OBJECTIVE
To assess the distant outcomes during three-year post-hospital follow-up of patients after in-patient care for COronaVIrus Disease 2019 (COVID-19) in a prospective registry.
MATERIALS AND METHODS
Outcomes for 3.2±0.7 years of follow-up after hospitalization for COVID-19 were analyzed in 836 patients (age 60.2±14.7 years, 51.2% were males). Cases of death, development of non-fatal myocardial infarction (MI) and non-fatal cerebral stroke (CS), hospitalizations, recurrent COVID-19 were evaluated.
RESULTS
During the follow-up period, 63 (7.5%) patients died, 8 (0.96%) cases of MI were registered and 9 (1.1%) — CS, 270 (32.3%) patients were hospitalized, 174 (20.8%) re-suffered COVID-19. Patients with cardiovascular multimorbidity had higher mortality (by a factor of 7), incidence of non-fatal MI and CS, hospitalization than in persons without cardiovascular diseases (CVDs). Male sex is associated with risk of death: HR=2.077, p=0.007. Factors of age, intensive care unit stay during reference hospitalization are associated (p<0.005) not only with the risk of death from all causes (hazard ratio (HR)=1.065 and HR=4.2, respectively), but also with the risk of composite endpoint development (death, non-fatal MI and CS, revascularization procedures): odds ratio (OR)=1.033 and OR=1.85. Hospitalization is associated with older age (OR)=1.027; p<0.001), presence of CVDs (OR=1.66; p=0.01) and chronic non-cardiac diseases (OR=1.51; p=0.013). Risk of developing new CVDs and non-cardiac diseases is associated with older age (OR=1.02; p=0.03). Risk of COVID-19 recurrent cases is higher in presence of CVDs (HR=1.62; p=0.011), lower in persons vaccinated against SARS-CoV-2 (HR=0.55; p<0.001). Higher acute upper respiratory infections morbidity is associated (p<0.001) with younger age and lack of non-cardiac multimorbidity.
CONCLUSION
The proportion of dead amounted to 7.5% for 3 years of post-hospital follow-up of patients for COVID-19, hospitalizations and COVID-19 recurrent cases were the most frequent events. Mortality was 7 times higher in the group with cardiovascular multimorbidity than in persons without cardiovascular diseases. Factors associated with the fatal outcome development were the following: age, cardiovascular and non-cardiac multimorbidity, treatment in the intensive care unit during reference hospitalization. Risk of re-hospitalization for any cause is associated with older age, presence of cardiovascular diseases and non-cardiac diseases. Risk of COVID-19 recurrent cases was 1.5 times higher in presence of cardiovascular diseases, but almost 2 times lower in vaccinated against SARS-CoV-2 subjects in the post-COVID period.
