Long-term health outcomes following hospitalisation for COVID-19: a 30- month cohort analysis

Abstract

Context: Increased risks of death and hospitalisation for organ disorders after discharge for COVID-19 hospitalisation have been reported but their persistence is unknown. Methods: We conducted a nationwide cohort study using the French claims database; subjects hospitalised for COVID-19 between 2020/01/01 and 2020/08/30 were followed up to 30-months and matched to controls from the general population (GP) not hospitalised for COVID-19 during this period. Outcomes were all-cause mortality and organ disorders-related hospitalisation identified using ICD-10 codes. Cumulative incidences were estimated using the Kaplan-Meier method. Incidence rate ratios (IRR) were estimated such as the adjusted sub-distribution hazard ratio on 6-month periods during the follow-up using Cox regressions. Results: 63,990 COVID-19 subjects (mean age (SD) 65 years (18), 53.1% male) were matched to 319,891 controls. The weighted cumulative incidences of all-cause mortality and all-cause hospitalisation were 5,218/105 person-years (PY) [95%CI 5,127; 5,305] and 16,334/105 PY [16,162; 16,664] among COVID-19 subjects and 4,013/105 [3,960; 4,047] and 12,095/105 PY [12,024; 12,197] among controls, respectively. COVID-19 subjects were more likely to be hospitalised for cardiovascular (IRR 1.22 [1.15; 1.29]), psychiatric (IRR 1.41 [1.29; 1.53]), neurological (IRR 1.50 [1.41; 1.61]), and respiratory events (IRR 1.99 [1.87; 2.12]). The excess risk strongly decreased after the first 6 months for all outcomes but remained significantly increased up to 30-month for neurological, respiratory disorders, chronic renal failure and diabetes. Conclusions: COVID-19 hospitalised subjects were at increased risk of death or hospitalisation for various organ disorders up to 30 months after discharge, reflecting the multi-organ consequences of the disease.