Christian Günster1, Reinhard Busse2, Melissa Spoden1, Tanja Rombey2, Gerhard Schillinger1, Wolfgang Hoffmann3, Steffen Weber-Carstens4, Andreas Schuppert5, Christian Karagiannidis6. 1. Research Institute of the Local Health Care Funds, Federal Association of the Local Health Care Funds, Berlin, Germany. 2. Department of Health Care Management, Technische Universität Berlin, Berlin, Germany. 3. Section Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany. 4. Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany. 5. Institute for Computational Biomedicine II, University Hospital RWTH Aachen University, Aachen, Germany. 6. Department of Pneumology and Critical Care Medicine, Cologne-Merheim Hospital, Kliniken der Stadt Köln, Witten/Herdecke University Hospital, Cologne, 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.
BACKGROUND:COVID-19 frequently necessitates in-patient treatment and in-patientmortality 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-19patients 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-19patients 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.
Authors: Mateusz Sokolski; Konrad Reszka; Tomasz Suchocki; Barbara Adamik; Adrian Doroszko; Jarosław Drobnik; Joanna Gorka-Dynysiewicz; Maria Jedrzejczyk; Krzysztof Kaliszewski; Katarzyna Kilis-Pstrusinska; Bogusława Konopska; Agnieszka Kopec; Anna Larysz; Weronika Lis; Agnieszka Matera-Witkiewicz; Lilla Pawlik-Sobecka; Marta Rosiek-Biegus; Justyna M Sokolska; Janusz Sokolowski; Anna Zapolska-Tomasiewicz; Marcin Protasiewicz; Katarzyna Madziarska; Ewa A Jankowska Journal: J Clin Med Date: 2022-01-03 Impact factor: 4.241