ﺑﺮرﺳﯽ ﻋﻮاﻣﻞ ﺧﻄﺮ ﻣﺮگ و ﻣﯿﺮ ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﮐﻮوﯾﺪ-19: ﯾﮏ ﻣﻄﺎﻟﻌﻪ ﻣﻮرد-ﻫﻤﮕﺮوﻫﯽ در ﯾﺰد

Death Risk Among COVID-19 Patients in Yazd, Iran: A Hospital-based Case-cohort Study

اﭘﯿﺪﻣﯽ و ﻣﻬﺎر وﯾﺮوس ﮐﻮوﯾﺪ-19 ﺑﻪ ﯾﮑﯽ از ﻣﺸﮑﻼت ﺟﻬﺎﻧﯽ ﺗﺒﺪﯾﻞ ﺷﺪه و در اﯾﻦ ﻣﯿﺎن ﻧﻘﺶ ﻣﺘﻐﯿﺮﻫﺎي ﻣﺨﺘﻠﻒ ﻫﻨﻮز ﺑﺮاي ﺳﯿﺎﺳﺖ ﮔﺬاران ﻧﺎﺷﻨﺎﺧﺘﻪ اﺳﺖ. ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ ﻋﻮاﻣﻞ ﺧﻄﺮ ﻣﺮگ و ﻣﯿﺮ ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﮐﻮوﯾﺪ-19 ﺑﻪ ﺻﻮرت ﯾﮏ ﻣﻄﺎﻟﻌﻪ ﻣﻮرد-ﻫﻤﮕﺮوﻫﯽ ﺑﻪ اﻧﺠﺎم رﺳﯿﺪ. روشﻫﺎ: ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ از ﻧﻮع ﻣﻄﺎﻟﻌﻪ ﻣﻮرد-ﻫﻤﮕﺮوﻫﯽ ﻣﯽﺑﺎﺷﺪ. ﻧﻤﻮﻧﻪ ﺗﺤﻘﯿﻖ ﺷﺎﻣﻞ 1465 ﻧﻔﺮ در ﯾﺰد ﺑﻮدﻧﺪ ﮐﻪ در ﺷﺶ ﻣﺎﻫﻪ اول ﺳﺎل 1399 ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ اﻃﻼﻋﺎت ﺑﺎ اﺳﺘﻔﺎده از آﻣﺎرهﻫﺎي ﺗﻮﺻﯿﻔﯽ و آزﻣﻮنﻫﺎي آﻣﺎري ﮐﺎي اﺳﮑﻮﺋﺮ و رﮔﺮﺳﯿﻮن ﮐﺎﮐﺲ اﻧﺠﺎم ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: از ﻣﺠﻤﻮع 1465 ﺟﻤﻌﯿﺖ ﻫﻤﮕﺮوه، 1236 ﻧﻔﺮ در ﮔﺮوه ﺷﺎﻫﺪ و 229 ﻧﻔﺮ در ﮔﺮوه ﻣﻮرد، ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﻧﺘﺎﯾﺞ رﮔﺮﺳﯿﻮن ﮐﺎﮐﺲ ﭼﻨﺪﮔﺎﻧﻪ ﻧﺸﺎن داد اﻓﺰاﯾﺶ ﯾﮏ ﺳﺎل ﺳﻦ ﺷﺎﻧﺲ ﻣﺮگ را 2/7 درﺻﺪ اﻓﺰاﯾﺶ ﻣﯽدﻫﺪ )0/001< HR = 1/027 ،P(. دارا ﺑﻮدن ﺑﯿﻤﺎري ﻗﻠﺒﯽ و ﻋﺮوﻗﯽ، ﺑﯿﻤﺎري دﯾﺎﺑﺖ، ﺑﯿﻤﺎري ﻣﺰﻣﻦ ﻋﺼﺒﯽ، ﺑﯿﻤﺎري ﻣﺰﻣﻦ رﯾﻮي و ﺑﺪﺧﯿﻤﯽ ﺷﺎﻧﺲ ﻣﺮگ را اﻓﺰاﯾﺶ ﻣﯽدﻫﺪ. ﺑﯿﻤﺎران ﺑﺴﺘﺮي در ﺑﺨﺶ ﻣﺮاﻗﺒﺖﻫﺎي وﯾﮋه ﻧﺴﺒﺖ ﺑﻪ ﺳﺎﯾﺮﯾﻦ 200 درﺻﺪ ﺧﻄﺮ ﻣﺮگ ﺑﯿﺸﺘﺮي داﺷﺘﻨﺪ )0/001< HR = 3/009 ،P(. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻧﺘﺎﯾﺞ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد ﻣﺮگ و ﻣﯿﺮ در ﮔﺮوه ﻣﻮرد و اﻓﺮاد ﻣﺴﻦ و داراي ﺑﯿﻤﺎريﻫﺎي زﻣﯿﻨﻪاي ﺑﯿﺸﺘﺮ از ﺳﺎﯾﺮ ﺑﯿﻤﺎران ﺑﻮده اﺳﺖ. ﺗﻮﺟﻪ وﯾﮋه ﺑﻪ ﺑﯿﻤﺎران در ﻣﻌﺮض ﺧﻄﺮ و ﺳﺎﻟﻤﻨﺪ در زﻣﯿﻨﻪ ﺗﺎﻣﯿﻦ رژﯾﻢ ﻏﺬاﯾﯽ ﻣﻨﺎﺳﺐ، ﺗﻘﻮﯾﺖ ﺧﻮد ﻣﺮاﻗﺒﺘﯽ در اﯾﻦ اﻓﺮاد و ﻓﺮاﻫﻢﺳﺎزي ﺗﺴﻬﯿﻼت ﺑﻠﻨﺪ ﻣﺪت ﭘﺰﺷﮑﯽ و ﻣﺮاﻗﺒﺘﯽ ﺑﺎﯾﺪ ﻣﻮرد ﺗﻮﺟﻪ ﻗﺮار ﮔﯿﺮد.

The COVID-19 epidemic control has become a global challenge and many contributing variables are still unknown to policymakers. This case-cohort study was conducted to investigate the risk factors of mortality in COVID-19 patients. Methods: This case-cohort study was conducted on 1465 samples in Yazd Province in the first six months of 2020. Data analysis was done using descriptive statistics and chi-square, and Cox regression analysis. Results: Of a total cohort population of 1465, 1236 were assigned to the control group and 229 were assigned to the case group. The results of multiple Cox regression showed that increasing one year of age increases the chance of death by 2.7% (HR = 1.027, P <0.001). Having cardiovascular disease, diabetes, chronic neurological disease, chronic lung disease and malignancy increases the chance of death. Patients admitted to the intensive care unit had a 200% higher risk of death than others (HR = 3.009, P <0.001). Conclusion: The results showed a higher mortality rate in elderly patients as well as those with underlying diseases. Attention should be paid to at-risk and elderly patients in terms of ensuring a healthy diet, improving their self-care practices, and providing long-term medical and healthcare facilities.