Keywords
Abstract
Background: We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia and risk factors associated for mortality.
Methods: In this study, we included inpatient with acute respiratory distress syndrome at Golestan Hospitals who had been discharged or had died in 2020. Epidemiological, and clinical data were extracted from electronic medical records and compared between recovered and died cases. We used multiple logistic regression methods to explore the risk factors associated with in-hospital death.
Results: In overall 2,835 acute respiratory distress syndrome patients were included in this study, of these patients, 874 (30.83.9%) were positive for 2019nCoV. Five hundred and sixty-three patients (19.86%) died, 1,687 patients (59.51%) were recovered. Of the total deaths, only 288 (10.15%) were attributed to COVID-19. The most common symptoms at onset of illness were respiratory distress (1,795 [63.32%]), fever (1,601 [56.47%]), dry cough (1,595 [56.26%]), Sore throat (445 [15.70%]), and myalgia (342 [12.06%]). One thousand and twelve (35.7%) had 1 or more coexisting medical conditions. In multiple logistic regression analysis, risk factors associated with the death included older age (OR (Odds Ratio), 1.03; 95% CI; 1.02-1.04), blood oxygen level (SpO2<93%) (OR, 2.44; 95% CI; 1.79-3.31), comorbidities (OR, 2.15; 95% CI; 1.62-2.84), respiratory distress (OR, 1.74; 95% CI; 1.28-2.37), and headache (OR, 0.44 95% CI; 0.21-0.92).
Conclusions: The 2019-nCoV infection caused collections of severe respiratory illness and was associated high ratio of hospitalization in ICU and high mortality. Older age and comorbidities were associated with more risk of death among patients with 2019nCoV.
References
2. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. 2020;323(11):1061-9. doi:10.1001/jama.2020.1585
3. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. 2020. doi: 10.1056/NEJMoa2001316
4. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. 2020;395(10223):507-13. https://doi.org/10.1016/S0140-6736(20)30211-7
5. Kalteh Ea, Fararooei M, Aljalili S, Ghelichi-Ghojogh Mjijoph. Susceptibility to COVID-19 in Pregnant and Breastfeeding Women. 2020;49:132-3. https://doi.org/10.18502/ijph.v49iS1.3686
6. Organization WH. Clinical management of severe acute respiratory infection when novel coronavirus ( nCoV) infection is suspected: interim guidance, 25 January 2020. World Health Organization; 2020.
7. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. 2020. https://doi.org/10.1542/peds.2020-0702
8. Munn Z, Moola S, Riitano D, Lisy KJIjohp, management. The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. 2014;3(3):123. doi: 10.15171/ijhpm.2014.71.
9. Soni AK. Update on the SARS-CoV-2 (COVID-19) Outbreak: A Global Pandemic Challenge. 2020. doi: 10.20944/preprints202004.0082.v1
10. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BPJJoh. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. 2006;45(4):529-38. doi: 10.1016/j.jhep.2006.05.013.
11. Hu B, Zeng L-P, Yang X-L, Ge X-Y, Zhang W, Li B, et al. Discovery of a rich gene pool of bat SARS-related coronaviruses provides new insights into the origin of SARS coronavirus. PLoS pathogens. 2017;13(11). https://doi.org/10.1371/journal.ppat.1006698
12. Yin Y, Wunderink RG. MERS, SARS and other coronaviruses as causes of pneumonia. Respirology. 2018;23(2):130-7. doi: 10.1111/resp.13196.
13. Song Z, Xu Y, Bao L, Zhang L, Yu P, Qu Y, et al. From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses. 2019;11(1):59. doi: 10.3390/v11010059
14. html WHOJhwwicsctei. Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003. 2003.
15. Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. New England Journal of Medicine. 2003;348(20):1986-94. doi: 10.1056/NEJMoa030685
16. Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. The Lancet infectious diseases. 2013;13(9):752-61. doi: 10.1016/S1473-3099(13)70204-4
17. Moxley G, Posthuma D, Carlson P, Estrada E, Han J, Benson LL, et al. Sexual dimorphism in innate immunity. Arthritis & Rheumatism. 2002;46(1):250-8. doi : 10.5812/archcid.103093
18. Badawi A, Ryoo SG. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis. International Journal of Infectious Diseases. 2016;49:129-33. doi: 10.1016/j.ijid.2016.06.015.
19. Wu C, Chen X, Cai Y, Zhou X, Xu S, Huang H, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA internal medicine. 2020. doi:10.1001/jamainternmed.2020.0994
20. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet (London, England). 2020;395(10229):1054-62. doi: 10.1016/S0140-6736(20)30566-3.
21. Ehsan allah K, Rajabi A. COVID-19 and digital epidemiology. Journal of Public Health. 2020:1. https://doi.org/10.1007/s10389-020-01295-y