Marko Lucijanić, Hematology Department,University Hospital Dubrava, Av. Gojka Šuška 6, 10000 Zagreb, Croatia,
Croat Med J. 2022 Aug 31;63(4):335-342. doi: 10.3325/cmj.2022.63.335.
To assess the long-term survival after hospital discharge of patients hospitalized due to coronavirus disease 2019 (COVID-19).
We retrospectively reviewed data on post-discharge survival of 2586 COVID-19 patients hospitalized in our tertiary hospital from March 2020 to March 2021.
Among 2586 patients, 1446 (55.9%) were men. The median age was 70 years, interquartile range (IQR, 60-80). The median Charlson comorbidity index was 4 points, IQR (2-5). The median length of hospital stay was 10 days, IQR (7-16). During a median follow-up of 4 months, 192 (7.4%) patients died. The median survival time after hospital discharge was not reached, and 3-month, 6-month, and 12-month survival rates were 93%, 92%, and 91%, respectively. In a multivariate analysis, mutually independent predictors of worse mortality after hospital discharge were age >75 years, Eastern Cooperative Oncology Group status 4, white blood cell count >7 ×109/L, red cell distribution width >14%, urea on admission >10.5 mmol/L, mechanical ventilation during hospital stay, readmission after discharge, absence of obesity, presence of chronic obstructive pulmonary disease, dementia, and metastatic malignancy (P<0.05 for all).
Substantial risk of death persists after hospital admission due to COVID-19. Factors related to an increased risk are older age, higher functional impairment, need for mechanical ventilation during hospital admission, parameters indicating more pronounced inflammation, impaired renal function, and particular comorbidities. Interventions aimed at improving patients' functional capacity may be needed.
评估因 2019 年冠状病毒病(COVID-19)住院患者出院后的长期生存情况。
我们回顾性分析了 2020 年 3 月至 2021 年 3 月期间在我院住院的 2586 例 COVID-19 患者出院后生存数据。
在 2586 例患者中,1446 例(55.9%)为男性。中位年龄为 70 岁,四分位距(IQR,60-80)。中位 Charlson 合并症指数为 4 分,IQR(2-5)。中位住院时间为 10 天,IQR(7-16)。中位随访 4 个月期间,192 例(7.4%)患者死亡。出院后中位生存时间未达到,3 个月、6 个月和 12 个月生存率分别为 93%、92%和 91%。多变量分析显示,出院后死亡率较高的独立预测因素为年龄>75 岁、东部合作肿瘤组(ECOG)状态 4、白细胞计数>7×109/L、红细胞分布宽度>14%、入院时尿素>10.5mmol/L、住院期间需要机械通气、出院后再入院、无肥胖、慢性阻塞性肺疾病、痴呆和转移性恶性肿瘤(所有 P<0.05)。
因 COVID-19 住院后仍存在较大死亡风险。与死亡风险增加相关的因素包括年龄较大、功能损害更严重、住院期间需要机械通气、表明炎症更明显的参数、肾功能受损以及特定的合并症。可能需要采取干预措施来改善患者的功能能力。