Long-Term Survival among Patients Hospitalized for COVID-19 during the First Three Epidemic Waves: An Observational Study in a Northern Italy Hospital

Abstract

The mortality rate of hospitalized COVID-19 patients differed strongly between the first three pandemic waves. Nevertheless, their long-term survival has been poorly assessed. The aim of this study was to compare the clinical characteristics and mortality rates of 825 patients with coronavirus disease 2019 (COVID-19) infection who were hospitalized at the Alessandria hub hospital, in Northern Italy, during the first fifty days of the first three pandemic waves. Each subject was followed in terms of vital status for six months from the date of hospital admission or until deceased. Patients admitted during the three waves differed in age (p = 0.03), disease severity (p < 0.0001), Charlson comorbidity index (p = 0.0002), oxygen therapy (p = 0.002), and invasive mechanical ventilation (p < 0.0001). By the end of follow-up, 309 deaths (38.7%) were observed, of which 186 occurred during hub hospitalization (22.5%). Deaths were distributed differently among the waves (p < 0.0001), resulting in being higher amongst those subjects admitted during the first wave. The COVID-19 infection was reported as the main cause of death and patients with a higher mortality risk were those aged ≥65 years [adjusted HR = 3.40 (95% CI 2.20–5.24)], with a higher disease severity [adjusted HR = 1.87 (95%CI 1.43–2.45)], and those requiring oxygen therapy [adjusted HR = 2.30 (95%CI 1.61–3.30)]. In conclusion, COVID-19 patients admitted to our hub hospital during the second and the third waves had a lower risk of long-term mortality than those admitted during the first. Older age, more severe disease, and the need for oxygen therapy were among the strongest risk factors for poor prognosis.

Mortality and COVID Infection: Predictors of Mortality 10 Months after Discharge

“…Other authors report all-cause mortality rates of hospitalized COVID-19 patients during 1 year after discharge ranging from 4.7% to 9.3% [ 22 , 39 , 40 ] although higher mortality rates have been reported in the literature [ 41 , 42 ]. Our results are similar to those reported by Li et al who found a mortality of 11.2% in hospitalized patients with COVID-19 after a mean follow-up of 72.8 days [ 43 ] and with those of Bertolotti et al, who described a post-discharge mortality of 16.2% and an overall mortality of 38.7% [ 44 ] after a 6-month outpatient follow-up period. In addition, the follow-up time was longer in our study, which could lead to higher mortality.…”