Evaluating the Effects of Clinical Characteristics and Therapeutic Regimens on Mortality in Hospitalized Patients with Severe COVID-19

Elahe  Karimpour-razkenari; Javad Boskabadi; Monireh Ghazaeian; Hamidreza Samaee; Hanieh Azizi; Fatemeh Esfandiari; Seyed Abdollah Mousavi; Sahar Fallah; Sekineh Talebi

doi:10.18502/jpc.v10i3.10790

Elahe Karimpour-razkenari Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.
Javad Boskabadi Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.
Monireh Ghazaeian Pharmaceutical Sciences Research Center, Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
Hamidreza Samaee Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.
Hanieh Azizi Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.
Fatemeh Esfandiari School of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.
Seyed Abdollah Mousavi Department of Pediatric Surgery, Pediatric Infectious Diseases Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Sahar Fallah Department of Biostatistic, Ibne Sina Medical and Educational Center, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.
Sekineh Talebi Department of Nursing, Ibne Sina Medical and Educational Center, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.

DOI: https://doi.org/10.18502/jpc.v10i3.10790

Keywords: COVID-19; Mortality; Epidemiology

Abstract

Background: The coronavirus disease 2019 (COVID-19) is highly contagious and has turned into a global health problem. In this study, we investigated the role of clinical and laboratory characteristics along with administered therapeutic agents in patients with COVID-19, and identified some effective factors on the mortality of these individuals.

Methods: In this retrospective study, we evaluated the data from all the hospitalized patients who had been diagnosed with COVID-19 between February 23 and May 23, 2020. The data were obtained from medical records. Additionally, a checklist was used to record demographic, clinical, laboratory, imaging, and treatment data for each patient.

Results: Totally, 478 patients were involved in this study, and their median age was 58.5 years. Of these, 53.3% patients were male. The most common pre-existing underlying disease was hypertension (37.9%), and the mortality group had significantly more comorbidities (85.4%). Higher neutrophil lymphocyte ratio (NLR), lymphopenia, and reduced hemoglobin were more frequent in the mortality group (p < 0.001). Similarly, the need to be admitted to the intensive care unit was significantly greater in the mortality group (p<0.001). The most frequently administered therapeutic regimens included hydroxychloroquine and lopinavir/ritonavir, which did not have any correlation with survival outcome.

Conclusion: Older age, opioid addiction, cardiovascular disease, kidney disease, baseline NLR and hemoglobin, and ICU admission were independently associated with COVID-19 mortality. On the other hand, hydroxychloroquine and lopinavir/ritonavir indicated no beneficial effects on patients’ outcome.