Postdischarge All-Cause Mortality in COVID-19-Recovered Patients: The Impact of CKD

Résumé fourni par la source

Background: In Brazil, the COVID-19 burden was substantial, and risk factors associated with higher in-hospital mortality rates have been extensively studied. However, information on short-term all-cause mortality and factors associated with death in patients who survived the hospitalization period of acute SARS-CoV-2 infection is less abundant. We analyzed the 6-mo post-hospitalization mortality rate and possible risk factors of COVID-19 patients admitted from Mar/20 to Dec/20 in a single center in Brazil. Methods: Retrospective cohort study focused on a 6-mo follow-up. Exclusion criteria were: death during hospitalization, transference to another hospital, and age under 18. We collected data from the charts of all hospitalized patients from Mar/20 to Dec/20 with positive RT-PCR test for SARS-CoV-2, a time when vaccination against the infection was not available and no variant other than the wild one had been identified in Brazil. The main outcome was death after hospitalization. Comorbidities and demographics were evaluated as risk factors. Results: We studied 106 patients. The crude post-hospitalization death rate was 16.0%. The first 30 days of follow-up had the highest mortality rate. In a Cox regression model for post-hospitalization mortality, previous CKD (HR, 4.06, 95%CI 1.46 - 11.30) and longer hospital length of stay (HR 1.01, 95%CI 1.00 - 1.02) were the only factors statistically associated with death. Conclusions: Substantial 6-mo all-cause mortality was observed. Within the 6-mo follow-up, a higher risk of death was observed for patients who had prior CKD and longer hospital length of stay. These findings highlight the importance of more intensive medical surveillance during this period.

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