Cozzolino Domenico, Romano Ciro, Sardu Celestino, Nevola Riccardo, Umano Giuseppina Rosaria, Rinaldi Luca, Adinolfi Luigi Elio, Catalini Christian, Marrone Aldo, Municinò Maurizio, Sasso Ferdinando Carlo, Marfella Raffaele
Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, 80138 Naples, Italy.
Department of the Woman and the Child and of General and Specialized Surgery, University of Campania L. Vanvitelli, 80138 Naples, Italy.
J Clin Med. 2023 Aug 31;12(17):5691. doi: 10.3390/jcm12175691.
Limited data are available on outcomes among COVID-19 patients beyond the acute phase of the disease. All-cause mortality among our COVID-19 patients one year after hospital discharge and factors/conditions associated with death were evaluated. All patients discharged from our COVID center were periodically evaluated by clinical assessment and by digital healthcare registry consultation. All findings acquired on discharge day represented the baseline data and were utilized for statistics. Of the 208 patients admitted, 187 patients were discharged. Among these, 17 patients died within 12 months (non-survivors). Compared to survivors, non-survivor patients were significantly ( < 0.05) older, exhibited significantly greater comorbidities and prevalence of active malignancy, heart failure, and arrhythmias, and showed significantly higher circulating levels of B-type natriuretic peptide, troponin, C-reactive protein, and d-dimer, as well as a longer heart-rate-corrected QT interval and significantly lower values for the glomerular filtration rate. Following multivariate analysis, cancer, arrhythmias, and high C-reactive protein levels were found to be factors independently associated with death. At the one-year follow-up, about 9% of patients discharged from our COVID center had a fatal outcome. Ageing, myocardial injury, impaired renal function, and, in particular, cancer, hyperinflammation, and arrhythmias represented strong predictors of the worst long-term outcome among COVID-19 patients.
关于新冠病毒疾病急性期之后的新冠病毒肺炎患者的预后数据有限。我们评估了新冠病毒肺炎患者出院一年后的全因死亡率以及与死亡相关的因素/病症。我们新冠中心所有出院患者均通过临床评估和数字医疗注册咨询进行定期评估。出院当天获取的所有结果代表基线数据,并用于统计分析。在收治的208例患者中,187例患者出院。其中,17例患者在12个月内死亡(非幸存者)。与幸存者相比,非幸存者患者年龄显著更大(P<0.05),合并症以及活动性恶性肿瘤、心力衰竭和心律失常的患病率显著更高,B型利钠肽、肌钙蛋白、C反应蛋白和D-二聚体的循环水平显著更高,心率校正QT间期更长,肾小球滤过率值显著更低。多因素分析后发现,癌症、心律失常和高C反应蛋白水平是与死亡独立相关的因素。在一年随访时,我们新冠中心出院患者中约9%出现了致命结局。衰老、心肌损伤、肾功能受损,尤其是癌症、炎症反应过度和心律失常是新冠病毒肺炎患者长期预后最差的有力预测因素。