One-year mortality in COVID-19 is associated with patients’ comorbidities rather than pneumonia severity

• DOI: 10.1016/j.resmer.2022.100976
• Publication Date: 2022-11-25T16:52:40Z
• Authors: Luca Novelli; Federico Raimondi; Greta Carioli; Alessandra Carobbio; Simone Pappacena; Roberta Biza; Roberta Trapasso; Marisa Anelli; Mariangela Amoroso; Chiara Allegri; Luca Malandrino; Gianluca Imeri; Caterina Conti; Marta Beretta; Mauro Gori; Emilia D'Elia; Michele Senni; Ferdinando Luca L...; Marco Rizzi; Roberto Cosentini; Alessandro Rambaldi; Arianna Masciulli; Antonello Gavazzi; Paolo Solidoro; Sandro Sironi; Stefano Fagiuoli; Tiziano Barbui; Fabiano Di Marco
• Keywords: SARS-CoV-2; COVID-19; Aftercare; Pneumonia; Patient Discharge; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Original Article; Comorbidities; COVID-19; Mortality; Pneumonia; Respiratory failure; Comorbidities; COVID-19; Mortality; Pneumonia; Respiratory failure;; Aged

In patients with pneumonia or acute respiratory distress syndrome who survived hospitalization, one-year mortality can affect up to one third of discharged patients. Therefore, significant long-term mortality after COVID-19 respiratory failure could be expected. The primary outcome of the present study was one-year all-cause mortality in hospitalized COVID-19 patients.Observational study of COVID-19 patients hospitalized at Papa Giovanni XXIII Hospital (Bergamo, Italy), during the first pandemic wave.A total of 1326 COVID-19 patients were hospitalized. Overall one-year mortality was 33.6% (N 446/1326), with the majority of deaths occurring during hospitalization (N=412, 92.4%). Thirty-four patients amongst the 914 discharged (3.7%) subsequentely died within one year. A third of these patients died for advanced cancer, while death without a cause other than COVID-19 was uncommon (8.8% of the overall post-discharge mortality). In-hospital late mortality (i.e. after 28 days of admission) interested a population with a lower age, and fewer comorbidities, more frequentely admitted in ICU. Independent predictors of post-discharge mortality were age over 65 years (HR 3.19; 95% CI 1.28-7.96, p-value=0.013), presence of chronic obstructive pulmonary disease (COPD) (HR 2.52; 95% CI 1.09-5.83, p-value=0.031) or proxy of cardiovascular disease (HR 4.93; 95% CI 1.45-16.75, p-value=0.010), and presence of active cancer (HR 3.64; 95% CI 1.50-8.84, p-value=0.004), but not pneumonia severity.One-year post-discharge mortality depends on underlying patients' comorbidities rather than COVID-19 pneumonia severity per se. Awareness among physicians of predictors of post-discharge mortality might be helpful in structuring a follow-up program for discharged patients.