ICMR study findings suggest post-discharge mortality rate of 6.5% in patients hospitalised for COVID-19
A new study led by the Clinical Studies and Trials Unit of the Indian Council of Medical Research (ICMR) found that vaccination against COVID-19 before contracting the infection provided around 60 per cent protection against post-discharge death after at least one dose.
According to the researchers, vaccine effectiveness reduced after 168-195 days but was still around 86 per cent, the paper released on Monday highlighted.
Overall, the study findings suggest that a post-discharge mortality rate of 6.5 per cent in patients hospitalized for COVID-19 warrants a vigilant follow-up, the study said.
“Younger as well as older age, male gender, moderate-to-severe disease, and presence of comorbidities are associated with higher odds of post-discharge one-year mortality,” the researchers emphasised.
“We observed that the male gender, age above 40 years, history of moderate-to-severe COVID-19 disease, and presence of comorbidities increased the odds of death within one year of discharge from the hospital,” the researchers said.
“Moderate-to-severe disease, being linked to post-discharge all-cause mortality, indicates lingering damage due to COVID-19. Although some reports have claimed that the severity of pneumonia had no bearing on post-discharge mortality, many have documented the association of intensive care unit stay or mechanical ventilation with post-discharge mortality,” the researchers said.
The current analysis additionally showed that the participants younger than 18 years had 1.7 times higher odds of dying after discharge from the hospital. “Our earlier reports have shown that comorbidities among admitted children are more severe, such as malignancies, kidney disorders, hematological disorders, and others,” the study said.
Post-COVID condition (PCC) was reported in 17.1 per cent of the participants and was linked with 2.7 times higher odds of post-discharge mortality. PCC is defined by the Centres for Disease Control and Prevention (CDC) as “signs, symptoms, or conditions that persist or develop at four weeks or more after the initial infection”. The World Health Organization includes a wide range of symptoms in others, including constitutional, neurological, cardiovascular, and gastrointestinal.
The odds of dying after the first follow-up between 4-8 weeks were higher among those with comorbidity and those who reported PCC. “The odds of death after the first follow-up were lower among those who had a moderate-to-severe disease during initial hospitalization and had received anti-SARS-CoV-2 vaccination, although the association was not significant,” the researchers said.
As many as 14,419 participants were followed up at least once between four weeks and one-year post-discharge. Of the 942 deaths, 175 (18.6 per cent) were in the age group of 18-45 years.
A series of three nested case-control analyses were conducted on follow-up data collected in the National Clinical Registry for COVID-19 between September 2020 and February 2023 from 31 hospitals.
Nested case-control analyses are studies that include diagnosed individuals in comparison to matched controls who have not developed the disease.
The National Clinical Registry for COVID-19 is an ongoing electronic platform developed and maintained by the ICMR in collaboration with the Ministry of Health and Family Welfare, All India Institute of Medical Sciences, and the National Institute of Medical Statistics.
The study does have the limitation of being conducted via telephone, which could indicate an under-reporting of symptoms. Moreover, the patients included were hospitalised due to COVID-19 and thus cannot be generalized to all patients who had COVID-19.
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