Evaluating the Effects of Clinical Characteristics and Therapeutic Regimens on Mortality in Hospitalized Patients with Severe COVID-19

The coronavirus disease 2019 (COVID-19) is highly contagious and has turned into a global health problem.  In this study, we investigated the role of clinical and laboratory characteristics along with administered therapeutic agents in patients with COVID-19, and identified some effective factors on the mortality of these individuals. 

In this retrospective study, we evaluated the data from all the hospitalized patients who had been diagnosed with COVID-19 between February 23 and May 23, 2020. The data were obtained from medical records. Additionally, a checklist was used to record demographic, clinical, laboratory, imaging, and treatment data for each patient. 

Totally, 478 patients were involved in this study, and their median age was 58.5 years. Of these, 53.3% patients were male. The most common pre-existing underlying disease was hypertension (37.9%), and the mortality group had significantly more comorbidities (85.4%).  Higher neutrophil lymphocyte ratio (NLR), lymphopenia, and reduced hemoglobin were more frequent in the mortality group (p < 0.001).  Similarly, the need to be admitted to the intensive care unit was significantly greater in the mortality group (p<0.001). The most frequently administered therapeutic regimens included hydroxychloroquine and lopinavir/ritonavir, which did not have any correlation with survival outcome. 

Older age, opioid addiction, cardiovascular disease, kidney disease, baseline NLR and hemoglobin, and ICU admission were independently associated with COVID-19 mortality. On the other hand, hydroxychloroquine and lopinavir/ritonavir indicated no beneficial effects on patients’ outcome.