An investigation of risk factors of in-hospital death due to COVID-19: a case-control study in Rasht, Iran

Abstract

Background Identifying the non-survived patients' characteristics compared to survived subjects and introducing the critical risk factors of COVID-19 mortality would help enhance patients' prognosis and treatment. Methods In the current case-control study, medical records of 103 non-survived COVID-19 patients (cases) and 147 sexmatched survivors (controls) who admitted to Razi University Hospital in Rasht, Guilan, Northern Iran from April 21 to August 21, 2020, were explored. Data on demographic, anthropometric, clinical, and laboratory assessment was extracted from the electronic medical records. To estimate the association between variables of interest and mortality odds due to COVID-19 logistic regression was carried out. Results The patients who died (mean age = 62.87 years) were older than the discharged patients (57.33 years; P value = 0.009). According to the results of multivariable regression adjusted for potential confounders, elevated BMI (OR = 2.49; 95% CI = 1.15-5.41), higher CRP levels (OR = 2.28; 95% CI = 1.08-4.78), increased FBS levels (OR = 2.88; 95% CI = 1.35-6.17), higher levels of total cholestrol (OR = 2.55; 95% CI = 1.19-5.45) and LDL (OR = 2.27; 95% CI = 1.07-4.79), elevated triglyceride (OR = 5.14; 95% CI = 2.28-11.56), and raised levels of D-dimer (OR = 5.68; 95% CI = 2.22-14.49) were identified as independent risk factors of COVID-19 mortality. No significant association was detected regarding HDL level, QTc interval or heart size, and COVID-19 fatality odds. Conclusion The present findings demonstrated that obesity, higher levels of CRP, blood sugar, D-dimer, and lipid markers were likely to be predictive factors of COVID-19-related mortality odds.

Lipid profile changes in patients with COVID-19 referred to medical centers in Kermanshah, Iran; a case–control study

“…A previous study in Iran demonstrated that obesity, higher levels of CRP, blood sugar, D-dimer, and lipid markers are predictive factors of COVID-19-related mortality. 4 …”

“…A previous study in Iran demonstrated that obesity, higher levels of CRP, blood sugar, D-dimer, and lipid markers are predictive factors of COVID-19-related mortality. 4 In humans, COVID-19, caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), progresses rapidly to induce acute respiratory distress syndrome (ARDS), leading to the appearance of symptoms. 5 During ARDS due to COVID-19, changes to the host's immunological status occur, including neutropenia, dendritic cell depletion, natural killer cell depletion, decreased T (T CD4þ and CD8þ) and B lymphocytes, and increased proinflammatory cytokines.…”

High-density lipoprotein cholesterol: A marker of COVID-19 infection severity?

“…A retrospective case-control study conducted in Iran included 250 COVID-19 patients [ 23 ]. No significant difference on HDL-C levels was observed between 103 deceased and 147 survived patients.…”

“…No significant difference on HDL-C levels was observed between 103 deceased and 147 survived patients. Of note, higher levels of TCHOL [Odds ratio (OR) = 2.55; 95% CI = 1.19–5.45] and LDL (OR = 2.27; 95% CI = 1.07–4.79) as well as elevated triglycerides (OR = 5.14; 95% CI = 2.28–11.56), were identified as independent risk factors of COVID-19 mortality, while no significant association was detected regarding HDL-C [ 23 ].…”

Comment on ‘Comparison of losartan and amlodipine effects on the outcomes of patient with COVID‐19 and primary hypertension: A randomised clinical trial’

“…2. One risk factor of mortality in COVID-19 patients is the age, 2 and in this study, a stratified randomisation of age has not been done, the mean age of the groups was 67.3 years and 60.1 years, respectively.…”