Clinical Characteristics and Survival Outcomes of Invasive Mechanically Ventilated COVID-19 Patients: A Single-Center Study from Iran
-
Naghmeh Ahmadi
,
Shima Karbasi
,
Nasim Rabani
,
Zahra Sardarpour
,
Marjan Mansourian
,
Nazanin Seddighi
,
Mahmoud Saghaei
Abstract
Background: COVID-19 patients requiring invasive mechanical ventilation represent the most severe cases with high mortality rates. This study aimed to analyze survival outcomes and identify prognostic factors in a cohort of invasive mechanically ventilated COVID-19 patients in Iran.
Methods: In this retrospective cohort study, we analyzed 639 adult COVID-19 patients who underwent invasive mechanical ventilation at Al-Zahra Hospital's ICUs in Isfahan. Survival analysis and Cox regression models were used to identify factors associated with mortality.
Results: Among 639 mechanically ventilated patients, mortality was 87.9%. The mean age was 63.01±16.4 years. 59.8% of participants were male. Hypertension (42.6%), diabetes (33.8%), and cardiovascular disease (25.0%) were the most prevalent comorbidities. The overall median survival time was 35 days. Cox regression analysis identified significant mortality predictors, including male sex (HR=3.489, 95% CI: 1.150-10.585), age (HR=1.064, 95% CI: 1.024-1.106), cardiovascular disease (HR=1.445, 95% CI: 1.096-1.905), higher APACHE IV score (HR=1.028, 95% CI: 1.005-1.051), and delayed mechanical ventilation after disease onset (HR=1.111, 95% CI: 1.031-1.196).
Conclusion: COVID-19 patients with invasive mechanical ventilation demonstrated high mortality rates. Older age, male sex, cardiovascular disease, higher APACHE IV score, and delayed mechanical ventilation after symptom onset were significant predictors of mortality. These findings highlight the importance of timely intervention in high-risk patients and may help optimize resource allocation during future pandemic waves.
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[22] Gholinataj Jelodar M, Rafieian S, Allah Dini A, Khalaj F, Zare S, et al. Analyzing Trends in Demographic, Laboratory, Imaging, and Clinical Outcomes of ICU‐Hospitalized COVID‐19 Patients. Can J Infect Dis Med Microbiol. 2023;2023(1):3081660.
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[24] Peckham H, de Gruijter NM, Raine C, Radziszewska A, Ciurtin C, Wedderburn LR, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun. 2020;11(1):6317.
[25] Takahashi T, Ellingson MK, Wong P, Israelow B, Lucas C, Klein J, et al. Sex differences in immune responses that underlie COVID-19 disease outcomes. Nature. 2020;588(7837):315-20.
[26] Bayazidi S, Moradi G, Masoumi S, Setarehdan SA, Baradaran HR. Predicting COVID-19 progression in hospitalized patients in Kurdistan Province using a multi-state model. J Diabetes Metab Disord. 2025;24(1):88.
[27] Choi KW, Chau TN, Tsang O, Tso E, Chiu MC, Tong WL, et al. Outcomes and prognostic factors in 267 patients with severe acute respiratory syndrome in Hong Kong. Ann Intern Med. 2003;139(9):715-23.
[28] Hong K-H, Choi J-P, Hong S-H, Lee J, Kwon J-S, Kim S-M, et al. Predictors of mortality in Middle East respiratory syndrome (MERS). Thorax. 2018;73(3):286-9.
[29] Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80(6):e14-e8.
[30] Mesas AE, Cavero-Redondo I, Álvarez-Bueno C, Sarriá Cabrera MA, Maffei de Andrade S, Sequí-Dominguez I, et al. Predictors of in-hospital COVID-19 mortality: A comprehensive systematic review and meta-analysis exploring differences by age, sex and health conditions. PloS one. 2020;15(11):e0241742.
[31] Mirjalili M, Raadabadi M, Dehghani M, Aliabad MB, Mansouri M, Martini M, et al. Analysis of death risk factors among COVID-19 patients in Yazd, Iran: A case-cohort study. J Prev Med Hyg. 2023;64(3):E304.
[32] Romero Starke K, Petereit-Haack G, Schubert M, Kämpf D, Schliebner A, Hegewald J, et al. The age-related risk of severe outcomes due to COVID-19 infection: a rapid review, meta-analysis, and meta-regression. Int J Environ Res Public Health. 2020;17(16):5974.
[33] Bajaj V, Gadi N, Spihlman AP, Wu SC, Choi CH, Moulton VR. Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections? Front Physiol. 2021;11:571416.
[34] Biswas M, Rahaman S, Biswas TK, Haque Z, Ibrahim B. Association of sex, age, and comorbidities with mortality in COVID-19 patients: a systematic review and meta-analysis. Intervirology. 2021;64(1):36-47.
[35] Godaert L, Proye E, Demoustier-Tampere D, Coulibaly PS, Hequet F, Drame M. Clinical characteristics of older patients: the experience of a geriatric short-stay unit dedicated to patients with COVID-19 in France. J Infect. 2020;81(1):e93.
[36] Auld SC, Caridi-Scheible M, Blum JM, Robichaux C, Kraft C, Jacob JT, et al. ICU and ventilator mortality among critically ill adults with coronavirus disease 2019. Crit Care Med. 2020;48(9):e799-e804.
[37] Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, et al. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (albany NY). 2020;12(13):12493.
[38] Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
[39] Bae S, Kim SR, Kim M-N, Shim WJ, Park S-M. Impact of cardiovascular disease and risk factors on fatal outcomes in patients with COVID-19 according to age: a systematic review and meta-analysis. Heart. 2021;107(5):373-80.
[40] Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271-80. e8.
[41] Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nat Rev Cardiol. 2020;17(9):543-58.
[42] Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia–a systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020;14(4):395-403.
[43] Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr. 2020;14(4):535-45.
[44] Lippi G, Wong J, Henry BM. Hypertension and its severity or mortality in Coronavirus Disease 2019 (COVID-19): a pooled analysis. Pol Arch Intern Med. 2020;130(4):304-9.
[45] Pranata R, Lim MA, Huang I, Raharjo SB, Lukito AA. Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: a systematic review, meta-analysis and meta-regression. J Renin Angiotensin Aldosterone Syst. 2020;21(2):1470320320926899.
[46] Rosenthal N, Cao Z, Gundrum J, Sianis J, Safo S. Risk factors associated with in-hospital mortality in a US national sample of patients with COVID-19. JAMA network open. 2020;3(12):e2029058-e.
[47] Zou X, Li S, Fang M, Hu M, Bian Y, Ling J, et al. Acute physiology and chronic health evaluation II score as a predictor of hospital mortality in patients of coronavirus disease 2019. Crit Care Med. 2020;48(8):e657-e65.
[48] Vandenbrande J, Verbrugge L, Bruckers L, Geebelen L, Geerts E, Callebaut I, et al. Validation of the Acute Physiology and Chronic Health Evaluation (APACHE) II and IV Score in COVID‐19 Patients. Crit Care Res Pract. 2021;2021(1):5443083.
[49] Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. Jama. 2020;323(22):2329-30.
[50] Tobin MJ, Laghi F, Jubran A. Caution about early intubation and mechanical ventilation in COVID-19. Ann Intensive Care. 2020;10:1-3.
[51] Sklienka P, Frelich M, Burša F. Patient Self-Inflicted Lung Injury—A Narrative Review of Pathophysiology, Early Recognition, and Management Options. J Pers Med. 2023;13(4):593.
[52] Ferreyro BL, Angriman F, Munshi L, Del Sorbo L, Ferguson ND, Rochwerg B, et al. Association of noninvasive oxygenation strategies with all-cause mortality in adults with acute hypoxemic respiratory failure: a systematic review and meta-analysis. Jama. 2020;324(1):57-67.
[53] Vera M, Kattan E, Born P, Rivas E, Amthauer M, Nesvadba A, et al. Intubation timing as determinant of outcome in patients with acute respiratory distress syndrome by SARS-CoV-2 infection. J Crit Care. 2021;65:164-9.
[54] Zhang Q, Shen J, Chen L, Li S, Zhang W, Jiang C, et al. Timing of invasive mechanic ventilation in critically ill patients with coronavirus disease 2019. J Trauma Acute Care Surg. 2020;89(6):1092-8.
[55] Hernandez-Romieu AC, Adelman MW, Hockstein MA, Robichaux CJ, Edwards JA, Fazio JC, et al. Timing of intubation and mortality among critically ill coronavirus disease 2019 patients: a single-center cohort study. Crit Care Med. 2020;48(11):e1045-e53.
[56] Lee YH, Choi K-J, Choi SH, Lee SY, Kim KC, Kim EJ, et al. Clinical significance of timing of intubation in critically ill patients with COVID-19: a multi-center retrospective study. J Clin Med. 2020;9(9):2847.
[57] Papoutsi E, Giannakoulis VG, Xourgia E, Routsi C, Kotanidou A, Siempos II. Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies. Crit Care. 2021;25:1-9.
[2] Zhou P, Yang X-L, Wang X-G, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3.
[3] Mohammadi M, Khamseh AKP, Varpaei HA. Invasive Airway" Intubation" in COVID-19 Patients; Statistics, Causes, and Recommendations: A Review Article. Anesth Pain Med. 2021;11(3):e115868.
[4] Paraskevis D, Kostaki EG, Magiorkinis G, Panayiotakopoulos G, Sourvinos G, Tsiodras S. Full-genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event. Infect Genet Evol. 2020;79:104212.
[5] Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med. 2020;46:854-87.
[6] Daniel P, Mecklenburg M, Massiah C, Joseph MA, Wilson C, Parmar P, et al. Non-invasive positive pressure ventilation versus endotracheal intubation in treatment of COVID-19 patients requiring ventilatory support. Am J Emerg Med. 2021;43:103-8.
[7] Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical characteristics of Covid-19 in New York city. N Engl J Med. 2020;382(24):2372-4.
[8] Padrao EM, Valente FS, Besen BA, Rahhal H, Mesquita PS, de Alencar JC, et al. Awake prone positioning in COVID‐19 hypoxemic respiratory failure: exploratory findings in a single‐center retrospective cohort study. Acad Emerg Med. 2020;27(12):1249-59.
[9] Cena T, Cammarota G, Azzolina D, Barini M, Bazzano S, Zagaria D, et al. Predictors of intubation and mortality in COVID-19 patients: a retrospective study. J Anesth Analg Crit Care. 2021;1:1-10.
[10] Gerotziafas GT, Van Dreden P, Fraser DD, Voiriot G, Patel MA, Daley M, et al. The COMPASS-COVID-19-ICU study: Identification of factors to predict the risk of intubation and mortality in patients with severe COVID-19. Hemato. 2022;3(1):204-18.
[11] Zimmerman PW, Stroever SJ, Burton T, Hester KE, Kim M, Fahy RT, et al. Mortality associated with intubation and mechanical ventilation in patients with COVID-19. MedRxiv. 2020:2020.08. 13.20174524.
[12] Halim AA, Alsayed B, Embarak S, Yaseen T, Dabbous S. Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients. Egypt J Chest Dis Tuberc. 2016;65(1):81-7.
[13] Shi S, Qin M, Cai Y, Liu T, Shen B, Yang F, et al. Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019. Eur Heart J. 2020;41(22):2070-9.
[14] Gil MR, Gonzalez-Lugo JD, Rahman S, Barouqa M, Szymanski J, Ikemura K, et al. Correlation of coagulation parameters with clinical outcomes in Coronavirus-19 affected minorities in United States: Observational cohort. medRxiv. 2020:2020.05. 01.20087932.
[15] Klang E, Kassim G, Soffer S, Freeman R, Levin MA, Reich DL. Severe obesity as an independent risk factor for COVID‐19 mortality in hospitalized patients younger than 50. Obesity. 2020;28(9):1595-9.
[16] Yang X, Yu Y, Xu J, Shu H, Xia Ja, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81.
[17] Zhu Y, Du Z, Zhu Y, Li W, Miao H, Li Z. Evaluation of organ function in patients with severe COVID-19 infections. Med Clin. 2020;155(5):191-6.
[18] Giacomelli A, Ridolfo AL, Milazzo L, Oreni L, Bernacchia D, Siano M, et al. 30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: a prospective cohort study. Pharmacol Res. 2020;158:104931.
[19] Lim ZJ, Subramaniam A, Ponnapa Reddy M, Blecher G, Kadam U, Afroz A, et al. Case fatality rates for patients with COVID-19 requiring invasive mechanical ventilation. A meta-analysis. Am J Respir Crit Care Med. 2021;203(1):54-66.
[20] Bienvenu LA, Noonan J, Wang X, Peter K. Higher mortality of COVID-19 in males: sex differences in immune response and cardiovascular comorbidities. Cardiovasc Res. 2020;116(14):2197-206.
[21] Falagas ME, Mourtzoukou EG, Vardakas KZ. Sex differences in the incidence and severity of respiratory tract infections. Respir Med. 2007;101(9):1845-63.
[22] Gholinataj Jelodar M, Rafieian S, Allah Dini A, Khalaj F, Zare S, et al. Analyzing Trends in Demographic, Laboratory, Imaging, and Clinical Outcomes of ICU‐Hospitalized COVID‐19 Patients. Can J Infect Dis Med Microbiol. 2023;2023(1):3081660.
[23] Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574-81.
[24] Peckham H, de Gruijter NM, Raine C, Radziszewska A, Ciurtin C, Wedderburn LR, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun. 2020;11(1):6317.
[25] Takahashi T, Ellingson MK, Wong P, Israelow B, Lucas C, Klein J, et al. Sex differences in immune responses that underlie COVID-19 disease outcomes. Nature. 2020;588(7837):315-20.
[26] Bayazidi S, Moradi G, Masoumi S, Setarehdan SA, Baradaran HR. Predicting COVID-19 progression in hospitalized patients in Kurdistan Province using a multi-state model. J Diabetes Metab Disord. 2025;24(1):88.
[27] Choi KW, Chau TN, Tsang O, Tso E, Chiu MC, Tong WL, et al. Outcomes and prognostic factors in 267 patients with severe acute respiratory syndrome in Hong Kong. Ann Intern Med. 2003;139(9):715-23.
[28] Hong K-H, Choi J-P, Hong S-H, Lee J, Kwon J-S, Kim S-M, et al. Predictors of mortality in Middle East respiratory syndrome (MERS). Thorax. 2018;73(3):286-9.
[29] Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80(6):e14-e8.
[30] Mesas AE, Cavero-Redondo I, Álvarez-Bueno C, Sarriá Cabrera MA, Maffei de Andrade S, Sequí-Dominguez I, et al. Predictors of in-hospital COVID-19 mortality: A comprehensive systematic review and meta-analysis exploring differences by age, sex and health conditions. PloS one. 2020;15(11):e0241742.
[31] Mirjalili M, Raadabadi M, Dehghani M, Aliabad MB, Mansouri M, Martini M, et al. Analysis of death risk factors among COVID-19 patients in Yazd, Iran: A case-cohort study. J Prev Med Hyg. 2023;64(3):E304.
[32] Romero Starke K, Petereit-Haack G, Schubert M, Kämpf D, Schliebner A, Hegewald J, et al. The age-related risk of severe outcomes due to COVID-19 infection: a rapid review, meta-analysis, and meta-regression. Int J Environ Res Public Health. 2020;17(16):5974.
[33] Bajaj V, Gadi N, Spihlman AP, Wu SC, Choi CH, Moulton VR. Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections? Front Physiol. 2021;11:571416.
[34] Biswas M, Rahaman S, Biswas TK, Haque Z, Ibrahim B. Association of sex, age, and comorbidities with mortality in COVID-19 patients: a systematic review and meta-analysis. Intervirology. 2021;64(1):36-47.
[35] Godaert L, Proye E, Demoustier-Tampere D, Coulibaly PS, Hequet F, Drame M. Clinical characteristics of older patients: the experience of a geriatric short-stay unit dedicated to patients with COVID-19 in France. J Infect. 2020;81(1):e93.
[36] Auld SC, Caridi-Scheible M, Blum JM, Robichaux C, Kraft C, Jacob JT, et al. ICU and ventilator mortality among critically ill adults with coronavirus disease 2019. Crit Care Med. 2020;48(9):e799-e804.
[37] Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, et al. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (albany NY). 2020;12(13):12493.
[38] Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
[39] Bae S, Kim SR, Kim M-N, Shim WJ, Park S-M. Impact of cardiovascular disease and risk factors on fatal outcomes in patients with COVID-19 according to age: a systematic review and meta-analysis. Heart. 2021;107(5):373-80.
[40] Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271-80. e8.
[41] Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nat Rev Cardiol. 2020;17(9):543-58.
[42] Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia–a systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020;14(4):395-403.
[43] Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr. 2020;14(4):535-45.
[44] Lippi G, Wong J, Henry BM. Hypertension and its severity or mortality in Coronavirus Disease 2019 (COVID-19): a pooled analysis. Pol Arch Intern Med. 2020;130(4):304-9.
[45] Pranata R, Lim MA, Huang I, Raharjo SB, Lukito AA. Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: a systematic review, meta-analysis and meta-regression. J Renin Angiotensin Aldosterone Syst. 2020;21(2):1470320320926899.
[46] Rosenthal N, Cao Z, Gundrum J, Sianis J, Safo S. Risk factors associated with in-hospital mortality in a US national sample of patients with COVID-19. JAMA network open. 2020;3(12):e2029058-e.
[47] Zou X, Li S, Fang M, Hu M, Bian Y, Ling J, et al. Acute physiology and chronic health evaluation II score as a predictor of hospital mortality in patients of coronavirus disease 2019. Crit Care Med. 2020;48(8):e657-e65.
[48] Vandenbrande J, Verbrugge L, Bruckers L, Geebelen L, Geerts E, Callebaut I, et al. Validation of the Acute Physiology and Chronic Health Evaluation (APACHE) II and IV Score in COVID‐19 Patients. Crit Care Res Pract. 2021;2021(1):5443083.
[49] Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. Jama. 2020;323(22):2329-30.
[50] Tobin MJ, Laghi F, Jubran A. Caution about early intubation and mechanical ventilation in COVID-19. Ann Intensive Care. 2020;10:1-3.
[51] Sklienka P, Frelich M, Burša F. Patient Self-Inflicted Lung Injury—A Narrative Review of Pathophysiology, Early Recognition, and Management Options. J Pers Med. 2023;13(4):593.
[52] Ferreyro BL, Angriman F, Munshi L, Del Sorbo L, Ferguson ND, Rochwerg B, et al. Association of noninvasive oxygenation strategies with all-cause mortality in adults with acute hypoxemic respiratory failure: a systematic review and meta-analysis. Jama. 2020;324(1):57-67.
[53] Vera M, Kattan E, Born P, Rivas E, Amthauer M, Nesvadba A, et al. Intubation timing as determinant of outcome in patients with acute respiratory distress syndrome by SARS-CoV-2 infection. J Crit Care. 2021;65:164-9.
[54] Zhang Q, Shen J, Chen L, Li S, Zhang W, Jiang C, et al. Timing of invasive mechanic ventilation in critically ill patients with coronavirus disease 2019. J Trauma Acute Care Surg. 2020;89(6):1092-8.
[55] Hernandez-Romieu AC, Adelman MW, Hockstein MA, Robichaux CJ, Edwards JA, Fazio JC, et al. Timing of intubation and mortality among critically ill coronavirus disease 2019 patients: a single-center cohort study. Crit Care Med. 2020;48(11):e1045-e53.
[56] Lee YH, Choi K-J, Choi SH, Lee SY, Kim KC, Kim EJ, et al. Clinical significance of timing of intubation in critically ill patients with COVID-19: a multi-center retrospective study. J Clin Med. 2020;9(9):2847.
[57] Papoutsi E, Giannakoulis VG, Xourgia E, Routsi C, Kotanidou A, Siempos II. Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies. Crit Care. 2021;25:1-9.
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| Coronavirus Disease 2019 (COVID-19) SARS-CoV-2 intensive care units invasive mechanical ventilation mortality survival | ||
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How to Cite
1.
Ahmadi N, Karbasi S, Rabani N, Sardarpour Z, Mansourian M, Seddighi N, Saghaei M. Clinical Characteristics and Survival Outcomes of Invasive Mechanically Ventilated COVID-19 Patients: A Single-Center Study from Iran. Arch Anesth & Crit Care. 2025;.
