COVID-۱۹ in Iran: Clinical, Therapeutic, and Laboratory Findings Associated with Mortality

Introduction: Currently, humankind is facing a COVID-۱۹ pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-۱۹ outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-۱۹.Methods: This retrospective study included a total of ۱۹۱ confirmed COVID-۱۹ patients aged ≥۱۸ who were admitted to an intensive care unit in the northeast of Iran in ۲۰۲۰. Clinical, therapeutic, and laboratory findings were recruited. The data were analyzed using SPSS software (version ۲۳) through the Mann-Whitney U test, Chi-Square test, independent sample t-test, as well as a single variable and multivariable logistic regression.Results: Out of a total of ۱۹۱ hospitalized patients, ۱۳۷ (۷۱.۷%) survived and ۵۴ (۲۸.۲%) expired. The mean age of non-survived patients was ۱۷ years higher than that of survived patients (P<۰.۰۰۰۱). Hypertension, diabetes, and coronary and pulmonary diseases were significantly related to mortality (OR: ۳, ۲.۸, ۲۱.۴, and ۵.۴, respectively; P<۰.۰۵). Respiratory rate >۲۴/min, heart rate>۱۲۵/min, platelet count <۱۰۰*۱۰۹/L, creatinine >۱۳۳ μmol/L, LDH >۲۴۵ U/L, WBC count >۱۰*۱۰۹/L, lymphocyte count <۰.۸*۱۰۹/L and D-dimer >۱ μg/mL were frequently observed in non-survivor patients (P<۰.۰۵). Most of the patients had an abnormality on chest radiographs, and bilateral pulmonary infiltration was the dominant chest radiograph abnormality in these patients. Moreover, consolidation and ground-glass opacification were observed more frequently in non-survived patients (P<۰.۰۵). More than ۵۷% of severe cases required non-invasive and invasive mechanical ventilation before they died, while it was ۱% in survived cases (P<۰.۰۵).Conclusion: Older age, previous comorbidities such as diabetes, hypertension, coronary and pulmonary diseases, lymphopenia, leukocytosis, increased respiratory rate, creatinine, LDH, and D-dimer levels were related to a poor prognosis and mortality in patients with SARS-CoV-۲ infection.

Keywords:

COVID-۱۹ , Coronavires , SARS-CoV-۲ , Iran , Mortality