Risk Stratification for In-Hospital Mortality in Adult Patients with  COVID-19

Marzieh Pazoki; Pooya Payandemehr; Mahnaz Montazeri; Samira Kafan; Mehrdad Sheikhvatan; Mehran Sotoodehnia; Ahmad Salimzadeh; Mehdi Ebrahimi; Atabak Najafi; Reza Shariat Moharari; Mohammad Reza Khajavi; Mohammad Talebpour; Haleh Ashraf; Seyed Mohammad Kazem Aghamir; Shahrokh  Karbalai Saleh; Ali Shakouri Rad; Hedieh Moradi Tabriz; Farhad Najmeddin; Pantea Arya; Niloufar Peirovi; Sina Kazemian; Mehdi Kashani; Sorya Babaei; Azar Hadadi

doi:10.18502/jimc.v4i4.8480

Marzieh Pazoki Department of Pulmonary Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Pooya Payandemehr Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mahnaz Montazeri Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
Samira Kafan Department of Pulmonary Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mehrdad Sheikhvatan Heidelberg Medical Hospital, Heidelberg, Germany
Mehran Sotoodehnia Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Ahmad Salimzadeh Rheumatology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mehdi Ebrahimi Department of Endocrinology Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Atabak Najafi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Reza Shariat Moharari Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Reza Khajavi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Talebpour Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Haleh Ashraf Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Seyed Mohammad Kazem Aghamir Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Shahrokh Karbalai Saleh Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Ali Shakouri Rad Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Hedieh Moradi Tabriz Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Farhad Najmeddin Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
Pantea Arya Department of Psychology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Niloufar Peirovi Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
Sina Kazemian Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
Mehdi Kashani Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Sorya Babaei Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Azar Hadadi Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v4i4.8480

Keywords: COVID-19, Mortality, Risk factors, SARS-CoV-2

Abstract

Background: Since the outbreak of coronavirus 2019 (COVID-19), identifying risk factors associated with in-hospital mortality has been a global priority. In this study, the purpose was to evaluate the clinical, laboratory, and radiological characteristics of hospitalized patients with COVID-19 to develop a predictive model and scoring system for in-hospital mortality.

Methods: In this retrospective cohort study, 611 adult patients with COVID-19, admitted to Sina hospital were enrolled and followed up.

Results: Out of the total number of 611 patients, 104 patients (17%) deceased during hospitalization, including 75 (12.2%) deaths in ICU and 29 (4.7%) deaths in the wards. After multivariate logistic regression analysis, several characteristics including age >55 years, previous history of malignancy, history of cerebrovascular accident, tachypnea on admission, CRP>54 on admission, D-dimer>1300, and bilateral pulmonary consolidation on chest Computed Tomography (CT) were shown to be the main determinants for stratifying the risk for in-hospital death. The factors were finally considered for introducing a new predictive scoring system for COVID-19 related death.

Conclusion: In-hospital mortality rate in patients with COVID-19 is estimated to be 17%. A new scoring system for predicting in-hospital mortality in such patients was structured based on determinant factors of advanced age, history of malignancy, cerebrovascular accident, tachypnea, raised CRP, raised D-dimer on admission, and bilateral pulmonary consolidation on chest CT scan.