Risk Factors Associated with Mortality in COVID-19 Patient’s: Survival Analysis
-
Seyedeh Solmaz Talebi
,
Ali Hosseinzadeh
,
Fariba Zare
,
Salman Daliri
,
Hozhabr Jamali Atergeleh
,
Ahmad Khosravi
,
Shahrbanoo Goli
,
Marzieh Rohani-Rasaf
Abstract
Background: The effect of related factors on recovery or death rates may vary from country to country. Therefore, we aimed to investigate the relationship between demographic, clinical, laboratory factors on the survival rates of confirmed cases of COVID-19 in Shahroud, Iran.
Methods: This is an analytical study of the estimation of the survival of patients with COVID-19. Patients who had positive PCR test were considered as COVID-19 cases, and the 2-month survival of these patients was estimated. Among the diseases, heart disease and diabetes were considered as separate variables, and the patients' histories of other diseases were included in the model as comorbidities.
Results: Of 396 confirmed patients hospitalized, 109 patients (27.5%) had a history of heart disease, 100 (25.3%) were diabetic, and 80 (20.2%) had a history of other comorbidities. The number of deaths due to the disease was 59 (14.9%). The median age of those who died was 76 years. The multivariate Cox regression analysis shows that heart disease increases hazard ratio more than two times (HR=2.37, 95% CI: 1.33-4.23). The neutrophil-to-lymphocyte ratio (NLR) factor, (HR=1.15, 95% 1.08-1.22), and older age (HR=1.06, 95% CI: 1.03-1.08) increases the risk of death significantly.
Conclusion: The heart disease history, NLR factor and older age are associated with death of COVID-19 and may be helpful for the early warning and prediction of disease progression.
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33. Tao Y, Shi M, Chommanard C, et al (2017). Surveillance of bat coronaviruses in Kenya identifies relatives of human coronaviruses NL63 and 229E and their recombination history. J Virol, 91(5): e01953-16.
2. Wenham C, Smith J, Morgan R (2020). COVID-19: the gendered impacts of the outbreak. The lancet, 395(10227): 846-848.
3. CDC COVID-19 Response Team, Stephanie Bialek, Ellen Boundy, Virginia Bowen, et al (2020). Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep, 69(12): 343-346.
4. Weiskopf D, Weinberger B, Grubeck‐Loebenstein B (2009). The aging of the immune system. Transpl Int, 22(11): 1041-50.
5. Skloot GS (2017). The effects of aging on lung structure and function. Clin Geriatr Med, 33(4): 447-457.
6. Battegay M, Kuehl R, Tschudin-Sutter S, et al (2020). 2019-novel Coronavirus (2019-nCoV): estimating the case fatality rate–a word of caution. Swiss Med Wkly, 150:w20203.
7. Wu C, Chen X, Cai Y, et al (2020). Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan China. JAMA Intern Med, 180(7): 934-943.
8. Kong W, Agarwal PP (2020). Chest imaging appearance of COVID-19 infection. Radiol Cardiothorac Imaging, 2(1): e200028.
9. Fu L, Fei J, Xiang H, et al (2020). Influence factors of death risk among COVID-19 patients in Wuhan China: a hospital-based case-cohort study. MedRxiv, doi: https://doi.org/10.1101/2020.03.13.20035329.
10. Li Z, Wu M, Yao J, et al (2020). Caution on kidney dysfunctions of COVID-19 patients. MedRxiv, doi: https://doi.org/10.1101/2020.02.08.20021212.
11. Zhou F, Yu T, Du R, et al (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 395(10229): 1054-1062.
12. Wu Z, McGoogan JM (2020). Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 323(13): 1239-1242.
13. Vardavas CI, Nikitara K (2020). COVID-19 and smoking: A systematic review of the evidence. Tob Induc Dis, 18:20.
14. Jordan RE, Adab P, Cheng K (2020). Covid-19: risk factors for severe disease and death. BMJ, 368:m1198.
15. Guo T, Fan Y, Chen M, et al (2020). Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol, 5(7): 811-818.
16. Gao Y, Li T, Han M, et al (2020). Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID‐19. J Med Virol, 92(7): 791-796.
17. Rodriguez-Morales A. J, Cardona-Ospina JA, Gutiérrez-Ocampo E, et al (2020). Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis, 34:101623.
18. Zheng YY, Ma Y T, Zhang J Y, et al (2020). COVID-19 and the cardiovascular system. Nat Rev Cardiol, 17(5): 259-260.
19. Su VYF, Yang YH, Yang KY, et al (2020). The risk of death in 2019 novel coronavirus disease (COVID-19) in Hubei Province. Available at SSRN 3539655.
20. Cheng Y, Luo R, Wang K, et al (2020). Kidney impairment is associated with in-hospital death of COVID-19 patients. MedRxiv, doi: https://doi.org/10.1101/2020.02.18.20023242.
21. Yang J, Zheng Y, Gou X, et al (2020). Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis, 94:91-95.
22. Hu Y, Sun J, Dai Z, et al (2020). Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis. J Clin Virol, 127: 104371.
23. Team E (2020). The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)—China, 2020. China CDC Wkly, 2(8): 113-122.
24. Guilmoto CZ (2020). COVID-19 death rates by age and sex and the resulting mortality vulnerability of countries and regions in the world. MedRxiv, doi: https://doi.org/10.1101/2020.05.17.20097410.
25. Huang X, Wei F, Hu L, et al (2020). Epidemiology and clinical characteristics of COVID-19. Arch Iran Med, 23(4): 268-271.
26. Lescure FX, Bouadma L, Nguyen D, et al (2020). Clinical and virological data of the first cases of COVID-19 in Europe: a case series. Lancet Infect Dis, 20(6): 697-706.
27. Wise J (2020). A third of covid-19 patients admitted to UK hospitals die. BMJ, 369:m1794.
28. Thai PQ, Son DT, Van HTH, et al (2020). Factors associated with the duration of hospitalisation among COVID-19 patients in Vietnam: A survival analysis. Epidemiol Infect, 148:e114.
29. Sousa GJB, Garces TS, Cestari VRF, et al (2020). Mortality and survival of COVID-19. Epidemiol Infect, 148:e123.
30. Shi Y, Yu X, Zhao H, et al (2020). Host susceptibility to severe COVID-19 and establishment of a host risk score: findings of 487 cases outside Wuhan. Crit Care, 24(1): 108.
31. Yang AP, Liu JP, Tao WQ, et al (2020). The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol, 84: 106504.
32. Ciccullo A, Borghetti A, Dal Verme LZ, et al (2020). Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line. Int J Antimicrob Agents, 56(2): 106017.
33. Tao Y, Shi M, Chommanard C, et al (2017). Surveillance of bat coronaviruses in Kenya identifies relatives of human coronaviruses NL63 and 229E and their recombination history. J Virol, 91(5): e01953-16.
| Files | ||
| Issue | Vol 51 No 3 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i3.8942 | |
| Keywords | ||
| COVID-19 Iran Mortality Risk factors Survival | ||
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How to Cite
1.
Talebi SS, Hosseinzadeh A, Zare F, Daliri S, Jamali Atergeleh H, Khosravi A, Goli S, Rohani-Rasaf M. Risk Factors Associated with Mortality in COVID-19 Patient’s: Survival Analysis. Iran J Public Health. 2022;51(3):652-658.
