Results
Between March 2020 and November 2020, a total of 525 patients with COVID-19 PCR positive (n=504; 96.0%) or PCR negative and CT positive (n=21; 4.0%) were included in the study from the previously determined FHCs. Demographic and baseline characteristics were compared between outpatient, hospitalized, ICU, and dead patients (Table 1). While the most common complaint in outpatients was fatigue, the most common complaint in patients admitted to the hospital or ICU or who died was cough. Cough, fever, and shortness of breath were more common in patients who were hospitalized or in the ICU or who died compared to outpatients (p < 0.01) (Table 1). Education level, employment status and occupation data were not included in the analyzes because the relevant data were not available for all of the study population.
The COVID-19 treatment approach varied in time from March 2020, to November 2020 (Figure 1). While in April 2020 the predominant treatment was hydroxychloroquine, by November 2020 the predominant treatment was favipiravir according to guidelines of Turkish Ministry of Health. Considering the mortality, ICU admission and hospitalization rates by month, the highest mortality rate was seen in June 2020 with 4.8%. The highest rate of hospitalization and ICU admission was seen in March 2020; 92.9% and 14.3%, respectively (Table 2).
Increasing age was associated with an increased probability of hospitalization (p<0.05), ICU admission, and mortality (p<0.01). In addition, the presence of thoracic CT findings increased the probability of hospitalization 21 times (p<0.01), polypharmacy increased the probability of hospitalization by two times (p<0.05). Those with thoracic CT findings were 18 times more likely to be admitted to the ICU than those without (p<0.01). Being married was associated with a reduced probability of ICU admission (p<0.05) (Table 3).
The number of patients with asthma/chronic obstructive pulmonary disease (COPD) was 48 (Table 1). In 62.5% of these patients, COVID-19 thoracic CT findings were positive. Asthma/COPD was associated with developing thoracic CT findings; x2(1) = 23.667; p<0.01.
There was no statistically significant difference in developing COVID-19 thoracic CT findings between never smoked/quit smoking and being a smoker (p>0.05). The same was true when non-smokers were compared with quitting/smoking (p>0.05).
The effects of medications used in the previous 6 months before contracting COVID-19 on hospitalization, ICU admission or dead were analyzed using the logistic regression models adjusted for age and comorbidity. DM medications increased the probability of hospitalization 3 times (p<0.05) (Table 4), while CCBs increased the probability of admission in the ICU 155 times (p<0.01) (Table 5), and the probability of mortality 295 times (p < 0.01) (Table 6). When DM drugs are subdivided into metformin, sulfonylureas, meglitinides, thiazolidinediones, α-glucosidase inhibitors, GLP-1 agonists, DPP4 inhibitors, SGLT-2 inhibitors, and insulin, in the logistic regression model adjusted for age and comorbidity, there was no statistically significant difference between the subgorups of DM medications in terms of effects on hospitalization, ICU admission or mortality (p>0.05).
Regarding COVID-19 pharmacological treatments, according to the chi-square analysis that included only hospitalized patients, different COVID-19 pharmacological treatments were not associated with ICU admission and mortality (p>0.05).