Hospitalized COVID patients at higher risk for organ-related death, readmission for 2.5 years, data suggest

Nurse attending to hospital patient

Jacob Wackerhausen / iStock

Patients hospitalized for COVID-19 were much more likely than controls to be readmitted for or die from organ disorders in the next 2.5 years, French researchers reported yesterday in Infectious Diseases.

The team used national claims data to track rates of all-cause death, all-cause hospitalization, and organ-disorder–related hospital admission among 63,990 adult COVID-19 patients hospitalized from January to August 2020 for 30 months and 319,891 matched controls not hospitalized for this indication during the same period. The average participant age was 65 years, and 53.1% were men.

Excess risk dropped after first 6 months

During follow-up, the crude all-cause death rate was 17.7% in the COVID-19 group and 8.5% among controls. The weighted cumulative incidence of all-cause mortality and all-cause hospitalization was 5,218 and 16,334 per 100,000 person-years in COVID-19 patients and 4,013 and 12,095 per 100,000 person-years in controls, respectively. 

COVID-19 patients were more likely than controls to be hospitalized for cardiovascular (incidence rate ratio [IRR], 1.22), psychiatric (IRR, 1.41), neurologic (IRR, 1.50), and respiratory events (IRR, 1.99). The excess risk decreased sharply after the first 6 months for all outcomes but stayed significantly elevated for up to 30 months for neurologic and respiratory disorders, chronic kidney failure, and diabetes.

In total, 22 of 29 specific organ disorders occurred at significantly higher rates in COVID-19 patients than in controls, which the authors said aligns with the findings of other studies with shorter follow-up periods. The highest rates were for myocarditis (IRR, 3.91) and peripheral thromboembolic events (IRR, 1.86).

Older adults more likely to be readmitted 

Men and women were at similar risk for hospitalization except for psychiatric hospitalization, which was mainly seen in women. While rates of readmission were elevated for all age-groups, both all-cause and organ-specific re-hospitalizations were higher in patients older than 70 years. 

These findings are a stark reminder of the far-reaching impact of COVID-19, which extends far beyond the initial infection.

Sarah Tubiana, PharmD, PhD

COVID-19 patients admitted to an intensive care unit (ICU) experienced greater rates of respiratory disorders than those not admitted to ICU, which the researchers said could be related to factors such as the severity of COVID-19 infection and ICU-related complications.

"These findings are a stark reminder of the far-reaching impact of COVID-19, which extends far beyond the initial infection," lead author Sarah Tubiana, PharmD, PhD, an infectious disease specialist at the Clinical Investigation Center at Bichat Hospital in Paris, said in a Taylor & Francis Group news release.

"While much attention has been given to the immediate dangers of the virus, our research shows that hospitalised COVID-19 survivors remain at greater risks of severe health complications months and even years later," she added. "The long-term implications for public health are significant."

The researchers caution that the findings may not generalize to SARS-CoV-2 strains that emerged after the study period. "Further research is needed to assess whether more recent variants have similar long-term health consequences," they wrote. "Considering the large number of cases all over the world, the development of clinics specialising in multidisciplinary follow-up after an episode of COVID-19 requiring hospitalisation should continue, in order to accompany patients through to full recovery."

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