Prevalence and predictors of in-hospital mortality of patients hospitalized with COVID-19 infection

BACKGROUND: The severity and mortality from COVID-19 infection vary among populations. The aim of this study was to determine the prevalence and predictors of mortality among patients hospitalized with COVID-19 infection in a tertiary care hospital in Oman. METHODS: We conducted a retrospective study using database that included: demographic, clinical characteristics, laboratory parameters, medications and clinical outcomes of all patients hospitalized in Royal Hospital, Muscat, Oman, between March 12, 2020 and December 1st 2020. Univariate and multivariate logistic regression was performed to investigate the relationship between each variable and the risk of death of COVID-19 infected patients. RESULTS: In total,1002 patients with COVID-19 infection with mean age of the cohort was 54 ± 16 years (65% (n = 650) male) were included, with an overall and intensive care unit (ICU) mortalities of 26% (n = 257) and 42% (n = 199/473), respectively. The prevalence of ICU admission was 47% (n = 473) and the need for mechanical ventilation was 41% (n = 413). The overall length of stay in the ICU was 13 (9–21) days. Adjusting for other factors in the model, the multivariable logistic regression demonstrated that in-hospital mortality in admitted COVID-19 patients was associated with old age (p < 0.001), heart diseases (adjusted odds ratio (aOR), 1.84; 95% confidence interval (CI): 1.11–3.03; p = 0.018), liver diseases (aOR, 4.48; 95% CI: 1.04–19.3; p = 0.044), those with higher ferritin levels (aOR, 1.00; 95% CI: 1.00–1.00; p = 0.006), acute respiratory distress syndrome (ARDS) (aOR, 3.20; 95% CI: 1.65–6.18; p = 0.001), sepsis (aOR, 1.77; 95% CI: 1.12–2.80; p = 0.022), and those that had ICU admission (aOR, 2.22; 95% CI: 1.12–4.38; p = 0.022). CONCLUSION: In this cohort, mortality in hospitalized COVID-19 patients was high and was associated with advanced age, heart diseases, liver disease, high ferritin, ARDS, sepsis and ICU admission. These high-risk groups should be prioritized for COVID-19 vaccinations.