ULL examines Covid mortality factors 10 months after hospital discharge
Researchers from the University of La Laguna (ULL) analyzed predictors of coronavirus mortality At 10 months after discharge, patients admitted to the University Hospital of the Canary Islands (HUC) from March to December 2020, during the first three waves of the pandemic.
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The university center reported on Monday a case of the disease caused by the SARS-CoV-2 coronavirus, which in 2020 bring global health under control and led to a pandemic, it can proceed in different ways: asymptomatically, with mild or moderate symptoms, or with more serious clinical forms.
Over the years, many studies have been published describing risk factors for both contracting the infection and its subsequent development into a more serious form, such as: risk factors for cardiovascular disease (obesity, high blood pressure, diabetes, high cholesterol or tobacco use, among others), as well as a history of pathologies such as cardiovascular disease or chronic respiratory diseases.
All these factors are highly prevalent in the Canary Islands population, ULL points out, noting that it is quite common to find published studies that mention risk factors for mortality during acute phase of infectionthat is, the mortality rate of patients who died during their stay in the hospital was assessed.
However, what happens in the long term to patients who have overcome acute infection and have the risk factors described earlier is not well understood.
Now, researcher Candelaria Martin from the Department of Internal Medicine, Dermatology and Psychiatry has calculated how many patients died after contracting Covid-19 upon admission to HUC, both during the acute phase of infection and ten months after hospital discharge, and analyzed which factors predicted a greater risk of death.
A total of 762 patients who were consecutively admitted to the HUC COVID unit during the first three waves of the pandemic (March to December 2020), all with diagnostic test confirmation, were included in the study.
Patients in the study
The inclusion criteria for patients in the study were mainly physicians who were suspected of having any risk factor for developing a serious infection for example, those over 60 years of age, high blood pressure, cardiovascular disease (heart failure or previous myocardial infarction), obesity, chronic lung disease, cancer, those with cognitive impairment, those with any pathology that compromises the immune system or who are on immunosuppressive treatment, transplant patients, or patients with chronic kidney disease.
Another criterion for inclusion in this group was clinical severity (double pneumonia, respiratory failure), as well as social factors such as inability to care for themselves or patients who required hospitalization because they could not isolate at home or lived in dormitories with other vulnerable patients.
All patients underwent a complete history, physical examination, laboratory tests, and chest radiography. They were followed daily throughout their hospitalization, and survival was subsequently re-evaluated at ten months.
Regarding the main findings, the researchers found that 108 patients died upon admission. And After ten months of follow-up, a total of 195 people had died.
The main factors associated with a higher risk of mortality at admission were cardiac or renal decompensation and age over 71 years.
When assessing what was associated with long-term mortality, these included the presence of cardiac or renal decompensation on admission, a history of cognitive impairment or cancer, and an elevated white blood cell count on admission.
The main difficulty in conducting this study was that care overload that the health care system was damaged during the pandemic, “when we had to examine many patients with serious infections, which made it very difficult to propose an investigation of this kind,” the researchers note.
However, they wanted to find an answer to the question of how this infection would behave in the long term, with the aim of the results of the study having an impact on improving patient care, they add, and this motivation was the impetus for carrying out this study, which became the basis for Victor Vera’s doctoral thesis, recently delivered at the University of La Laguna.
Many medical and nursing assistants, nurses, male nurses and doctors, whose work was of fundamental importance, participated in the examination of these patients.
These findings may help identify patients who require more intensive follow-up after hospital discharge to improve long-term prognosis.