Coronavirus | June 28, 2023 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

At a year, after-effects of COVID-19 hospitalization other than VTE similar to flu, sepsis

Compared to patients hospitalized with flu or sepsis, those with COVID-19 had increased risk of venous thromboembolism (VTE), stroke, depression, and anxiety in the 30 days after discharge, but over a year, only the risk for VTE was significantly elevated.

Being hospitalized for COVID-19 is associated with increased risk of venous thromboembolism in the subsequent year but otherwise, rates of new medical and mental health diagnoses appear similar to those after an admission for flu or sepsis, a recent study found.

The population-based cohort study included 379,366 patients hospitalized in Ontario, Canada: 26,499 who survived hospitalization for COVID-19 between April 1, 2020, and Oct. 31, 2021, were compared to 299,989 historical, prepandemic controls (17,516 hospitalized for influenza and 282,473 for sepsis) and 52,878 contemporary controls with sepsis. The primary outcome was occurrence of any of 13 prespecified conditions, including cardiovascular, neurological, and mental health conditions and rheumatoid arthritis, within a year of hospitalization. Results were published by JAMA Internal Medicine on June 20.

Within 30 days of discharge, hospitalization for COVID-19 was associated with significantly higher risk of venous thromboembolic disease with adjusted hazard ratios (aHRs) ranging from 3.04 versus influenza to 1.43 versus sepsis during the pandemic, as well as stroke (aHR range, 1.40 to 1.19) and depression and anxiety (aHR range, 1.49 to 1.33). The risk for venous thromboembolism versus influenza persisted when the full year after hospitalization was considered (aHR, 1.77; 95% CI, 1.36 to 2.31), but there was no increase in risk for any of the other studied cerebrovascular, cardiovascular, and neurological disorders, rheumatoid arthritis, or mental health conditions in patients hospitalized with COVID-19 compared to those with influenza or sepsis.

“It is important to note that a higher proportion of people hospitalized for COVID-19 died during hospitalization compared with influenza or sepsis, which influences the risk profile of survivors and may explain why the risks of many outcomes were lower among survivors of COVID-19 hospitalization compared with influenza or sepsis,” the study authors said. The study's results “do not diminish the effects of [post-COVID-19 conditions] on populations and health systems around the world” but do “suggest that many of these conditions may be related to the severity of illness from any infection that necessitated hospitalization, rather than being direct consequences of infection with SARS-CoV-2,” the authors noted.

The results differ from some previous research, possibly due to the use of healthier comparator groups in other studies, the authors said.