Clinical Characteristics and Outcomes of 905 COVID-19 Patients Admitted to Imam Khomeini Hospital Complex in the Capital City of Tehran, Iran

Arch Iran Med. 2020 Nov 1;23(11):766-775. doi: 10.34172/aim.2020.102.

Abstract

Background: We studied the clinical characteristics and outcomes of 905 hospitalized coronavirus disease 2019 (COVID-19) patients admitted to Imam Khomeini Hospital Complex (IKHC), Tehran, Iran.

Methods: COVID-19 patients were recruited based on clinical symptoms and patterns of computed tomography (CT) imaging between February 20 and March 19. All patients were tested for the presence of COVID-19 RNA. The Poisson regression model estimated the incidence rate ratio (IRR) for different parameters.

Results: The average age (± standard deviation) was 56.9 (±15.7) years and 61.77% were male. The most common symptoms were fever (93.59%), dry cough (79.78%), and dyspnea (75.69%). Only 43.76% of patients were positive for the RT-PCR COVID-19 test. Prevalence of lymphopenia was 42.9% and more than 90% had elevated lactate dehydrogenase (LDH) or C-reactive protein (CRP). About 11% were severe cases, and 13.7% died in the hospital. The median length of stay (LOS) was 3 days. We found higher risks of mortality in patients who were older than 70 years (IRR = 11.77, 95% CI 3.63-38.18), underwent mechanical ventilation (IRR = 7.36, 95% CI 5.06-10.7), were admitted to the intensive care unit (ICU) (IRR = 5.47, 95% CI 4.00-8.38), tested positive on the COVID-19 test (IRR = 2.80, 95% CI 1.64-3.55), and reported a history of comorbidity (IRR = 1.76, 95% CI 1.07-2.89) compared to their corresponding reference groups. Hydroxychloroquine therapy was not associated with mortality in our study.

Conclusion: Older age, experiencing a severe form of the disease, and having a comorbidity were the most important prognostic factors for COVID-19 infection. Larger studies are needed to perform further subgroup analyses and verify high-risk groups.

Keywords: Clinical characteristics; Iran; Mortality; Outcome; SARS-CoV-2.

MeSH terms

  • Adult
  • Aged
  • COVID-19 / diagnosis
  • COVID-19 / mortality*
  • COVID-19 / physiopathology
  • COVID-19 Drug Treatment
  • COVID-19 Nucleic Acid Testing / standards
  • COVID-19 Nucleic Acid Testing / statistics & numerical data
  • Comorbidity
  • Female
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Intensive Care Units / statistics & numerical data
  • Iran / epidemiology
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pandemics
  • Respiration, Artificial / adverse effects
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • Hydroxychloroquine