A large study conducted in England found that, compared to the general population, people who had been hospitalized for COVID-19—and survived for at least one week after discharge—were more than twice as likely to die or be readmitted to the hospital in the next several months. Krishnan Bhaskaran and colleagues from the London School of Hygiene and Tropical Medicine, University of Oxford and clinical software provider TPP present these findings in the open-access journal PLOS Medicine.
Previous research has suggested that people with COVID-19 may face a greater risk of health issues for several months following their initial infection. However, evidence on this topic remains limited.
To help clarify long-term health risks for people with COVID-19, Bhaskaran and colleagues focused on those who had been hospitalized for the disease. The researchers conducted a statistical analysis of electronic health records from the database OpenSAFELY, evaluating data on nearly 25,000 patients who had been discharged after being hospitalized for COVID-19 in 2020, and for comparison, more than 100,000 members of the general population.
The analysis showed that, compared to the general population, people who had been hospitalized for COVID-19 and lived for at least one week after discharge had twice the overall risk of hospital readmission or death in subsequent months. They also faced nearly five times the risk of death from any cause.
In order to account for risks after hospitalization for an infectious disease, the researchers also considered data from more than 15,000 people who had been hospitalized for influenza in 2017-19. Statistical analysis found that, compared to the influenza patients, COVID-19 patients faced a slightly lower combined risk of hospitalization or death overall. However, people who had been hospitalized for COVID-19 had a greater risk than influenza patients of death from any cause, a greater risk of hospital readmission or death resulting from their initial infection, and a greater risk of death due to dementia.
Overall, these findings align with other research showing increased risks of subsequent health issues for people who have had COVID-19. The authors suggest these risks could be mitigated by policies to increase monitoring of COVID-19 patients after discharge and to raise awareness of potential complications.
Bhaskaran adds, “Our findings suggest that people who have had a severe case of COVID-19 requiring a hospital stay are at substantially elevated risk of experiencing further health problems in the months after their hospitalisation; it is important that patients and their doctors are aware of this so that any problems that develop can be treated as early as possible. Our findings also highlight the importance of getting vaccinated, which is the best tool we have for preventing severe COVID-19 in the first place.”
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Citation: Bhaskaran K, Rentsch CT, Hickman G, Hulme WJ, Schultze A, Curtis HJ, et al. (2022) Overall and cause-specific hospitalisation and death after COVID-19 hospitalisation in England: A cohort study using linked primary care, secondary care, and death registration data in the OpenSAFELY platform. PLoS Med 19(1): e1003871. https://doi.org/10.1371/journal.pmed.1003871
Author Countries: United Kingdom
Funding: This work was jointly funded by UKRI, NIHR and Asthma UK-BLF [COV0076; MR/V015737/] and the Longitudinal Health and Wellbeing strand of the National Core Studies programme. The OpenSAFELY data science platform is funded by the Wellcome Trust. TPP provided technical expertise and infrastructure within their data centre pro bono in the context of a national emergency. KB holds a Senior Research Fellowship from Wellcome (220283/Z/20/Z). RME is funded by HDR UK (grant: MR/S003975/1) and MRC (grant: MC_PC 19065). RM holds a Sir Henry Wellcome fellowship funded by Wellcome. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests. The authors declare that: AS is employed by LSHTM on a fellowship sponsored by GSK. CWG is supported by a Wellcome Intermediate Clinical Fellowship (201440/Z/16/Z), and also holds grants from the Alzheimer’s Society, the British Heart Foundation and the Rosetrees Trust for unrelated work. RM has received consulting fees from AMGEN unrelated to the submitted work. ID has received grants from and holds shares in GSK. HIM is funded by the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Vaccines and Immunisation, a partnership between Public Health England and the London School of Hygiene & Tropical Medicine. JP is an employee of TPP (Leeds) Ltd who own SystmOne. BG has received research funding from the Laura and John Arnold Foundation, the NHS National Institute for Health Research (NIHR), the NIHR School of Primary Care Research, the NIHR Oxford Biomedical Research Centre, the Mohn-Westlake Foundation, NIHR Applied Research Collaboration Oxford and Thames Valley, the Wellcome Trust, the Good Thinking Foundation, Health Data Research UK (HDRUK), the Health Foundation, and the World Health Organisation; he also receives personal income from speaking and writing for lay audiences on the misuse of science.