Predictors of mortality in hospitalized patients with COVID-۱۹: implications for nursing care in north-western Iran

Background: COVID-۱۹ is a contagious infectious disease with high mortality, especially among hospitalized patients. Identifying mortality-related factors can help nurses improve early detection and clinical monitoring. This study aimed to determine the mortality status and related risk/protective factors in hospitalized patients with COVID-۱۹ from a nursing perspective. Methods: This cross-sectional descriptive-analytical study included all patients with confirmed COVID-۱۹ admitted to Imam Reza Hospital in Tabriz, Iran, between March and September ۲۰۲۱, selected via census sampling. Data included demographic characteristics, laboratory findings, intubation status, and clinical outcomes. Data were analyzed using SPSS version ۲۷, with a significance level of P<۰.۰۵. Results: Of ۱۸۱ patients, ۱۱۰ (۶۰.۸%) were male, with a median age of ۶۶ years (range: ۱۶–۹۶). Mortality was significantly associated with intubation (P<۰.۰۰۰۱), abnormal chest X-ray (P<۰.۰۰۰۱), CT scan findings (P=۰.۰۲), underlying renal disease (P=۰.۰۱), older age (P<۰.۰۰۰۱), and elevated WBC (P=۰.۰۰۲), potassium (P=۰.۰۰۲), phosphorus (P=۰.۰۰۸), urea (P<۰.۰۰۰۱), creatinine (P<۰.۰۰۰۱), and LDH (P=۰.۰۰۸). In contrast, higher pH (P=۰.۰۰۵), bicarbonate (P=۰.۰۰۲), and oxygen saturation (SaO۲) (P<۰.۰۰۰۱) were protective factors associated with lower mortality. Conclusion: Several easily measurable clinical and laboratory parameters can predict mortality in COVID-۱۹ patients. From a nursing standpoint, close monitoring of respiratory status (SaO۲, intubation needs), renal function (creatinine, urea), and acid-base balance (pH, HCO۳) is critical. These findings empower nurses to identify high-risk patients earlier and adjust care plans accordingly, potentially reducing mortality during future COVID-۱۹ surges.

Keywords:

COVID-۱۹ , Mortality , Hospitalized patients , Nursing care , Risk factors