MORBIDITY AND MORTALITY OUTCOMES FOR PATIENTS WITH MODERATE-TO-SEVERE COVID-19 DISEASES: A POST-HOSPITALIZATION FOLLOW-UP STUDY
Intro: The burden of post-COVID-related morbidity and mortality is significant yet undermined. We studied the morbidity and mortality outcomes of COVID-19 patients with moderate-to-severe diseases by 90-day post-hospitalization. Methods: This retrospective cohort study included 510 COVID-19 patients...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-05-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971223005052 |
| _version_ | 1827945162128490496 |
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| author | C.P. Hor L.K. Teo H.X. Wang Y.J. Teoh T.L. Chong C.H. Yen N. Abdul Mutalib J.T. Cheng |
| author_facet | C.P. Hor L.K. Teo H.X. Wang Y.J. Teoh T.L. Chong C.H. Yen N. Abdul Mutalib J.T. Cheng |
| author_sort | C.P. Hor |
| collection | DOAJ |
| description | Intro: The burden of post-COVID-related morbidity and mortality is significant yet undermined. We studied the morbidity and mortality outcomes of COVID-19 patients with moderate-to-severe diseases by 90-day post-hospitalization. Methods: This retrospective cohort study included 510 COVID-19 patients admitted to Kepala Batas Hospital with moderate to severe diseases, requiring oxygen therapy during hospitalization (Malaysia COVID severity category ≥5; WHO scale ≥5), between January and August 2021. We conducted telephone surveillance for 90 days post-discharge from the hospital, assessing for post- COVID complications and mortality. Relevant clinical data were extracted from medical records. Multiple logistic regression was employed to examine factors associated with post-COVID mortality after index hospitalization. Findings: Among 510 patients, 51%(n=260) were male with a mean age of 52.1 (14.65) years. A third had hypertension (39.8%) and diabetes (31.4%). Only 15.5% were partially vaccinated and 4.9% had complete vaccination before hospitalization. Nearly 65% were supplemented with nasal prong or face mask oxygenation (<10L/ min), 25.7% received high flow oxygenation and 10% were mechanically ventilated. Approximately 23.3% (n=119) of patients were admitted to the intensive care unit. By 90-day post-hospitalization, 46% (n=203) reported residual symptoms: lethargy (14.5%), dyspnoea (12.2%), hair loss (7.5%), memory loss (6.3%), depression (3.9%), anxiety (2.7%) and 1.6% required home oxygen supplementation. Forty-four patients (8.5%) were re- hospitalized at least once, with 40.9% due to post-COVID complications. About 87% of patients attended their post-COVID clinic appointment. Nearly 13.5% (n=69) of patients died within 90 days after being discharged from the hospital. Adjusted for gender, comorbids and ventilatory status, age ≥60 years (aOR 7.96; 95%CI 3.75-16.92; p<0.001), diabetes (aOR 2.30; 95%CI 1.12-4.72; p=0.024) and high oxygen requirement (aOR 3.41; 95%CI 1.56-7.46; p=0.002), were associated with increased 90-day post-COVID mortality. Conclusion: Post-COVID morbidity and mortality are significant among survivors hospitalized for moderate- to-sever disease. Comprehensive care must be addressed to improve the outcomes of post-COVID patients. |
| first_indexed | 2024-03-13T10:39:48Z |
| format | Article |
| id | doaj.art-24847dae739a4ed89a0dadbec1bd5a2b |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-03-13T10:39:48Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-24847dae739a4ed89a0dadbec1bd5a2b2023-05-18T04:39:12ZengElsevierInternational Journal of Infectious Diseases1201-97122023-05-01130S152S153MORBIDITY AND MORTALITY OUTCOMES FOR PATIENTS WITH MODERATE-TO-SEVERE COVID-19 DISEASES: A POST-HOSPITALIZATION FOLLOW-UP STUDYC.P. Hor0L.K. Teo1H.X. Wang2Y.J. Teoh3T.L. Chong4C.H. Yen5N. Abdul Mutalib6J.T. Cheng7Kepala Batas Hospital, Department of Medicine, Kepala Batas, MalaysiaPulau Pinang Hospital, Clinical Research Centre, George Town, MalaysiaKepala Batas Hospital, Department of Medicine, Kepala Batas, MalaysiaKepala Batas Hospital, Department of Pharmacy, Kepala Batas, MalaysiaKepala Batas Hospital, Department of Medicine, Kepala Batas, MalaysiaQueen Elizabeth II Hospital, Clinical Research Centre, Kota Kinabalu, MalaysiaKepala Batas Hospital, Health Management Unit, Kepala Batas, MalaysiaKepala Batas Hospital, Department of Medicine, Kepala Batas, MalaysiaIntro: The burden of post-COVID-related morbidity and mortality is significant yet undermined. We studied the morbidity and mortality outcomes of COVID-19 patients with moderate-to-severe diseases by 90-day post-hospitalization. Methods: This retrospective cohort study included 510 COVID-19 patients admitted to Kepala Batas Hospital with moderate to severe diseases, requiring oxygen therapy during hospitalization (Malaysia COVID severity category ≥5; WHO scale ≥5), between January and August 2021. We conducted telephone surveillance for 90 days post-discharge from the hospital, assessing for post- COVID complications and mortality. Relevant clinical data were extracted from medical records. Multiple logistic regression was employed to examine factors associated with post-COVID mortality after index hospitalization. Findings: Among 510 patients, 51%(n=260) were male with a mean age of 52.1 (14.65) years. A third had hypertension (39.8%) and diabetes (31.4%). Only 15.5% were partially vaccinated and 4.9% had complete vaccination before hospitalization. Nearly 65% were supplemented with nasal prong or face mask oxygenation (<10L/ min), 25.7% received high flow oxygenation and 10% were mechanically ventilated. Approximately 23.3% (n=119) of patients were admitted to the intensive care unit. By 90-day post-hospitalization, 46% (n=203) reported residual symptoms: lethargy (14.5%), dyspnoea (12.2%), hair loss (7.5%), memory loss (6.3%), depression (3.9%), anxiety (2.7%) and 1.6% required home oxygen supplementation. Forty-four patients (8.5%) were re- hospitalized at least once, with 40.9% due to post-COVID complications. About 87% of patients attended their post-COVID clinic appointment. Nearly 13.5% (n=69) of patients died within 90 days after being discharged from the hospital. Adjusted for gender, comorbids and ventilatory status, age ≥60 years (aOR 7.96; 95%CI 3.75-16.92; p<0.001), diabetes (aOR 2.30; 95%CI 1.12-4.72; p=0.024) and high oxygen requirement (aOR 3.41; 95%CI 1.56-7.46; p=0.002), were associated with increased 90-day post-COVID mortality. Conclusion: Post-COVID morbidity and mortality are significant among survivors hospitalized for moderate- to-sever disease. Comprehensive care must be addressed to improve the outcomes of post-COVID patients.http://www.sciencedirect.com/science/article/pii/S1201971223005052 |
| spellingShingle | C.P. Hor L.K. Teo H.X. Wang Y.J. Teoh T.L. Chong C.H. Yen N. Abdul Mutalib J.T. Cheng MORBIDITY AND MORTALITY OUTCOMES FOR PATIENTS WITH MODERATE-TO-SEVERE COVID-19 DISEASES: A POST-HOSPITALIZATION FOLLOW-UP STUDY International Journal of Infectious Diseases |
| title | MORBIDITY AND MORTALITY OUTCOMES FOR PATIENTS WITH MODERATE-TO-SEVERE COVID-19 DISEASES: A POST-HOSPITALIZATION FOLLOW-UP STUDY |
| title_full | MORBIDITY AND MORTALITY OUTCOMES FOR PATIENTS WITH MODERATE-TO-SEVERE COVID-19 DISEASES: A POST-HOSPITALIZATION FOLLOW-UP STUDY |
| title_fullStr | MORBIDITY AND MORTALITY OUTCOMES FOR PATIENTS WITH MODERATE-TO-SEVERE COVID-19 DISEASES: A POST-HOSPITALIZATION FOLLOW-UP STUDY |
| title_full_unstemmed | MORBIDITY AND MORTALITY OUTCOMES FOR PATIENTS WITH MODERATE-TO-SEVERE COVID-19 DISEASES: A POST-HOSPITALIZATION FOLLOW-UP STUDY |
| title_short | MORBIDITY AND MORTALITY OUTCOMES FOR PATIENTS WITH MODERATE-TO-SEVERE COVID-19 DISEASES: A POST-HOSPITALIZATION FOLLOW-UP STUDY |
| title_sort | morbidity and mortality outcomes for patients with moderate to severe covid 19 diseases a post hospitalization follow up study |
| url | http://www.sciencedirect.com/science/article/pii/S1201971223005052 |
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