariable regression adjusted for potential confounders, elevated BMI (OR = 2.49; 95% CI = 1.15-5.41), higher CRP levels (OR = 2.28; 95% CI = 1.08-4.78), increased FBS levels (OR = 2.88; 95% CI = 1.35-6.17), higher levels of total cholestrol (OR = 2.55; 95% CI = 1.19-5.45) and LDL (OR = 2.27; 95% CI = 1.07-4.79), elevated triglyceride (OR = 5.14; 95% CI = 2.28-11.56), and raised levels of D-dimer (OR = 5.68; 95% CI = 2.22-14.49) were identified as independent risk factors of COVID-19 mortality. No significant association was detected regarding HDL level, QTc interval or heart size, and COVID-19 fatality odds.
The present findings demonstrated that obesity, higher levels of CRP, blood sugar, D-dimer, and lipid markers were likely to be predictive factors of COVID-19-related mortality odds.
与幸存患者相比，识别未幸存患者的特征，并提出 COVID-19 死亡率的关键风险因素，将有助于改善患者的预后和治疗效果。
在本病例对照研究中，我们调查了 2020 年 4 月 21 日至 8 月 21 日期间入住伊朗北部吉兰省拉什特拉齐大学医院的 103 例非幸存 COVID-19 患者（病例）和 147 例性别匹配的幸存者（对照）的医疗记录。从电子病历中提取人口统计学、人体测量学、临床和实验室评估数据。为了估计因 COVID-19 导致死亡的变量与死亡率之间的关联，我们进行了逻辑回归分析。
死亡患者（平均年龄 62.87 岁）比出院患者（57.33 岁；P 值=0.009）年龄更大。根据多变量回归分析结果，校正了潜在混杂因素后，BMI 升高（OR=2.49；95%CI=1.15-5.41）、CRP 水平升高（OR=2.28；95%CI=1.08-4.78）、FBS 水平升高（OR=2.88；95%CI=1.35-6.17）、总胆固醇水平升高（OR=2.55；95%CI=1.19-5.45）、LDL 水平升高（OR=2.27；95%CI=1.07-4.79）、甘油三酯升高（OR=5.14；95%CI=2.28-11.56）和 D-二聚体水平升高（OR=5.68；95%CI=2.22-14.49）均被确定为 COVID-19 死亡率的独立危险因素。然而，我们没有发现 HDL 水平、QTc 间隔或心脏大小与 COVID-19 病死率之间存在显著关联。
本研究结果表明，肥胖、CRP、血糖、D-二聚体和血脂标志物水平升高可能是 COVID-19 相关死亡率的预测因素。
