The Prognostic Factors Affecting the Survival of Kurdistan Province COVID-19 Patients: A Cross-sectional Study From February to May 2020

Document Type : Original Article


1 Kurdistan University of Medical Sciences, Sanandaj, Iran

2 Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran

3 Department of Infectious Disease, Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran


Coronavirus disease 2019 (COVID-19) is a new viral disease and in a short period of time, the world has been affected in various economic, social, and health aspects. This disease has a high rate of transmission and mortality. The aim of this study is to investigate the factors affecting the survival of COVID-19 patients in Kurdistan province.
In this retrospective study, the data including demographic features and the patient’s clinical background in terms of co-morbidities such as diabetes, cancer, chronic lung disease (CLD), coronary heart disease (CHD), chronic kidney disease (CKD) and weak immune system (WIS) were extracted from electronic medical records. We use Cox’s regression proportional hazard (PH) to model.
In this study, out of 1831 patients, 1019 were males (55.7%) and 812 were females (44.3%) with an average age of 52.74 ± 22.16 years. For survival analysis, data from people infected with COVID-19 who died or were still being treated were used. According to Cox’s regression analysis, age variables (hazard ratio [HR]: 1.03, CI: 1.02-1.04), patients with a history of diabetes (HR: 2.16, CI: 1.38-3.38), cancer (HR: 3.57, CI: 1.82-7.02), CLD (HR: 2.21, CI: 1.22-4) and CHD (HR: 2.20, CI: 1.57-3.09) were significant and affected the hazard of death in patients with COVID-19 and assuming that the other variables in the model are constant, the hazard of death increases by 3% by increasing one unit (year), and the hazard of death in COVID-19 patients with CHD, diabetes, cancer, CLD is 2.16, 3.57, 2.2 and 2.21, respectively.
According to findings, it is necessary to evaluate the prevalence of COVID-19 in patients with CLD, diabetes, cancer, CHD, and elder, as patients with these characteristics may face a greater risk of death. Therefore, we suggest that elders and people with those underlying illnesses need to be under active surveillance and screened frequently.


Main Subjects

  1. Jung SM, Akhmetzhanov AR, Hayashi K, et al. Real-time estimation of the risk of death from novel coronavirus (COVID-19) infection: inference using exported cases. J Clin Med. 2020;9(2). doi:10.3390/jcm9020523
  2. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. doi:10.1016/s0140-6736(20)30566-3
  3. Zhang L, Zhu F, Xie L, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020;31(7):894-901. doi:10.1016/j.annonc.2020.03.296
  4. World Health Organization (WHO). Coronavirus Disease 2019 (COVID-19): Situation Report, 93. WHO; 2020.
  5. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846-848. doi:10.1007/s00134-020-05991-x
  6. Cheng Y, Luo R, Wang K, et al. Kidney impairment is associated with in-hospital death of COVID-19 patients. medRxiv. 2020. doi:10.1101/2020.02.18.20023242
  7. Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020;17(5):259-260. doi:10.1038/s41569-020-0360-5
  8. Sohrabi C, Alsafi Z, O'Neill N, et al. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76:71-76. doi:10.1016/j.ijsu.2020.02.034
  9. Li B, Yang J, Zhao F, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531-538. doi:10.1007/s00392-020-01626-9
  10. Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17(3):181-192. doi:10.1038/s41579-018-0118-9
  11. Choi KW, Chau TN, Tsang O, et al. Outcomes and prognostic factors in 267 patients with severe acute respiratory syndrome in Hong Kong. Ann Intern Med. 2003;139(9):715-723. doi:10.7326/0003-4819-139-9-200311040-00005
  12. Oh MD, Park WB, Park SW, et al. Middle East respiratory syndrome: what we learned from the 2015 outbreak in the Republic of Korea. Korean J Intern Med. 2018;33(2):233-246. doi:10.3904/kjim.2018.031
  13. Hong KH, Choi JP, Hong SH, et al. Predictors of mortality in Middle East respiratory syndrome (MERS). Thorax. 2018;73(3):286-289. doi:10.1136/thoraxjnl-2016-209313
  14. Zumla A, Hui DS, Perlman S. Middle East respiratory syndrome. Lancet. 2015;386(9997):995-1007. doi:10.1016/s0140-6736(15)60454-8
  15. Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802-810. doi:10.1001/jamacardio.2020.0950
  16. Groneberg DA, Zhang L, Welte T, Zabel P, Chung KF. Severe acute respiratory syndrome: global initiatives for disease diagnosis. QJM. 2003;96(11):845-852. doi:10.1093/qjmed/hcg146
  17. Schoen K, Horvat N, Guerreiro NFC, de Castro I, de Giassi KS. Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity. BMC Infect Dis. 2019;19(1):964. doi:10.1186/s12879-019-4592-0
  18. Song Z, Xu Y, Bao L, et al. From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses. 2019;11(1). doi:10.3390/v11010059
  19. Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020;395(10231):1225-1228. doi:10.1016/s0140-6736(20)30627-9
  20. Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-95. doi:10.1016/j.ijid.2020.03.017
  21. He W, Chen L, Chen L, et al. COVID-19 in persons with haematological cancers. Leukemia. 2020;34(6):1637-1645. doi:10.1038/s41375-020-0836-7
Volume 11, Issue 4
April 2022
Pages 453-458
  • Receive Date: 08 June 2020
  • Revise Date: 08 August 2020
  • Accept Date: 09 August 2020
  • First Publish Date: 01 April 2022