Background Few reports have addressed the clinical and laboratory features of patients with coronavirus disease-2019 (COVID-19) in mountainous areas, especially in Iran. Objectives To report the clinical and laboratory data and manifestations predicting mortality of patients with COVID-19 in the west of Iran. Methods We conducted a retrospective cohort study of 286 patients hospitalized with COVID-19 between 25 February 2020 and 12 May 2020 to describe their clinical symptoms and laboratory

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... findings when they were admitted at the Hajar Hospital affiliated with the Shahrekord University of Medical Sciences, and a multivariable analysis of factors that predict their disease severity and mortality. Results After hospital admission, 18 patients died and 268 were discharged. Older age [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.01–1.04, P = 0.001], presence of underlying diseases (OR = 1.86, 95% CI = 1.01–3.45, P = 0.04), elevated hematocrit (OR = 1.08, 95% CI = 1.03–1.13, P = 0.002), and increase in red blood cell distribution width (RDW) coefficient of variation (OR = 1.18, 95% CI = 1.02–1.36, P = 0.02) were significantly associated with disease severity. Older age (OR = 1.00, 95% CI = 1.00–1.07, P = 0.03), hypocalcemia (OR = 0.20, 95% CI = 0.09–0.58, P = 0.002), hypophosphatemia (OR = 0.50, 95% CI = 0.26–1.02, P = 0.04), and increase in platelet-larger cell ratio (P-LCR; OR = 1.10, 95% CI = 1.00–1.15, P = 0.04) were significantly associated with mortality. The areas under the receiver operating characteristic curves were as follows: calcium 0.759; lactate dehydrogenase (LDH) 0.731; phosphorus 0.725; bilirubin 0.689; C-reactive protein 0.679; and RDW – standard deviation (RDW-SD) 0.624. Conclusions Those who did not survive tended to be elderly and had a greater incidence of comorbidities. Elevated LDH, decreased levels of calcium and phosphorus, and anemia at diagnosis were associated with greater risk of death for these Iranian patients hospitalized with COVID-19. Regular assessment of these markers would help to manage patients with COVID-19.