Tehran University Medical Journal

Background: Early prediction of the outcome situation of COVID-19 patients can decrease mortality risk by assuring efficient resource allocation and treatment planning. This study introduces a very accurate and fast system for the prediction of COVID-19 outcomes using demographic, vital signs, and laboratory blood test data.
Methods: In this analytic study, which is done from May 2020 to June 2021 in Tehran, 41 features of 244 COVID-19 patients were recorded on the first day of admission to the Masih Daneshvari Hospital. These features were categorized into eight different groups, demographic and patient history features, vital signs, and six different groups of laboratory blood tests including complete blood count (CBC), coagulation, kidney, liver, blood gas, and general. In this study, first, the significance of each of the extracted features and then the eight groups of features for prediction of mortality outcomes were considered, separately. Finally, the best combination of different groups of features was assessed. The statistical methods including the area under the receiver operating characteristic curve (AUC-ROC) based on binary Logistic Regression classification algorithm were used for evaluation.

Background: Coronavirus in 2019 was recognized as one of the leading causes of death worldwide. According to reports, the mortality rate in people who need mechanical ventilation varies from 50 to 97 percent. The aim of this study was to evaluate the outcome of Covid-19 disease based on different characteristics in patients and mechanically ventilated variables.
Methods: This descriptive-analytical study was conducted on 160 patients with a definite diagnosis of Covid-19 who were under mechanical ventilation and admitted to the intensive care unit of Alzahra Hospital in Isfahan from March 2020 to March 2021. Data was collected by checklist. The checklist included demographic information, including age, gender, as well as information such as underlying diseases, disease outcome, length of hospitalization, etc. After collecting the data, they were analyzed in SPSS software version 22 and at a significance level of less than 0.05.

Results: In this study, the overall mortality rate among mechanically ventilated patients was 62.5%. The mean age of patients was 69.99±17.87 years and the mean duration of hospitalization in surviving patients was 15.47±11.73 days and for deceased ones was 55.21±69.14 days. The mean age of the deceased group (65.71±16.59) was significantly higher than the surviving group 53±21.17 was (P=0.0001). The length of hospital stay in the deceased group was significantly longer than the surviving group (P=0.005). As a result, ventilator mode and inotropic agent intake during treatment increased the chance of mortality in patients under mechanical ventilation (P=0.001). There was a significant relationship between underlying diseases of hypertension, kidney disease and autoimmune disease with mortality in patients (P<0.05). Conclusion: Various factors including the length of stay in the hospital, comorbidities such as hypertension, renal disease and autoimmunity may affect the outcome of critically ill ICU patients under mechanical ventilation. Patients who require long-term invasive ventilation and the use of inotropic drugs to maintain their cardiovascular status while hospitalized in the ICU are at higher risk for mortality.

Background: Alkaptonuria is a rare disorder that leads to excessive production and accumulation of homogentisic acid in body tissues, and this increase causes tissue degeneration and organ dysfunction through a process called achromasia. Due to very few studies in the field of this disease and access to epidemiological data for the first time in Iran, the present study was conducted with the aim of epidemiological investigation of the mortality rate of patients with alkaptonuria during the years 2013 to 2022 in Iran.
Methods: The design of the present study was cross-sectional (descriptive-analytical). The data related to the deceased registered according to the international coding system of diseases (ICD-10) were extracted from the system of registration and classification of the causes of death of Iran for death due to alkaptonuria disease. The variables investigated in this study included: age, gender and residence status of the deceased. Chi-square and Fisher's exact test were also used to analyze the data.

Results: The specific death rate was calculated as 0.31 per one million people of the population. In this study, 90% of the deaths occurred at the age of less than five years. The age variable included two groups of less than five years and more than five years, where 90% of deaths occurred at the age of less than five years. 60% of the deceased were men and 40% were women. Regarding the residence status variable, 82% of the cases were urban and the rest were rural. Finally, there was no significant difference between the incidence of death due to alkaptonuria disease and the investigated variables, which are age (P=0.291), gender (P=0.958) and residence status (P=0.273). Conclusion: According to the findings in the present study, although no significant difference was observed between age and the number of cases of death due to alkaptonuria; But most cases of death have occurred in young age groups, which seems that more studies are needed to understand the different dimensions of this disease