One-year mortality in COVID-19 is associated with patients’ comorbidities rather than pneumonia severity - 06/06/23
, Greta Carioli c, Alessandra Carobbio c, Simone Pappacena a, b, Roberta Biza a, b, Roberta Trapasso a, b, Marisa Anelli a, b, Mariangela Amoroso a, b, Chiara Allegri a, b, Luca Malandrino a, b, Gianluca Imeri a, Caterina Conti a, Marta Beretta a, Mauro Gori d, Emilia D'Elia d, Michele Senni d, e, Ferdinando Luca Lorini e, f, Marco Rizzi g, Roberto Cosentini h, Alessandro Rambaldi b, i, Arianna Masciulli c, Antonello Gavazzi c, Paolo Solidoro l, Sandro Sironi e, m, Stefano Fagiuoli e, n, Tiziano Barbui c, Fabiano Di Marco a, bon behalf of
HPG23 Covid19 Study Group
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Abstract |
Background |
In patients with pneumonia or acute respiratory distress syndrome who survived hospitalization, one-year mortality can affect up to one third of discharged patients. Therefore, significant long-term mortality after COVID-19 respiratory failure could be expected. The primary outcome of the present study was one-year all-cause mortality in hospitalized COVID-19 patients.
Methods |
Observational study of COVID-19 patients hospitalized at Papa Giovanni XXIII Hospital (Bergamo, Italy), during the first pandemic wave.
Results |
A total of 1326 COVID-19 patients were hospitalized. Overall one-year mortality was 33.6% (N 446/1326), with the majority of deaths occurring during hospitalization (N=412, 92.4%). Thirty-four patients amongst the 914 discharged (3.7%) subsequentely died within one year. A third of these patients died for advanced cancer, while death without a cause other than COVID-19 was uncommon (8.8% of the overall post-discharge mortality). In-hospital late mortality (i.e. after 28 days of admission) interested a population with a lower age, and fewer comorbidities, more frequentely admitted in ICU. Independent predictors of post-discharge mortality were age over 65 years (HR 3.19; 95% CI 1.28-7.96, p-value=0.013), presence of chronic obstructive pulmonary disease (COPD) (HR 2.52; 95% CI 1.09-5.83, p-value=0.031) or proxy of cardiovascular disease (HR 4.93; 95% CI 1.45-16.75, p-value=0.010), and presence of active cancer (HR 3.64; 95% CI 1.50-8.84, p-value=0.004), but not pneumonia severity.
Conclusions |
One-year post-discharge mortality depends on underlying patients’ comorbidities rather than COVID-19 pneumonia severity per se. Awareness among physicians of predictors of post-discharge mortality might be helpful in structuring a follow-up program for discharged patients.
Le texte complet de cet article est disponible en PDF.Keywords : COVID-19, Pneumonia, Respiratory failure, Mortality, Comorbidities
Plan
Vol 83
Article 100976- juin 2023 Retour au numéro
Article précédent
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