Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia and risk factors associated for mortality.
Methods: In this retrospective cohort study, we included inpatient with acute respiratory distress syndrome at Golestan University of Medical Sciences Hospitals (Golestan province, Iran) who had been discharged or had died in 2020. Epidemiological, clinical, and laboratory data, including samples for viral RNA detection, 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, and 1,046 (36.90%) were negative and 915 (32.28%) were not available for PCR result. Five hundred and sixty-three patients (19.86%) died, 1,687 patients (59.51%) were recovered, and 585 (20.63%) under treatment. 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.