Objective: The COVID-19 pandemic has brought considerable loss to the world by means of pneumonia related mortality. In the current study, we aimed to discover the predictors of mortality and other worse outcomes in atypical pneumonia cases during the COVID-19 outbreak. Methods: A prospective cohort study was carried out in our emergency department (ED) between March and May, 2020. All adult patients presented to the ED with atypical pneumonia patterns related to COVID-19 based on a chest CT scan were included in the study, and patients with bacterial pneumonia patterns were excluded. The primary outcome measure was determined as the composite outcome, including mortality and intensive care unit admission or mechanical ventilation needs within a one-month period. A binary logistic regression model was constructed to predict the worse outcomes in those patients. Results: Of the 271 suspected pneumonia cases, 146 patients were included in the final analysis. The composite outcome occurred in 31 patients (21.2%), 17 of whom died within one month. The patients' age, history of heart failure, history of stroke, body temperature, dyspnea, cough, altered mental status, serious bronchospasm, bilateral lung involvement, hemoglobin level, LDH, lactate level, and bicarbonate and creatinine levels were added to the final model. Finally, patients' altered mental status (OR:15.7, 95%CI:1.7-141.6), serious bronchospasm (OR:12.4, 95%CI:1.6-97.9), and lactate levels (OR:1.1, 95%CI:1.0-1.2) were found to be independent predictors for worse outcomes. Conclusion: Among various clinical and laboratory variables, altered mental status, serious bronchospasm, and lactate levels can be used to predict worse outcomes.
