bims-covirf 2022-01-02 papers

Issue of 2022–01–02
two papers selected by
Catherine Rycroft, BresMed

Heliyon. 2021 Dec;7(12): e08566

Determinants of all-cause in-hospital mortality among patients who presented with COVID-19 to a community teaching hospital in Michigan.

Ali Zakaria, Marc Piper, Lahib Douda, Nancy M Jackson, Jeffrey C Flynn, Dawn P Misra, Joseph Gardiner, Abdulghani Sankari.

Background & objectives: Race plays an important role in healthcare disparities, often resulting in worse health outcomes. It is unclear if other patient factors and race interactions may influence mortality in patients with COVID-19. We aimed to evaluate how multiple determinants of all-cause in-hospital mortality from COVID-19 were linked to race.
Methods: A retrospective observational study was conducted at two hospitals in metropolitan Detroit. We identified patients aged ≥18 years-old who had tested positive for COVID-19 and were admitted between March 9 through May 16, 2020. Multivariable logistic regression was performed assessing predictors of all-cause in-hospital mortality in COVID-19.
Results: We identified 1064 unique patients; 74% were African Americans (AA). The all-cause in-hospital mortality was 21.7%, with the majority of deaths seen in AA (65.4%, P = 0.002) and patients 80 years or older (52%, P < 0.0001). AA women had lower all-cause mortality than AA men, white women, and white men based on race-gender interactions. In multivariable logistic regression analysis, older age (>80-year-old), dementia, and chronic kidney disease were associated with worse all-cause in-hospital mortality. Adjusted for race and body mass index (BMI), the main odds ratios (OR) and 95% confidence intervals (CI) are: Age 80 and older vs < 60 in females: OR = 7.4, 95% CI: 2.9, 18.7; in males OR = 7.3, 95% CI: 3.3, 16.2; Chronic Kidney Disease (CKD): OR = 1.7, 95% CI: 1.2, 2.6; Dementia: OR = 2.2, 95% CI: 1.5, 3.3.
Conclusion: Gender significantly modified the association of race and COVID-19 mortality. African American females had the lowest all-cause in-hospital mortality risk compared to other gender-race groups.

Keywords: COVID-19; Mortality; Race-gender interaction; Racial disparity

DOI: https://doi.org/10.1016/j.heliyon.2021.e08566

Med J Islam Repub Iran. 2021 ;35 103

Predictors of death in patients with COVID-19: A cross-sectional study in West of Iran.

Manoochehr Karami, Mohammad Mirzaei, Fatemeh Shahbazi, Fariba Keramat, Ebrahim Jalili, Saeid Bashirian, Rashid Heidarimoghadam, Jalal Bathaei, Salman Khazaei.

Background: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a newly identified coronavirus. Our knowledge about the survival rate and prognostic factors of the disease is not established well. The purpose of this study was to evaluate the predictors of COVID-19 mortality in Hamadan province in western Iran. Methods: In this study, we included all laboratory-confirmed COVID-19 cases with known treatment outcomes in Hamadan province, Iran, between 20, 2020, to May 10, 2020. Demographic, clinical, laboratory data, and treatment outcomes were obtained from computerized medical records and compared between survived cases and patients with death outcomes. Univariable and multivariable logistic regression models were used to determine the predictors of death. Results: From 749 investigated patients, 77 patients (10.28%) died during the treatment. The Mean age of patients was 53.97±19.04 years. Multivariable logistic regression showed that males had 2.07 (95% CI: 1.73, 2.54) fold higher odds of death. Those with 60 years old and more had 6.49 (95% CI: 4.53, 7.93) fold higher odds of death. Patients with an underlying disease had 7.14 (95% CI: 6.94, 7.38) fold higher odds of death, and patients who were hospitalized in the ICU ward had 2.24 (95% CI: 1.75, 2.90) times higher odds of COVID-19 related mortality. Conclusion: The potential predictors of death in COVID-19 cases, including the male gender, older age, and having an underlying disease could help physicians to identify patients with poor prognoses at an early stage and better management of them.

Keywords: COVID-19; Coronavirus; Epidemiology; Iran; Mortality

DOI: https://doi.org/10.47176/mjiri.35.103