Research Article

Investigation of all-cause mortality and associated factors in patients diagnosed with COVID-19: A Retrospective Cohort Study

Volume: 21 Number: 3 December 15, 2023
EN

Investigation of all-cause mortality and associated factors in patients diagnosed with COVID-19: A Retrospective Cohort Study

Abstract

Objective: This study aims to investigate the extent and associated factors of all-cause mortality in patients diagnosed with COVID-19 in a hospital for over a one-year follow-up period. Methods: This retrospective cohort study was conducted on the patients who applied and tested positive for SARS-CoV-2 in the Dokuz Eylul University Hospital which is a large tertiary healthcare facility in Izmir, Turkey, between 19.03.2020 and 31.05.2021. The study included 8955 adult patients with a positive SARS-CoV-2 PCR test. Kaplan-Meier survival analysis and Cox regression models were used to examine the relationships between demographic and clinical characteristics and mortality. Results: The cumulative all-cause mortality rate was 4.7% in COVID-19 patients. Patients over 80 years old had a significantly higher risk of death compared to those younger than 50 years old (aHR:22.3; 95% CI: 10.4-47.7). Current or ex-smokers had a higher risk of death compared to non-smokers (aHR: 1.6; 95% CI: 1.1-2.4). Patients without any complaints before diagnosis had a higher risk of death compared to those with three or more complaints (aHR: 1.7; 95% CI: 1.2-2.6). Patients hospitalized in the intensive care unit had a significantly higher risk of death compared to outpatients (aHR: 62.3; 95% CI: 37.6-101.9). Conclusions: In COVID-19 patients, the risk of all-cause mortality is higher in the elderly, smokers, individuals admitted to medical or intensive care services, and those with a decreasing number of pre-diagnostic complaints. Monitoring patients with long follow-up periods and determining the course of illness and cause of death are important for understanding the natural course of COVID-19.

Keywords

COVID-19, mortality, Follow-Up Study

Supporting Institution

There is no Supporting Institution.

Project Number

The study was not carried out within the scope of the project.

References

  1. WHO. Coronavirus (COVID-19) Dashboard. Published October 8, 2023. Accessed October 8, 2022. https://covid19.who.int
  2. Natasha H, Egbert S, Annemarie TV. Conflict And Health. McGraw-Hill Education (UK); 2012.
  3. Karlinsky A, Kobak D. Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset. eLife. 2021;10:e69336. doi:10.7554/eLife.69336
  4. Alharthy A, Aletreby W, Faqihi F, et al. Clinical characteristics and predictors of 28-day mortality in 352 critically ill patients with COVID-19: a retrospective study. J Epidemiol Glob Health. 2021;11(1):98.
  5. Wang S, Ma P, Zhang S, et al. Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study. Diabetologia. 2020;63(10):2102-2111.
  6. Ioannidis JPA. Infection fatality rate of COVID-19 inferred from seroprevalence data. Bull World Health Organ. 2021;99(1):19-33F. doi:10.2471/BLT.20.265892
  7. WHO. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 3 March 2020. Published March 3, 2020. Accessed May 19, 2022. https://www.who.int/director-general/speeches/detail/who-director-general-s-openingremarks-at-the-media-briefing-on-covid-19---3-march-2020
  8. Verduri A, Short R, Carter B, et al. Comparison between first and second wave of COVID-19 outbreak in older people. The COPE multicentre European observational cohort study. Eur J Public Health. Published online August 23, 2022:ckac108. doi:10.1093/eurpub/ckac108
  9. Ferguson N, Laydon D, Nedjati Gilani G, et al. Report 9: Impact of Non-Pharmaceutical Interventions (NPIs) to Reduce COVID19 Mortality and Healthcare Demand. Imperial College London; 2020. doi:10.25561/77482
  10. Woorim K, Ji Min H, Kyung. Predictors of Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis. 2020;30(3):169-176.
APA
Süner, A. F., Emecen, A. N., Keskin, S., Şiyve, N., Başoğlu Şensoy, E., Turunç, Ö., & Ünal, B. (2023). Investigation of all-cause mortality and associated factors in patients diagnosed with COVID-19: A Retrospective Cohort Study. Turkish Journal of Public Health, 21(3), 336-348. https://doi.org/10.20518/tjph.1293201
AMA
1.Süner AF, Emecen AN, Keskin S, et al. Investigation of all-cause mortality and associated factors in patients diagnosed with COVID-19: A Retrospective Cohort Study. TJPH. 2023;21(3):336-348. doi:10.20518/tjph.1293201
Chicago
Süner, Ahmet Furkan, Ahmet Naci Emecen, Salih Keskin, et al. 2023. “Investigation of All-Cause Mortality and Associated Factors in Patients Diagnosed With COVID-19: A Retrospective Cohort Study”. Turkish Journal of Public Health 21 (3): 336-48. https://doi.org/10.20518/tjph.1293201.
EndNote
Süner AF, Emecen AN, Keskin S, Şiyve N, Başoğlu Şensoy E, Turunç Ö, Ünal B (December 1, 2023) Investigation of all-cause mortality and associated factors in patients diagnosed with COVID-19: A Retrospective Cohort Study. Turkish Journal of Public Health 21 3 336–348.
IEEE
[1]A. F. Süner et al., “Investigation of all-cause mortality and associated factors in patients diagnosed with COVID-19: A Retrospective Cohort Study”, TJPH, vol. 21, no. 3, pp. 336–348, Dec. 2023, doi: 10.20518/tjph.1293201.
ISNAD
Süner, Ahmet Furkan - Emecen, Ahmet Naci - Keskin, Salih - Şiyve, Neslişah - Başoğlu Şensoy, Ecem - Turunç, Öykü - Ünal, Belgin. “Investigation of All-Cause Mortality and Associated Factors in Patients Diagnosed With COVID-19: A Retrospective Cohort Study”. Turkish Journal of Public Health 21/3 (December 1, 2023): 336-348. https://doi.org/10.20518/tjph.1293201.
JAMA
1.Süner AF, Emecen AN, Keskin S, Şiyve N, Başoğlu Şensoy E, Turunç Ö, Ünal B. Investigation of all-cause mortality and associated factors in patients diagnosed with COVID-19: A Retrospective Cohort Study. TJPH. 2023;21:336–348.
MLA
Süner, Ahmet Furkan, et al. “Investigation of All-Cause Mortality and Associated Factors in Patients Diagnosed With COVID-19: A Retrospective Cohort Study”. Turkish Journal of Public Health, vol. 21, no. 3, Dec. 2023, pp. 336-48, doi:10.20518/tjph.1293201.
Vancouver
1.Ahmet Furkan Süner, Ahmet Naci Emecen, Salih Keskin, Neslişah Şiyve, Ecem Başoğlu Şensoy, Öykü Turunç, Belgin Ünal. Investigation of all-cause mortality and associated factors in patients diagnosed with COVID-19: A Retrospective Cohort Study. TJPH. 2023 Dec. 1;21(3):336-48. doi:10.20518/tjph.1293201