Post-COVID syndrome associated with significant morbidity and mortality beyond respiratory illnesses

1. Hospital readmission and all-cause mortality rates are 3.5 and 7.7 times higher in COVID-19 patients after discharge, than the general population.

2. In addition to respiratory illness, COVID-19 patients experienced higher rates of diagnosis of a major adverse cardiovascular event, diabetes, chronic kidney disease, and chronic liver disease.

Evidence Rating Level: 2 (Good)

Much of the research on post-COVID syndrome, or the long-term effects of COVID-19, have been focused on respiratory illness. However, there is growing evidence demonstrating effects on other organ systems and patterns of disease. To assess the epidemiology of post-COVID syndrome, the current study based in England identified the incidence of all-cause mortality, admission rates to the hospital, and organ specific impairment, after COVID-19 patients were discharged. This was compared to controls from the general population, matched by age, sex, ethnicity, comorbidities, and other personal and clinical characteristics. 47,780 COVID-19 patients were included in the study, 54.9% of whom were male, and with a mean (SD) age of 64.5 (19.2). For a mean follow-up of 140 days, the study found that 29.4% of COVID-19 patients were readmitted and 12.3% died following discharge, with an incidence of 766 readmissions (95% CI 753-779) and 320 deaths (312-328) per 1000 person years. Compared to the controls, these rates were 3.5 (95% CI 3.4-3.6) and 7.7 (7.2-8.3) times more respectively. In terms of organ specific impairment, 29.6% were diagnosed with respiratory illness, 4.9% with diabetes, 4.8% with an adverse cardiovascular event, 1.5% with chronic kidney disease, and 0.3% with chronic liver disease. COVID-19 patients were diagnosed with these conditions 6.0, 3.0, 2.8, 1.9, and 1.5 times more frequently than the matched controls respectively. Overall, this study showed that the long-term effects of COVID-19 affect numerous organ systems in the body, and COVID-19 patients are at greater risk of re-admissions and all-cause mortality than the general population.

Click to read the study in BMJ

Image: PD

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