Many Hospitalized COVID Patients Develop New Ailments Later

Severe effects of COVID-19 lingered past discharge, as hospitalized patients had increased rates of multi-organ dysfunction compared to the general population, British researchers found.

Hospitalized patients with COVID-19 were diagnosed with major cardiovascular events, chronic liver disease, chronic kidney disease, and diabetes after being discharged from the hospital more frequently than a matched cohort, reported Amitava Banerjee, DPhil, of University College London, and colleagues.

Not surprisingly, patients with acute COVID-19 who were discharged from the hospital had nearly four times greater rates of hospital readmission, and nearly eight times greater rates of death than the matched control group, with significantly raised rates of respiratory disease and cardiovascular disease, Banerjee’s group wrote in The BMJ.

The authors noted most studies focused on symptoms associated with post-COVID syndrome rather than organ dysfunction, and few have included a control group, “allowing the inference of counterfactual outcomes.”

Banerjee and colleagues examined data from National Health Service hospitals in England through Aug. 31, 2020. Just under 48,000 patients hospitalized with COVID-19 were matched to controls from the general population of England.

Mean age for COVID patients was 65, and 55% were men. They were more likely than controls to be men, 50 or older, former smokers, and overweight or obese, and to have pre-existing conditions and previous hospital admission.

Overall, about 29% of COVID patients were readmitted, with mean follow up of 140 days, and about 12% died after discharge. These rates were 3.5 times and 7.7 times greater than matched controls, respectively.

About 14,000 COVID patients had respiratory disease diagnosed after discharge, and about 6,100 of these diagnoses were new onset. This amounted to rates of 6.0 times and 27.3 times greater than matched controls.

Compared with matched controls, COVID patients experienced major adverse cardiovascular events 3.0 times more frequently, chronic kidney disease 2.8 times more frequently, chronic liver disease 1.9 times more frequently, and diabetes 1.5 times more frequently during follow-up.

Absolute risk of death, readmission, and multiorgan dysfunction after discharge was greater for individuals, ages 70 or older, versus younger individuals. These risks were higher among white versus non-white individuals.

“Compared with outcome rates that might be expected to occur in these groups in the general population, however, younger patients and ethnic minority individuals had greater relative risks than those aged 70 or more and those in the white ethnic group, respectively,” the authors wrote.

Limitations to the data included potential residual confounding, and an inability to disaggregate rate ratios stratified by age due to limited events in the control group. Individuals with undiagnosed hypertension and diabetes were classified as not having these conditions.

“Urgent research is needed to understand the risk factors for post-COVID syndrome so that treatment can be targeted better to demographically and clinically at risk populations,” Banerjee’s group concluded.

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  Molly Walker is an associate editor, who covers infectious diseases for MedPage Today. She has a passion for evidence, data and public health. Follow

Disclosures

Ayoubkhani disclosed no relevant relationships with industry.

Banerjee disclosed serving as a trustee of the South Asian Health Foundation (SAHF) and support from AstraZeneca. A co-author disclosed relevant relationships with the Independent Scientific Advisory Group for Emergencies (SAGE) and SAHF, as well as serving as director of the University of Leicester Centre for Black Minority Ethnic Health.

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