Clinical and Paraclinical Predictive Factors for In-hospital Mortality in Adult Patients with COVID-19: A Cross-sectional Study in Iran

Background: COVID-19, a type of coronavirus emerged in Wuhan, China in December 2019, causing an epidemic of pneumonia with unknown reasons. Objective: This study aimed to investigate the factors affecting in-hospital mortality of patients with COVID-19 hospitalized in one of the main hospitals in central Iran. Methods: This retrospective cross-sectional study (February-May 2020) was conducted on patients with a confirmed diagnosis of COVID-19 admitted to Yazd Shahid Sadoughi Hospital in Iran. The patients with uncompleted or missed medical files were excluded from the study. Data were extracted from the patients' medical files and then analyzed. The patients were categorized as survivors and non-survivors groups, and they were compared. Results: Total 573 patients were enrolled and 356 (62.2%) were male. The mean +/- SD of age was 56.29 +/- 17.53 years, and 93 (16.23%) died. All the complications were more in non-survivors. Intensive care unit (ICU) admission was in 20.5% of the patients, which was more in non-survivors (P<0.001). The results of multivariate logistic regression test showed that pleural effusion in lung computed tomography (CT) scan (OR=0.055, P=0.019), white blood cell (WBC) (OR=1.418, P=0.022), serum albumin (OR=0.009, P<0.001), non-invasive mechanical ventilation (OR=34.351, P<0.001), and acute respiratory distress syndrome (ARDS) (OR=66.039, P=0.003) were the predictive factors for in-hospital mortality. Conclusion: In-hospital mortality with COVID-19 was about 16%. Plural effusion in lung CT scan, increased WBC count, lower mount of serum albumin, non-invasive mechanical ventilation, and ARDS were obtained as the predictive factors for in-hospital mortality.