The Mortality Predictors in Patients with COVID-19 referred to the Emergency Department of Shahid Mohammadi Hospital in Bandar Abbas city in 2019 (preprint)

ABSTRACT

Background and aim: Identifying the predictors of Mortality in COVID-19 is a way of identifying high-risk patients. Previous studies reported comorbidities and old age as the essential components of Covid-19 Mortality. The present study aims to determine the predictors of mortality in patients with COVID-19 referred to the emergency department.Materials and method The present descriptive-analytical study was conducted retrospectively on patients with confirmed COVID − 19 referred to the emergency department of Shahid Mohammadi Hospital in Bandar Abbas in 2019. Patient information, including age, gender, underlying disease, history of smoking, clinical symptoms, type of treatment, and laboratory findings, were extracted from the covid registry.Results In this study, 2478 patients with covid 19 were examined. The average age of the study subjects was 52.57 ± 16.41 years. Among them, 1371 people (55.3%) were men. The most common clinical symptom of the patients was shortness of breath (63.2%), and the most common underlying disease was hypertension (24.3%). 16.9% of examined covid 19 patients died. According to the results of multiple logistic regression analysis, with each 1-year increase in the age of the patients, the chance of death increased by 4.7% (P < 0.001). In addition, dyspnea increased the probability of death by 2.4 times, hypertension by 1.6 times, ischemic heart disease by 1.7 times, dyslipidemia by 3.6 times, stroke by 2.9 times, and malignancy by 2.2 times. (P < 0.05). The most important predictor of Mortality was CRP 3+, which increased the probability of Mortality in Covid-19 patients by almost 25 times (OR = 25.338, with a 95% confidence interval in the range of 1.978 to 324.668, P = 0.013). In addition, with each unit increase in ESR, the chance of death in patients increased by 3.3% (P < 0.001). On the other hand, among the clinical symptoms, anorexia (OR = 0.711, with a 95% confidence interval in the range of 0.506 to 0.999, P = 0.050) and receiving Macrolides (OR = 0.212, with a 95% confidence interval in the range 0.091 to 0.492, P < 0.001) had a protective role against mortality.Conclusion Based on the results of this study, old age, dyspnea, hypertension, ischemic heart disease, dyslipidemia, stroke, malignancy, CRP 3+, and high ESR were identified as predictors of Mortality in Covid-19 patients. Of course, receiving Macrolide and the presence of anorexia had a protective role against mortality in these patients.