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.

Background: This study aimed to determine the effect of the Ketamine and Midazolam combination and compare it with the Apotel and Ketorolac combination in pain management of patients with renal colic in the emergency section. In this double-blind clinical trial study, 200 renal colic patients admitted to the ED with more than 8 NRS* (Numerical Rating Scale) of primary pain were divided into two groups by random blocking: one group received intravenous Ketamine (0.4 mg/kg), and intravenous Midazolam (at a dose of 0.016 mg/kg) and the other group received intravenous Ketorolac (30 mg) and intravenous Apotel (15 mg/kg). After that, we measured patients' pain at 1, 5, 10, 15, 30, and 45 min after the procedure. Results: 124 (62.0%) of 200 patients were men. Initial pain scores were 9(10-9) for Ketamine + Midazolam and 10(10-9) for Apotel + Ketorolac.Linear regression was performed to compare the two groups' adjusted pain scores, correcting for initial pain. The ultimate pain score increased by.392 units for each unit of starting pain. Group and time had significant effects (5.553, -.035, P=.001, respectively). Apotel + Ketorolac had a higher mean pain score than Ketamine + Midazolam at all post-intervention time intervals. During the trial, both groups' discomfort decreased dramatically. Conclusions: The combination of Ketamine and Midazolam was more effective than Apotel and Ketorolac in relieving the pain in renal colic. Therefore, if routine medications are contraindicated, a combination of Ketamine and Midazolam is recommended for pain control in patients with renal colic. Trial registration: This trial was registered in the Iranian Registry of Clinical Trials with IRCT registration number of IRCT20200422047163N1 (https://www.irct.ir/trial/47370) and registration date of 01/05/2020.

Background: This study aimed to determine the effect of the Ketamine and Midazolam combination and compare it with the Apotel and Ketorolac combination in pain management of patients with renal colic in the emergency section.In this double-blind clinical trial study, 200 renal colic patients admitted to the ED with more than 8 NRS* (Numerical Rating Scale) of primary pain were divided into two groups by random blocking: one group received intravenous Ketamine (0.4 mg/kg), and intravenous Midazolam (at a dose of 0.016 mg/kg) and the other group received intravenous Ketorolac (30 mg) and intravenous Apotel (15 mg/kg). After that, we measured patients' pain at 1, 5, 10, 15, 30, and 45 min after the procedure.Results: 124 (62.0%) of 200 patients were men. Initial pain scores were 9(10-9) for Ketamine + Midazolam and 10(10-9) for Apotel + Ketorolac.Linear regression was performed to compare the two groups' adjusted pain scores, correcting for initial pain. The ultimate pain score increased by.392 units for each unit of starting pain. Group and time had significant effects (5.553, -.035, P=.001, respectively).Apotel + Ketorolac had a higher mean pain score than Ketamine + Midazolam at all post-intervention time intervals. During the trial, both groups' discomfort decreased dramatically.Conclusions: The combination of Ketamine and Midazolam was more effective than Apotel and Ketorolac in relieving the pain in renal colic. Therefore, if routine medications are contraindicated, a combination of Ketamine and Midazolam is recommended for pain control in patients with renal colic.Trial registration: This trial was registered in the Iranian Registry of Clinical Trials with IRCT registration number of IRCT20200422047163N1 (https://www.irct.ir/trial/47370) and registration date of 2020-05-01.