Extended Abstract
Introduction
The early-stage symptoms of coronavirus disease 2019 (COVID-19) include pneumonia, fever, myalgia, fatigue, diarrhea, and loss of smell and taste. During the pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected humans across all age groups and ethnicities, both men and women, and spread through communities at an alarming rate. Clinical manifestations ranged from a common cold to more severe illnesses, such as bronchitis, pneumonia, acute respiratory distress syndrome (ARDS), multi-organ failure, and even death. It is believed that COVID-19 progressed increasingly rapidly in individuals with underlying conditions or comorbidities, often leading to mortality.
Risk factors for severe illness include advanced age and the presence of at least one underlying disease, such as diabetes, hypertension, chronic obstructive pulmonary disease (COPD), coronary artery disease, cerebrovascular disease, chronic kidney disease, and cigarette use. These patients may be at a higher risk for severe disease or death due to COVID-19. Additionally, older patients, particularly those over 65 years of age and those with co-existing conditions, have higher rates of admission to the intensive care unit (ICU) and mortality from COVID-19. These patients should take all necessary precautions to prevent infection, as they typically have the worst prognosis. Furthermore, early intervention is necessary for these patients to prevent the potential development of severe COVID-19. In the COVID-19 pandemic, effective patient risk stratification is crucial for optimizing patient care and the appropriate allocation of healthcare resources.
This study was conducted to compare certain risk factors associated with mortality due to COVID-19 in patients at Shohadaye Kargar Hospital in Yazd.
Methods
This descriptive study was conducted on 120 surviving (recovered) polymerase chain reaction (PCR)-positive COVID-19 patients (55 males and 65 females) with a mean age of 52.8 ± 18.88 years and 60 deceased PCR-positive COVID-19 patients (34 males and 26 females) with a mean age of 75.4 ± 15.4 years at Shohadaye Kargar Hospital in Yazd, Iran during 2019-2020.
Data in this cross-sectional study were collected descriptively using a library-based method. The statistical population of this study comprised all PCR-positive COVID-19 cases in Yazd Province between 2019 and 2020 who had presented as outpatients or inpatients.
The inclusion criterion comprised all PCR-positive COVID-19 patients, while the exclusion criterion included incomplete patient record information. Data were collected through the provincial COVID-19 committee database of Shohadaye Kargar Hospital in Yazd, Iran. Deceased patients were followed up for one year after the initial assessment, and the follow-up specifically ensured that the reported cause of death was COVID-19 and not due to other factors, such as natural causes.
Data were analyzed using SPSS-16 statistical software and Fisher's exact test and t-test at a significance level of less than 0.05.
Results
The frequency, survival rate, and mortality rate of PCR-positive COVID-19 patients, categorized by the presence of underlying conditions (diabetes, hypertension, cancer, ischemic heart disease, deep venous thrombosis [DVT], asthma, COPD, and cigarette use) are presented in Table 1.
The mean age of patients was significantly higher in the deceased group than in the recovery group (P<0.001). Survival and mortality rates of PCR-positive COVID-19 patients with and without diabetes, as well as those with and without hypertension, showed statistically significant differences (P<0.001). The prevalence of ischemic heart disease and COPD was significantly different between the recovered and deceased groups (P<0.001).
Gender, cigarette use, cancer, DVT, and asthma did not show statistically significant differences between the recovered and deceased groups.
Conclusion
Based on the findings of this study, the majority of deceased patients had comorbidities of diabetes and hypertension, whereas these diseases were absent in most members of the recovered group. Moreover, the absence of ischemic heart disease and COPD was observed in the majority of patients.
In the present study, hypertension was identified as a risk factor in COVID-19 patients. Conversely, cancer was not determined to be a risk factor for mortality in COVID-19 patients in this study.
Ethical Statement
The current study was approved by the Ethics Committee in Research of the Faculty of Pharmacy and Pharmaceutical Sciences, Islamic Azad University of Medical Sciences, Tehran Branch (IR.IAU.PS.REC.1399.249).
Funding
This article has been extracted from Mohammad Javad Barizi’s Ph.D dissertation in General Medicine at the Faculty of Medicine, Islamic Azad University, Yazd Branch.
Conflicts of Interest
No conflicts of interest.
Key Message: Advanced age and the presence of hypertension and diabetes are considered risk factors in COVID-19 patients.