Haji Aghajani Mohammad, Asadpoordezaki Ziba, Haghighi Mehrdad, Pourhoseingoli Asma, Taherpour Niloufar, Toloui Amirmohammad, Sistanizad Mohammad
Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Psychology, Maynooth University, Kildare, Ireland.
Arch Acad Emerg Med. 2021 Sep 30;9(1):e65. doi: 10.22037/aaem.v9i1.1363. eCollection 2021.
Adults with underlying medical disorders are at increased risk for severe illness from the virus that causes COVID-19. This study aimed to compare the effect of underlying diseases on the mortality of male and female patients as a primary objective. We also evaluated the effect of drugs previously used by COVID-19 patients on their outcome.
This retrospective cohort study was carried out on confirmed cases of COVID-19 who were admitted to a teaching hospital in Tehran, Iran. Data was gathered from patients' files. Log binomial model was used for investigating the association of underlying diseases and in-hospital mortality of these patients.
A total of 991 patients (mean age 61.62±17.02; 54.9% male) were recruited. Hypertension (41.1%), diabetes mellitus (30.6%), and coronary artery disease (19.6%) were the most common underlying diseases. The multivariable model showed that hypertension (RR = 1.62; 95% CI: 1.22-2.14, p = 0.001) in male patients over 55 years old and coronary artery disease (RR = 2.40; 95% CI: 1.24-4.46, p = 0.009) in female patients under 65 years old were risk factors of mortality. In females over 65 years old, the history of taking Angiotensin Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARB) (RR = 0.272; 95% CI: 0.17-0.41, p = 0.001) was a significant protective factor for death.
COVID-19 patients with a history of cardiovascular diseases such as hypertension and coronary artery disease, especially those in specific age and sex groups, are high-risk patients for in-hospital mortality. Additionally, a previous history of taking ACEi and ARB medications in females over 65 tears old was a protective factor against in-hospital mortality of COVID-19 patients.
患有基础疾病的成年人感染导致 COVID-19 的病毒后发生重症的风险增加。本研究旨在将基础疾病对男性和女性患者死亡率的影响作为主要目标进行比较。我们还评估了 COVID-19 患者先前使用的药物对其预后的影响。
本回顾性队列研究针对伊朗德黑兰一家教学医院收治的确诊 COVID-19 病例开展。数据从患者病历中收集。采用对数二项模型研究这些患者基础疾病与院内死亡率之间的关联。
共纳入 991 例患者（平均年龄 61.62±17.02；54.9% 为男性）。高血压（41.1%）、糖尿病（30.6%）和冠状动脉疾病（19.6%）是最常见的基础疾病。多变量模型显示，55 岁以上男性患者的高血压（RR = 1.62；95% CI：1.22 - 2.14，p = 0.001）以及 65 岁以下女性患者的冠状动脉疾病（RR = 2.40；95% CI：1.24 - 4.46，p = 0.009）是死亡风险因素。在 65 岁以上女性中，服用血管紧张素转换酶抑制剂（ACEi）和血管紧张素受体阻滞剂（ARB）的病史（RR = 0.272；95% CI：0.17 - 0.41，p = 0.001）是死亡的显著保护因素。
有高血压和冠状动脉疾病等心血管疾病史的 COVID-19 患者，尤其是特定年龄和性别的患者，是院内死亡的高危患者。此外，65 岁以上女性患者先前服用 ACEi 和 ARB 药物的病史是 COVID-19 患者院内死亡的保护因素。
