Arch Iran Med. 2022;25(6): 383-393.
doi: 10.34172/aim.2022.62

Scopus ID: 85134801373
  Abstract View: 747
  PDF Download: 466


Original Article

Severity of Disease and COVID-19 Complications During Hospital Stay: A Prospective Cohort Study

Ramin Sami 1 ORCID logo, Forogh Soltaninejad 1 ORCID logo, Azin Shayganfar 2 ORCID logo, Sam Mirfendereski 2 ORCID logo, Marjan Mansourian 3 ORCID logo, Nilufar Khademi 4 ORCID logo, Mehrnegar Dehghan 4 ORCID logo, Zahra Khorrami 5, Soheila Jalali 6, Zeinab Mokhtari 7* ORCID logo

1 Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Biostatistics, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
4 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
5 Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
7 Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
*Corresponding Author: Corresponding Author: Zeinab Mokhtari, PhD; Hezar Jerib street, Isfahan, Iran. Tel:+98-913-1021323, E-mail: zeinab_mokhtary@yahoo.com, , Email: mokhtari@nutr.mui.ac.ir


Background: COVID-19, with its high transmission and mortality rates and unknown outcomes, has become a major concern in the world. Among people with COVID-19, severe cases can quickly progress to serious complications, and even death. So, the present study aimed to examine the relationship between the severity of the disease and the outcome in patients afflicted by COVID-19 during hospitalization.

Methods: A total of 653 patients with COVID-19 aged 18 years or older were included from Khorshid hospital in Isfahan, Iran and followed for a mean of 22.72 days (median 23.50; range 1–47). Severe COVID-19 was defined by respiration rate≥30 times/min, oxygen saturation level≤88% in the resting position, and pulse rate≥130/min. The primary outcome was mortality. The secondary outcomes included need for mechanical ventilation and intensive care unit (ICU) admission.

Results: During 4233 person-days of follow-up, 49 (7.5%) deaths, 27 (4.1%) invasive ventilation and 89 (13.6%) ICU admissions in hospital were reported. After adjustment for potential confounders, severity of the disease was positively associated with risk of mortality, invasive ventilation and ICU admissions (hazard ratio [HR]: 5.99; 95% CI: 2.85, 12.59; P<0.001, HR: 7.09; 95% CI: 3.24, 15.52; P<0.001 and HR: 4.88; 95% CI: 2.98, 7.98; P<0.001, respectively). In addition, greater age (HR=1.04; 95% CI=1.02-1.07; P=0.002), chronic kidney disease (HR=3.05; 95% CI=1.35, 6.90; P=0.008), blood urea nitrogen (BUN) (HR=1.04; 95% CI=1.03–1.05; P<0.001) and creatinine (HR=1.44; 95% CI=1.26-1.65; P<0.001) were probably significant risk factors for mortality in severe COVID-19 patients.

Conclusion: More intensive therapy and special monitoring should be implemented for patients with older age, hypertension and kidney disease who are infected with COVID-19 to prevent rapid worsening.

Cite this article as: Sami R, Soltaninejad F, Shayganfar A, Mirfendereski S, Mansourian M, Khademi N, et al. Severity of disease and covid-19 complications during hospital stay: a prospective cohort study. Arch Iran Med. 2022;25(6):383-393. doi: 10.34172/ aim.2022.62
First Name
Last Name
Email Address
Security code

Abstract View: 748

Your browser does not support the canvas element.

PDF Download: 466

Your browser does not support the canvas element.

Submitted: 06 Mar 2021
Revision: 15 Sep 2021
Accepted: 04 Oct 2021
ePublished: 01 Jun 2022
EndNote EndNote

(Enw Format - Win & Mac)

BibTeX BibTeX

(Bib Format - Win & Mac)

Bookends Bookends

(Ris Format - Mac only)

EasyBib EasyBib

(Ris Format - Win & Mac)

Medlars Medlars

(Txt Format - Win & Mac)

Mendeley Web Mendeley Web
Mendeley Mendeley

(Ris Format - Win & Mac)

Papers Papers

(Ris Format - Win & Mac)

ProCite ProCite

(Ris Format - Win & Mac)

Reference Manager Reference Manager

(Ris Format - Win only)

Refworks Refworks

(Refworks Format - Win & Mac)

Zotero Zotero

(Ris Format - Firefox Plugin)