Determine the consequences of delay in referring to the hospital in patients with COVID-19 in Shahid Mostafa Khomeini Hospital of Ilam Province

Background: COVID-19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis. Infected subjects are at high risk for coagulation diseases such as venous thromboembolism. Therefore, the present study was conducted to investigate the consequences of delayed referral of patients with Quaid-19 in Ilam. Methods: In this study, a present prospective study was performed in 2020 on the registry data of patients with COVID-19 disease in the infectious ward of Shahid Mostafa Khomeini Hospital in Ilam.. In this study, the effect of delay in hospitalization from the onset of the first symptom of the disease on death and intubation of patients in special and general wards in 2350 patients with COVID-19 was investigated. Delays in referrals were recorded by day and based on the biographies recorded in the patients' files. In this registry, only 96% of patients reported a delay of 1 to 60 days. The effect of the delay on mortality as well as the intubation rate were analyzed using logistic regression models in Stata software 12. Results: The average number of days of delay in referral according to different variables for deceased patients, requiring intubation and requiring hospitalization in the ICU is listed in Table 1. The results of univariate logistic regression analysis for the main causes of death due to COVID-19 disease according to hospitalization in ICU and general ward showed that the variables of age, sex, marital status, heart disease, blood pressure, diabetes, chronic lung disease, chronic disease Kidney, neurological disease, cancer and delayed referral were statistically significantly associated with death at the 5% error level. The chance of death for delayed referral in ICU patients is equal (OR ICU ADMISSION = 1.06; 95% CI, 1.01 - 1.12; P value = 0.01) and in normal ward patients (OR = 0.88; 95% CI, 0.79 - 0.97; P value = 0.01 was obtained. Conclusions: According to the results of the final regression model which were adjusted to other variables, in hospitalized patients, each day of delay in hospitalization meant a 0.08% increase in the odds of mortality rate and a 0.05% increase in the odds of intubation.