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Trends of In-Hospital and Icu Mortality in Covid-19 Patients Over the Fourth and Fifth Covid-19 Surges in Iran: A Retrospective Cohort Study From Iran Publisher Pubmed



Abdi S1 ; Nemati S1 ; Nederi Darbaghshahi N2 ; Mohammadi M2 ; Saeedi E3 ; Naji P1 ; Taheri N1 ; Qandian A4 ; Joshang N4 ; Fattahi P1, 5 ; Namdar P6 ; Vand Rajabpour M1
Authors
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Authors Affiliations
  1. 1. Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Qarib St, Azadi St, Tehran, 13145-158, Iran
  2. 2. Emergency Medicine Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Hemat Highway, Tehran, 14496-14535, Iran
  3. 3. Department of Health Sciences, University of Leicester, George Davies Centre, University Road, Leicester, LE1 7RH, United Kingdom
  4. 4. Communicable Disease Office, Deputy of Health, Qazvin University of Medical Sciences, Bahonar St, Qazvin, 34197-59811, Iran
  5. 5. Qazvin University of Medical Sciences, Bahonar St, Qazvin, 34197-59811, Iran
  6. 6. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Bahonar St, Qazvin, 34197-59811, Iran

Source: International Journal for Quality in Health Care Published:2022


Abstract

Objective: The current study aimed to investigate the temporal trend of in-hospital and intensive care unit (ICU) mortality of coronavirus disease 2019 (COVID-19) patients over 6 months in the spring and summer of 2021 in Iran. Design: We performed an observational retrospective cohort study. Setting: Qazvin Province- Iran during 6 month from April to September 2021. Participants: All 14355 patients who were hospitalized with confirmed COVID-19 in hospitals of Qazvin Province. Intervention: No intervention. Main outcome measures: The trends of overall in-hospital mortality and ICU mortality were the main outcome of interest. We obtained crude and adjusted in-hospital and ICU mortality rates for each month of admission and over surge and lull periods of the disease. Results: The overall in-hospital mortality, early mortality and ICU mortality were 8.8%, 3.2% and 67.6%, respectively. The trend for overall mortality was almost plateau ranging from 6.5% in July to 10.7% in April. The lowest ICU mortality was 60.0% observed in April, whereas it reached a peak in August (ICU mortality = 75.7%). Admission on surge days of COVID-19 was associated with an increased risk of overall mortality (Odds ratio = 1.3, 95% confidence interval = 1.1, 1.5). The comparison of surge and lull status showed that the odds of ICU mortality in the surge of COVID-19 was 1.7 higher than in the lull period (P-value < 0.001). Conclusions: We found that the risk of both overall in-hospital and ICU mortality increased over the surge period and fourth and fifth waves of severe acute respiratory syndrome coronavirus 2 infection in Iran. The lack of hospital resources and particularly ICU capacities to respond to the crisis during the surge period is assumed to be the main culprit. © 2022 The Author(s). Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved.
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