Clinical Characteristics and Outcomes of 905 COVID-19 Patients Admitted to Imam Khomeini Hospital Complex in the Capital City of Tehran, Iran

Abstract

Background: We studied the clinical characteristics and outcomes of 905 hospitalized coronavirus disease 2019 (COVID-19) patients admitted to Imam Khomeini Hospital Complex (IKHC), Tehran, Iran. Methods: COVID-19 patients were recruited based on clinical symptoms and patterns of computed tomography (CT) imaging between February 20 and March 19. All patients were tested for the presence of COVID-19 RNA. The Poisson regression model estimated the incidence rate ratio (IRR) for different parameters. Results: The average age (± standard deviation) was 56.9 (±15.7) years and 61.77% were male. The most common symptoms were fever (93.59%), dry cough (79.78%), and dyspnea (75.69%). Only 43.76% of patients were positive for the RT-PCR COVID-19 test. Prevalence of lymphopenia was 42.9% and more than 90% had elevated lactate dehydrogenase (LDH) or C-reactive protein (CRP). About 11% were severe cases, and 13.7% died in the hospital. The median length of stay (LOS) was 3 days. We found higher risks of mortality in patients who were older than 70 years (IRR = 11.77, 95% CI 3.63–38.18), underwent mechanical ventilation (IRR = 7.36, 95% CI 5.06–10.7), were admitted to the intensive care unit (ICU) (IRR = 5.47, 95% CI 4.00–8.38), tested positive on the COVID-19 test (IRR = 2.80, 95% CI 1.64–3.55), and reported a history of comorbidity (IRR = 1.76, 95% CI 1.07–2.89) compared to their corresponding reference groups. Hydroxychloroquine therapy was not associated with mortality in our study. Conclusion: Older age, experiencing a severe form of the disease, and having a comorbidity were the most important prognostic factors for COVID-19 infection. Larger studies are needed to perform further subgroup analyses and verify high-risk groups.

Prognosis of patients hospitalized with a diagnosis of COVID-19 pneumonia in a tertiary hospital in Turkey

“… 16 – 21 However, others could not find a relationship between sex, mortality, and other unfavorable outcomes in COVID-19. 17 , 18 In the present study, mortality was similar between male and female patients. Although the prevalence of AKI and smoking was lower in women, the need for ICU, intubation, and mechanical ventilation was similar between male and female patients.…”

“…Fever was the most common (90%) symptom in our patient population, similar to other studies (frequency reported between 77.4–98.6%. 1 – 18 There are limited data showing an association between fever (body temperature) and mortality. A retrospective analysis of 9417 patients showed that low (<36°C) body temperature (BT) on admission was significantly associated with mortality.…”

Hydroxychloroquine

“…observed no significant differences in in-hospital mortality between patients treated with HCQ with or without azithromycin and patients who received neither drugs. [ 38 39 40 ] Lee et al . studied several observational studies and two huge randomised control trials and suggested that HCQ does not offer efficacy against hospitalised COVID-19 patients.…”

Call, chosen, HA2T2, ANDC: validation of four severity scores in COVID-19 patients

“…Identifying patients at high risk of disease progression may help allocating resources more efficiently. Since presentation and course of the infection can vary considerably (including asymptomatic cases), no single trait is sufficient to appropriately categorise patients [1][2][3][4][5][6][7][8][9]. Thus, several scores have attempted to improve identification of patients at high risk of progression or death of COVID-19.…”