COVID-19 fatality rates in hospitalized patients: A new systematic review and meta-analysis

Baptista, Alexandre M.; Vieira, Ana Cristina; Capela, Eunice; Julião, Pedro Lobo; Macedo, Ana

doi:10.1016/j.jiph.2023.07.006

Cited by 5 publications

(3 citation statements)

References 52 publications

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“…Survival improved as the pandemic progressed, which may suggest improvements in clinical care [ 29 ]. Additionally, a recent meta-analysis showed a mortality rate of 16% for general COVID-19 patients admitted to hospital [ 30 ]. Age, comorbidities such as cardiovascular disease or chronic kidney disease, as well as other medical factors suggesting risk of a poor clinical outcome were considered when deciding on admission to our hospital.…”

Section: Discussionmentioning

confidence: 99%

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

Vera-Delgado,

García-Rosado,

Pérez-Hernández

et al. 2024

Diseases

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Background: The long-term survival of patients hospitalized with COVID-19 and the factors associated with poorer survival months after infection are not well understood. The aims of the present study were to analyze the overall mortality 10 months after admission. Methods: 762 patients with COVID-19 disease were included. Patients underwent a complete clinical evaluation, routine laboratory analysis and chest X-ray. Data collected included demographic and clinical data, such as vascular risk factors, tobacco or alcohol use, comorbidity, and institutionalization. Results: Ten-month mortality was 25.6%: 108 deaths occurred in-hospital, while 87 patients died after discharge. In-hospital mortality was independently related to NT-proBNP values > 503.5 pg/mL [OR = 4.67 (2.38–9.20)], urea > 37 mg/dL [3.21 (1.86–7.31)] and age older than 71 years [OR = 1.93 (1.05–3.54)]. NT-proBNP values > 503.5 pg/mL [OR = 5.00 (3.06–8.19)], urea > 37 mg/dL [3.51 (1.97–6.27)], cognitive impairment [OR = 1.96 (1.30–2.95), cancer [OR = 2.23 (1.36–3.68), and leukocytes > 6330/mm3 [OR = 1.64 (1.08–2.50)], were independently associated with long-term mortality. Conclusions: the risk of death remains high even months after COVID-19 infection. Overall mortality of COVID-19 patients during 10 months after hospital discharge is nearly as high as that observed during hospital admission. Comorbidities such as cancer or cognitive impairment, organ dysfunction and inflammatory reaction are independent prognostic markers of long-term mortality.

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Section: Discussionmentioning

confidence: 99%

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

Vera-Delgado,

García-Rosado,

Pérez-Hernández

et al. 2024

Diseases

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Section: Introductionmentioning

confidence: 99%

“…A study in 2023 stated that the global hospital mortality rate of COVID-19 among general patients was 16%, with variations observed across different geographic areas. 2 Several therapeutic strategies have been attempted, including antiviral drugs, corticosteroids, and immunomodulator therapy. 3 The rationale behind using antiviral agents in treating COVID-19 is inhibiting viral replication, reducing disease severity, and mitigating cytokine storms by dampening the exaggerated immune response.…”

Section: Introductionmentioning

confidence: 99%

Remdesivir versus Favipiravir in Hospitalized Patients with Moderate to Severe COVID-19 Pneumonia: A Propensity Score-Matched Retrospective Cohort Study

Chavalertsakul,

Sutherasan,

Petnak

et al. 2024

IJGM

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Background Remdesivir treatment was associated with a reduced 28-day mortality and recovery time among patients hospitalized with severe COVID-19. Favipiravir is broadly used to treat COVID-19. However, various studies have had conflicting results on the efficacy of favipiravir for COVID-19. We hypothesized that remdesivir is more effective in clinical outcomes regarding the 29-day mortality rates, length of stay, and recovery rate than favipiravir in patients with moderate to severe COVID-19 pneumonia. Methods We performed a retrospective cohort study that included adult hospitalized COVID-19 pneumonia patients with hypoxemia. Patients were classified into two groups according to the antiviral drugs. Age, oxygen saturation, fraction of inspired oxygen, and Charlson comorbidity index were used for propensity score matching. The primary objective was to determine whether the type of antiviral agent is associated with 29-day mortality. Other outcomes were the 15-day recovery rate and the length of intensive care unit or hospital stay. Results A total of 249 patients with moderate to severe COVID-19 pneumonia were included. With an adjustment for propensity score-matched, there were 204 patients for further analysis (102 patients in each antiviral drug group). Remdesivir patients had higher Radiographic Assessment of Lung Edema (RALE) scores on Chest X-ray (14.32±9.08 vs 11.34±8.46; standardized mean difference =33.9%). The Charlson Comorbidity Index Scores were comparable. The prevalences of diabetes, obesity, hypertension, and non-HIV immunocompromised state were higher in the remdesivir group. Regarding the primary outcomes, after adjusting by diabetes, obesity, and RALE score, there was no difference in the 29-day mortality rate between both groups [26 patients (25.5%) in the remdesivir group vs 28 patients (27.5%) in the favipiravir group]. The Kaplan-Meier curve analysis at 29 days indicated no significant difference in cumulative survival rate. The two groups’ adjusted hazard ratio was 0.72; 95% CI, 0.41 to 1.25, p =0.24. A Kaplan-Meier analysis on the 15-day cumulative survival rate observed a trend towards a higher survival rate in the remdesivir group (adjusted hazard ratio 0.41; 95% CI, 0.20 to 0.84; p= 0.02) The proportion of patients who recovered on day 15, the length of intensive care unit(ICU) stays, and the hospital stay were not different between remdesivir and favipiravir groups (62 patients (60.8%) vs 56 patients (54.9%), p=0.39; 11.48 ± 11.88 days vs 10.87 ± 9.31 days, p =0.69; and 16.64±14.28 days vs 16.59 ±11.31 days, p =0.98, respectively). Conclusion In patients with moderate to severe COVID-19 pneumonia, Remdesivir did not demonstrate superior benefits over Favipiravir regarding 29-day mortality, 15-day recovery rates, or hospital and ICU stay lengths. However, further investigation into the 15-day cumulativ...

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One-year mortality and associated factors in older hospitalized COVID-19 survivors: a Nationwide Cohort Study in Korea

Kim,

Moon

et al. 2024

Sci Rep

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This study aimed to evaluate the 1-year mortality rate among older patients with COVID-19 discharged from hospital and to identify risk factors associated with this outcome. Using a COVID-19 dataset from the Korean National Health Insurance System, this study’s evaluation period spanned from October 8, 2020, through December 31, 2021. The primary outcome was the 1-year mortality rate following hospital discharge. A logistic regression model was employed for multivariable analysis to estimate the odds ratios for the outcomes, and the Kaplan-Meier method was used to analyze differences in 1-year survival rates. Among the 66,810 COVID-19 patients aged 60 years or older who were hospitalized during the study period, the in-hospital mortality rate was 4.8% ( n = 3219). Among the survivors ( n = 63,369), the 1-year mortality rate was 4.9% ( n = 3093). Non-survivors, compared to survivors, were significantly older (79.2 ± 9.5 vs. 68.9 ± 7.8, P < 0.001) and exhibited a lower rate of COVID-19 vaccination (63.0% vs. 91.7%, P < 0.001). Additionally, non-survivors experienced a higher incidence of organ dysfunction, along with a greater proportion of required mechanical ventilation (14.6% vs. 1.0%, P < 0.001) and extracorporeal membrane oxygenation (4.0% vs. 0.1%, P < 0.001). Multivariable logistic regression analysis identified older age, male sex, cardiovascular disease, immunosuppression, organ dysfunction, illness severity, and corticosteroid use during hospitalization as factors associated with death within 1 year after hospital discharge. However, vaccination was found to have a long-term protective effect against death among COVID-19 survivors. The 1-year mortality rate after hospital discharge for older COVID-19 patients was comparable to the in-hospital mortality rate for these patients in Korea. The long-term mortality rate among hospitalized older COVID-19 patients was influenced by demographic factors and the severity of illness experienced during hospitalization. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-76871-3.

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COVID-19 fatality rates in hospitalized patients: A new systematic review and meta-analysis

Cited by 5 publications

References 52 publications

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

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

Remdesivir versus Favipiravir in Hospitalized Patients with Moderate to Severe COVID-19 Pneumonia: A Propensity Score-Matched Retrospective Cohort Study

One-year mortality and associated factors in older hospitalized COVID-19 survivors: a Nationwide Cohort Study in Korea

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