Clinical and Paraclinical Predictive Factors for In-hospital Mortality in Adult Patients with COVID-19: A Cross-sectional Study in Iran

Abstract

Background: COVID-19, a type of coronavirus emerged in Wuhan, China in December 2019, causing an epidemic of pneumonia with unknown reasons. Objective: This study aimed to investigate the factors affecting in-hospital mortality of patients with COVID-19 hospitalized in one of the main hospitals in central Iran. Methods: This retrospective cross-sectional study (February-May 2020) was conducted on patients with a confirmed diagnosis of COVID-19 admitted to Yazd Shahid Sadoughi Hospital in Iran. The patients with uncompleted or missed medical files were excluded from the study. Data were extract-ed from the patients' medical files and then analyzed. The patients were categorized as survivors and non-survivors groups, and they were compared. Results: Total 573 patients were enrolled and 356 (62.2%) were male. The mean±SD of age was 56.29±17.53 years, and 93 (16.23%) died. All the complications were more in non-survivors. Inten-sive care unit (ICU) admission was in 20.5% of the patients, which was more in non-survivors (P<0.001). The results of multivariate logistic regression test showed that pleural effusion in lung computed tomography (CT) scan (OR=0.055, P=0.019), white blood cell (WBC) (OR=1.418, P=0.022), serum albumin (OR=0.009, P<0.001), non-invasive mechanical ventilation (OR=34.351, P<0.001), and acute respiratory distress syndrome (ARDS) (OR=66.039, P=0.003) were the predic-tive factors for in-hospital mortality. Conclusion: In-hospital mortality with COVID-19 was about 16%. Plural effusion in lung CT scan, increased WBC count, lower mount of serum albumin, non-invasive mechanical ventilation, and ARDS were obtained as the predictive factors for in-hospital mortality.