Medical Journal of the Islamic Republic Of Iran

en Age-Adjusted in-Hospital Mortality in Patients with COVID-19 Infection: Impact of the Presence of Multiple Comorbidities Endocrinology Endocrinology Original Research Original Research Background: Mortality has been indicated to be high in patients with underlying diseases. This study aimed to examine the comorbidities is associated with a higher risk of death during the hospital course.    Methods: We retrospectively evaluated the risk of in-hospital death in 1368 patients with COVID-19 admitted to 5 academic hospitals in Tehran between February 20 and June 13, 2020.  We also assessed the composite end-point of intensive care unit admission, invasive ventilation, and death. The Cox proportional survival model determined the potential comorbidities associated with deaths and serious outcomes.    Results: The retrospective follow-up of patients with COVID-19 over 5 months indicated 280 in-hospital deaths. Patients with diabetes (risk ratio (RR), 1.47 (95% CI, 1.10-1.95); P = 0.008) and chronic kidney disease (RR, 1.72 (95% CI, 1.16-2.56); P = 0.007) showed higher in-hospital mortality. Upon stratifying data by age, patients aged ˂65 years showed a greater risk of in-hospital death in the presence of 2 (hazard ratio (HR), 2.68 (95% CI, 1.46-4.95); P = 0.002) or more (HR, 3.47 (95% CI, 1.69-7.12); P = 0.001) comorbidities, compared with those aged ≥ 65 years.    Conclusion: Having ≥ 2 comorbidities in nonelderly patients is associated with a greater risk of death during hospitalization. To reduce the mortality of COVID-19 infection, younger patients with underlying diseases should be the focus of attention for prevention strategies.   COVID-19, Comorbidity, Invasive Ventilation, Mortality, Iran 394 400 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1795-5&slc_lang=en&sid=1 Nader Tavakoli tavakoli.n@iums.ac.ir 200319475328460089309 200319475328460089309 Yes Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran Nahid Hashemi Madani nahid.hashemimadani@gmail.com 200319475328460089310 200319475328460089310 No Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran Mojtaba Malek malek.m@iums.ac.ir 200319475328460089311 200319475328460089311 No Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran Zahra Emami zemami64@gmail.com 200319475328460089312 200319475328460089312 No Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran Alireza Khajavi alireza.khajavi.student@gmail.com 200319475328460089313 200319475328460089313 No 4. Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Rokhsareh Aghili raghili@farabi.tums.ac.ir 200319475328460089314 200319475328460089314 No 2. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran Maryam Honardoost honardoost.m@iums.ac.ir 200319475328460089315 200319475328460089315 No Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran Fereshteh Abdolmaleki fe.abdolmaleki@gmail.com 200319475328460089316 200319475328460089316 No Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran Mohammad E. Khamseh خمسه khamseh.m@iums.ac.ir 200319475328460089317 200319475328460089317 No Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran