In this study we reported the characteristics of all patients with COVID 19 in Ardebil province in the northwest of Iran. The clinical characteristics of these patients showed that the age (50-year-old and higher), hospitalization and hospitalization in ICU were the most important risk factors for death.
The present study also indicated that there is no gender difference in the prevalence of COVID-19 (49.7% in females vs. 50.3% in males). However, of deceased patients 43% was male. Some studies have reported greater prevalence of COVID-19 in males[17–19]. A study conducted in Iran showed that males are in higher risk of mortality. But, gender differences seems to have less importance as a prognostic factor for death compased with age . Some studies also have indicated that the susceptibility of older males is higher than older females. Anyway, in this study male gender didn’t have significant effect on death of patients in final adjusted regression logistic model.
Several studies have indicated that comorbidities are one the strongest predictors of death or sever COVID-19[22–24]. Another study from Iran showed that having comorbidities had a significant effect on mortality . Our findings showed that having any comorbidity was associated with hospitalization, hospitalization in ICU and outcome of disease. Also, in univariate analysis comorbidity increased the odds of death. However, this association didn’t remain significant in the final model. Further investigations are needed to assess the role of comorbidities on the mortality of COVID 19 in Iran.
Cough was to be the most common (74.7%) symptom among hospitalized patients followed by shortness of breath (62.7%). Of symptoms of the disease, we found that fever or chills, shortness of breath, aches and pains, headache, runny nose, diarrhea and chest pain were factors independently associated with mortality when adjusted for other variables. Among these symptoms, shortness of breath had the strongest effect on death (OR = 2.79). Some studies reported other frequencies for disease symptoms. For example among Italian and Spanish patients fever was reported as the most common symptom[19, 25]. Probably there are complex interactions between symptoms of COVID 19 and other independent variables like age and gender. Identifying such a complex relationship among independent variables may help to determine the portion of each symptom in death.
Our findings revealed that hospitalizing (OR = 12.28) and hospitalization in ICU (OR = 5.56) increased the odds of death among all patients. In line with our results, a study from Mexico reported that hospitalization (OR = 5.02) and hospitalization in ICU (OR = 1.79) were associated with death. This could happen due to condition of patients at admission time. Patients with severe and critical conditions are more likely to hospitalized or hospitalized in ICU, resulting in a high in hospital mortality.