6-month mortality and readmissions of hospitalized COVID-19 patients: A nationwide cohort study of 8,679 patients in Germany

Abstract

Background COVID-19 frequently necessitates in-patient treatment and in-patient mortality is high. Less is known about the long-term outcomes in terms of mortality and readmissions following in-patient treatment. Aim The aim of this paper is to provide a detailed account of hospitalized COVID-19 patients up to 180 days after their initial hospital admission. Methods An observational study with claims data from the German Local Health Care Funds of adult patients hospitalized in Germany between February 1 and April 30, 2020, with PCR-confirmed COVID-19 and a related principal diagnosis, for whom 6-month all-cause mortality and readmission rates for 180 days after admission or until death were available. A multivariable logistic regression model identified independent risk factors for 180-day all-cause mortality in this cohort. Results Of the 8,679 patients with a median age of 72 years, 2,161 (24.9%) died during the index hospitalization. The 30-day all-cause mortality rate was 23.9% (2,073/8,679), the 90-day rate was 27.9% (2,425/8,679), and the 180-day rate, 29.6% (2,566/8,679). The latter was 52.3% (1,472/2,817) for patients aged ≥80 years 23.6% (1,621/6,865) if not ventilated during index hospitalization, but 53.0% in case of those ventilated invasively (853/1,608). Risk factors for the 180-day all-cause mortality included coagulopathy, BMI ≥ 40, and age, while the female sex was a protective factor beyond a fewer prevalence of comorbidities. Of the 6,235 patients discharged alive, 1,668 were readmitted a total of 2,551 times within 180 days, resulting in an overall readmission rate of 26.8%. Conclusions The 180-day follow-up data of hospitalized COVID-19 patients in a nationwide cohort representing almost one-third of the German population show significant long-term, all-cause mortality and readmission rates, especially among patients with coagulopathy, whereas women have a profoundly better and long-lasting clinical outcome compared to men.

History of Heart Failure in Patients Hospitalized Due to COVID-19: Relevant Factor of In-Hospital Complications and All-Cause Mortality up to Six Months

“…While the severe and critical represented 21% of COVID-19 patients, the in-hospital infection fatality rates vary from 11% to 31% [ 8 , 9 , 10 ]. Three and six months all-cause mortality in patients hospitalized with COVID-19 was estimated at 28% and 30%, respectively [ 11 ]. However, the overall mortality rate in the population is lower ranging 0.3–5% [ 8 , 12 , 13 ].…”

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“…We must ensure the follow up of these patients, with a view to finding out how long these symptoms persist and whether they develop into chronic disorders. These conditions can lead to hospital readmission, estimated at around 3.6-4.5% in the first 30 days ( 24 , 25 ) and up to 27% after six months ( 26 ), resulting in a dramatic impact on communities and healthcare systems.…”

The Correlation of Length of Stay in Intensive Care with Duration of Ventilator Support Usage toward Post-COVID-19 Syndrome Incidence and Mortality in COVID-19 Survivors

“…9%, with the predictors of coagulopathy, age, and obese type II that were correlated with 180 days mortality after ICU discharge (18). in Australia, similar results demonstrated that ICU length of stay was correlated with long-term mortality but, comorbidities, age, Acute physiology score predict the long-term mortality better than the length of stay (19).…”