An investigation of risk factors of in-hospital death due to COVID-19: a case-control study in Rasht, Iran.

Background: Identifying the non-survived patients' characteristics compared to survived subjects and introducing the critical risk factors of COVID-19 mortality would help enhance patients' prognosis and treatment.

Methods: In the current case-control study, medical records of 103 non-survived COVID-19 patients (cases) and 147 sex-matched survivors (controls) who admitted to Razi University Hospital in Rasht, Guilan, Northern Iran from April 21 to August 21, 2020, were explored. Data on demographic, anthropometric, clinical, and laboratory assessment was extracted from the electronic medical records. To estimate the association between variables of interest and mortality odds due to COVID-19 logistic regression was carried out.

Results: The patients who died (mean age = 62.87 years) were older than the discharged patients (57.33 years; P value = 0.009). According to the results of multivariable regression adjusted for potential confounders, elevated BMI (OR = 2.49; 95% CI = 1.15-5.41), higher CRP levels (OR = 2.28; 95% CI = 1.08-4.78), increased FBS levels (OR = 2.88; 95% CI = 1.35-6.17), higher levels of total cholestrol (OR = 2.55; 95% CI = 1.19-5.45) and LDL (OR = 2.27; 95% CI = 1.07-4.79), elevated triglyceride (OR = 5.14; 95% CI = 2.28-11.56), and raised levels of D-dimer (OR = 5.68; 95% CI = 2.22-14.49) were identified as independent risk factors of COVID-19 mortality. No significant association was detected regarding HDL level, QTc interval or heart size, and COVID-19 fatality odds.

Conclusion: The present findings demonstrated that obesity, higher levels of CRP, blood sugar, D-dimer, and lipid markers were likely to be predictive factors of COVID-19-related mortality odds.