Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Bamdad Respiratory and Sleep Research Center, Department of Internal Medicine, Pulmonary and Sleep Ward, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Med Sci. 2021 Nov;46(6):487-492. doi: 10.30476/IJMS.2021.47835.
The cumulative rate of death of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has necessitated better recognizing the risk factors of the disease and the COVID-19-induced mortality. This cross-sectional study aimed to determine the potential risk factors that predict COVID-19-related mortality concentrating on the initial recorded laboratory tests. We extracted admission's medical records of a total of 136 deaths related to COVID-19 and 272 discharged adult inpatients (≥18 years old) related to four referral centers from February 24 to April 12, 2020, in Isfahan, Iran, to figure out the relationship between the laboratory findings and mortality beyond demographic and clinical findings. We applied the independent sample t test and a chichi square test with SPSS software to compare the differences between the survivor and non-survivor patients. A P value of less than 0.05 was considered significant. Our results showed that greater length of hospitalization (P≤0.001), pre-existing chronic obstructive pulmonary disease (P≤0.001), high pulse rate, hypoxia (P≤0.001), and high computed tomography scan score (P<0.001), in addition to high values of some laboratory parameters, increase the risk of mortality. Moreover, high neutrophil/lymphocyte ratio (OR, 1.890; 95% CI, 1.074-3.325, P=0.027), increased creatinine levels (OR, 15.488; 95% CI, 0.801-299.479, P=0.07), and elevated potassium levels (OR, 13.400; 95% CI, 1.084-165.618, P=0.043) independently predicted in-hospital death related to COVID-19 infection. These results emphasized the potential role of impaired laboratory parameters for the prognosis of fatal outcomes in adult inpatients.
新型冠状病毒（SARS-CoV-2）导致的死亡率居高不下，这使得我们有必要更好地认识这种疾病的危险因素和 COVID-19 导致的死亡率。本横断面研究旨在确定预测 COVID-19 相关死亡率的潜在危险因素，重点关注最初记录的实验室检查。我们从 2020 年 2 月 24 日至 4 月 12 日，从伊朗伊斯法罕的四个转诊中心提取了总共 136 例与 COVID-19 相关的死亡和 272 例与 COVID-19 相关的出院成年住院患者（≥18 岁）的住院记录，以确定实验室检查结果与死亡率之间的关系超出了人口统计学和临床发现。我们应用独立样本 t 检验和卡方检验，使用 SPSS 软件比较幸存者和非幸存者患者之间的差异。P 值小于 0.05 被认为具有统计学意义。我们的结果表明，住院时间较长（P≤0.001）、存在慢性阻塞性肺疾病（P≤0.001）、高脉搏率、缺氧（P≤0.001）和高计算机断层扫描评分（P<0.001），以及某些实验室参数值升高，会增加死亡风险。此外，高中性粒细胞/淋巴细胞比值（OR，1.890；95%CI，1.074-3.325，P=0.027）、升高的肌酐水平（OR，15.488；95%CI，0.801-299.479，P=0.07）和升高的钾水平（OR，13.400；95%CI，1.084-165.618，P=0.043）独立预测 COVID-19 感染相关的院内死亡。这些结果强调了实验室参数受损对成年住院患者致命结局预测的潜在作用。
