Iranian Journal of Medical Sciences

Document Type : Original Article(s)

Authors

1 Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2 Nursing Care Research Center, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran

3 Hazrate Ali-Asghar Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

4 Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

5 Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

6 Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

7 Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

8 Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

9 Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran

10 Aachen Faculty of Medicine, Aachen, North Rhine-Westphalia, Germany

11 Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran

10.30476/ijms.2021.89916.2068

Abstract

Background: The coronavirus disease 2019 (COVID-19) has become the leading source of pneumonia outbreaks in the world. The present study aimed to compare the condition of intensive care unit (ICU) and non-ICU COVID-19 patients in terms of epidemiological and clinical features, laboratory findings, and outcomes in three cities across Iran.
Methods: In a cross-sectional study, 195 COVID-19 patients admitted to five hospitals across Iran during March-April 2020 were recruited. Collected information included demographic data, laboratory findings, symptoms, medical history, and outcomes. Data were analyzed using SPSS software with t test or Mann-Whitney U test (continuous data) and Chi square test or Fisher’s exact test (categorical variables). P<0.05 was considered statistically significant.
Results: Of the 195 patients, 57.4% were men, and 67.7% had at least one comorbidity. The prevalence of stroke, chronic obstructive pulmonary disease, and autoimmune diseases was higher in ICU than in non-ICU patients (P=0.042, P=0.020, and P=0.002, respectively). Compared with non-ICU, ICU patients had significantly higher white blood cell (WBC) count (P=0.008), cardiac troponin concentrations (P=0.040), lactate dehydrogenase levels (P=0.027), erythrocyte sedimentation rates (P=0.008), and blood urea nitrogen (BUN) (P=0.029), but lower hematocrit levels (P=0.001). The mortality rate in ICU and non-ICU patients was 48.1% and 6.1%, respectively. The risk factors for mortality included age>40 years, body mass index<18 Kg/m2, hypertension, coronary artery disease, fever, cough, dyspnea, ST-segment changes, pericardial effusion, and a surge in WBC and C-reactive protein, aspartate aminotransferase, and BUN.
Conclusion: A high index of suspicion for ICU admission should be maintained in patients with positive clinical and laboratory predictive factors.

Keywords

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