Over 60 years of age as an independent prognostic factor of in-hospital mortality among COVID-19 patients: a cohort study in an Iranian high-incidence area

Public Health. 2021 Nov:200:33-38. doi: 10.1016/j.puhe.2021.09.007. Epub 2021 Sep 14.

Abstract

Objectives: COVID-19 continues to cause devastation throughout the world. Various factors influence the perioperative course and prognosis of COVID-19. This study aims to collate the independent prognostic factors among hospitalised COVID-19 patients in east Iran.

Study design: In this cohort study, all patients with a confirmed diagnosis of COVID-19 between 19 February 2020 and 1 August 2020 who were admitted to nine public hospitals of South Khorasan province, Iran, were enrolled.

Methods: Univariate analysis (chi-square [χ2], and Mann-Whitney U test) and multiple logistic regression were performed.

Results: This study included 1290 participants; 676 patients (52.4%) were male. A total of 1189 (92.2%) recovered, and 101 (7.8%) died. The results show that in-hospital mortality increases with advanced age (the optimal cut-off point = 62 years). The following three variables were shown to have the most significant role in in-hospital mortality: age >60 years (odds ratio [OR] = 8.01, 95% confidence interval [CI] 4.8-13.35), shortness of breath (OR = 2.65, 95% CI: 1.4-69.17) and atypical radiological manifestations in a chest X-ray on admission (OR = 2.16, 95% CI: 1.3-28.64). In the univariate analysis, associated comorbidities, such as cardiovascular diseases, influenced the in-hospital mortality rate, while the same could not be replicated in the multiple variable analysis.

Conclusions: This study revealed the potential predictors of COVID-19 and highlighted the need to be cautious with advanced age and heightened clinical symptoms at the time of admission.

Keywords: Cohort study; Coronavirus disease 2019 (COVID-19); Death; In-hospital mortality; Iran; Prognostic factors.

MeSH terms

  • Aged
  • COVID-19*
  • Cohort Studies
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Incidence
  • Iran / epidemiology
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2