Clinical Findings and Predictors of Mortality in 354 COVID-19 Cases; a Report from a Tertiary Center in Tehran, Iran.

OBJECTIVE We reported the clinical characteristics, laboratory findings, and radiologic features of a COVID-19 registry in Iran and compared disease manifestations between the deceased patients and those who recovered. DESIGN This was a retrospective cross-sectional study with census sampling. SETTING Three hundred forty-five patients were enrolled from February 25th, 2020, to April 21st, 2020, in a tertiary referral hospital. PARTICIPANTS Patients with suggestive lung computed tomography scans (CT scans) who had respiratory symptoms and one of the followings: 1) loss of consciousness, 2) Respiratory rate more than 24, 3) pulse rate more than 90, 4) Systolic blood pressure less than 90 mmHg, 5) abnormal respiratory sounds, or 6) O2 saturation less than 93% or high-risk patients with respiratory symptoms or fever were enrolled to the study. MAIN OUTCOME MEASURES The primary outcome measures were days of hospital stay, any event of intubation, ICU admission, and in-hospital death. Logistic regression was done to assess the association between survival status and patients’ characteristics. RESULTS Nearly 45% of patients were older than 65 years, and 57.6% were male. Twenty hundred and sixty-five patients (74.8%) survived. Univariate analysis showed a significant association between mortality and older age, higher body mass index, aspartate transaminase, consciousness, cancer, organ transplant, oxygen saturation (SO2), systolic and diastolic blood pressure, body temperature, respiratory rate, pulse rate, anemia, leukocytosis, neutrophil to lymphocyte ratio (NLR), thrombocytopenia, creatinine, CRP, PH, PCO2, and bicarbonate. The relationship between mortality and consciousness, cancer, low SO2, tachycardia, platelet count less than 150,000 per microliter of blood, creatinine over 1.2 mg/dL remained statistically significant in multivariate analysis. The average total length of hospital stay was 5.98 days (SD: 5.87). CONCLUSION We observed that increased tachycardia, high-grade fever, tachypnea, and NLR strongly correlated with in-hospital death. In contrast, higher levels of systolic blood pressure had a protective role.