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Multivariable Analysis of Clinical and Laboratory Data Manifestations Predicting Severity and Mortality Risk in Patients With Coronavirus Disease 2019 in the Mountainous West of Iran: A Retrospective Single-Center Study Publisher



Beni ZN1 ; Beni AN2 ; Samani FR1 ; Dayani MA1 ; Beni FN1 ; Radmehr H2 ; Noorshargh P2
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Authors Affiliations
  1. 1. Shahrekord University of Medical Sciences, Chaharmahal and Bakhtiari Province, Shahr-e Kord, 88167-54633, Iran
  2. 2. Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, 81496-44874, Iran

Source: Asian Biomedicine Published:2022


Abstract

Background: Few reports have addressed the clinical and laboratory features of patients with coronavirus disease-2019 (COVID-19) in mountainous areas, especially in Iran. Objectives: To report the clinical and laboratory data and manifestations predicting mortality of patients with COVID-19 in the west of Iran. Methods: We conducted a retrospective cohort study of 286 patients hospitalized with COVID-19 between 25 February 2020 and 12 May 2020 to describe their clinical symptoms and laboratory test findings when they were admitted at the Hajar Hospital affiliated with the Shahrekord University of Medical Sciences, and a multivariable analysis of factors that predict their disease severity and mortality. Results: After hospital admission, 18 patients died and 268 were discharged. Older age [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.01-1.04, P = 0.001], presence of underlying diseases (OR = 1.86, 95% CI = 1.01-3.45, P = 0.04), elevated hematocrit (OR = 1.08, 95% CI = 1.03-1.13, P = 0.002), and increase in red blood cell distribution width (RDW) coefficient of variation (OR = 1.18, 95% CI = 1.02-1.36, P = 0.02) were significantly associated with disease severity. Older age (OR = 1.00, 95% CI = 1.00-1.07, P = 0.03), hypocalcemia (OR = 0.20, 95% CI = 0.09-0.58, P = 0.002), hypophosphatemia (OR = 0.50, 95% CI = 0.26-1.02, P = 0.04), and increase in platelet-larger cell ratio (P-LCR; OR = 1.10, 95% CI = 1.00-1.15, P = 0.04) were significantly associated with mortality. The areas under the receiver operating characteristic curves were as follows: calcium 0.759; lactate dehydrogenase (LDH) 0.731; phosphorus 0.725; bilirubin 0.689; C-reactive protein 0.679; and RDW-standard deviation (RDW-SD) 0.624. Conclusions: Those who did not survive tended to be elderly and had a greater incidence of comorbidities. Elevated LDH, decreased levels of calcium and phosphorus, and anemia at diagnosis were associated with greater risk of death for these Iranian patients hospitalized with COVID-19. Regular assessment of these markers would help to manage patients with COVID-19. © 2022 Zahra Naderi Beni et al., published by Sciendo.
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