Long-Term Survival among Patients Hospitalized for COVID-19 during the First Three Epidemic Waves: An Observational Study in a Northern Italy Hospital

Marinella Bertolotti, Marta Betti, Fabio Giacchero, Chiara Grasso (), Genny Franceschetti, Margherita Carotenuto, Anna Odone, Guglielmo Pacileo, Daniela Ferrante and Antonio Maconi
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Marinella Bertolotti: Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
Marta Betti: Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
Fabio Giacchero: Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
Chiara Grasso: Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
Genny Franceschetti: Medical Directorate, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
Margherita Carotenuto: Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
Anna Odone: Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
Guglielmo Pacileo: Local Health Authority Alessandria, 15121 Alessandria, Italy
Daniela Ferrante: Unit of Medical Statistics, Department of Translational Medicine, Università del Piemonte Orientale and Cancer Epidemiology Unit, CPO-Piemonte, 28100 Novara, Italy
Antonio Maconi: Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy

IJERPH, 2022, vol. 19, issue 22, 1-11

Abstract: The mortality rate of hospitalized COVID-19 patients differed strongly between the first three pandemic waves. Nevertheless, their long-term survival has been poorly assessed. The aim of this study was to compare the clinical characteristics and mortality rates of 825 patients with coronavirus disease 2019 (COVID-19) infection who were hospitalized at the Alessandria hub hospital, in Northern Italy, during the first fifty days of the first three pandemic waves. Each subject was followed in terms of vital status for six months from the date of hospital admission or until deceased. Patients admitted during the three waves differed in age ( p = 0.03), disease severity ( p < 0.0001), Charlson comorbidity index ( p = 0.0002), oxygen therapy ( p = 0.002), and invasive mechanical ventilation ( p < 0.0001). By the end of follow-up, 309 deaths (38.7%) were observed, of which 186 occurred during hub hospitalization (22.5%). Deaths were distributed differently among the waves ( p < 0.0001), resulting in being higher amongst those subjects admitted during the first wave. The COVID-19 infection was reported as the main cause of death and patients with a higher mortality risk were those aged ≥65 years [adjusted HR = 3.40 (95% CI 2.20–5.24)], with a higher disease severity [adjusted HR = 1.87 (95%CI 1.43–2.45)], and those requiring oxygen therapy [adjusted HR = 2.30 (95%CI 1.61–3.30)]. In conclusion, COVID-19 patients admitted to our hub hospital during the second and the third waves had a lower risk of long-term mortality than those admitted during the first. Older age, more severe disease, and the need for oxygen therapy were among the strongest risk factors for poor prognosis.

Keywords: COVID-19; survival; waves; hospitalization; prognostic factors; follow-up (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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