At least one dose of vaccine prior to COVID-19 infection provided 60% protection against post-discharge mortality, an Indian Council of Medical Research (ICMR) study on factors related to mortality within one year after discharge in hospitalised COVID-19 patients has found.
The study has also found there’s a higher chance of mortality within one year following discharge in younger as well as older age groups, males over 40 years of age, with comorbidities, and with moderate to severe COVID-19 disease.
Overall, the study’s findings suggest that a post-discharge mortality rate of 6.5% in patients hospitalised for COVID-19 warrants a vigilant follow-up.
“Encouragingly, vaccination before the COVID-19 infection confers protection to post-discharge mortality. Post-COVID Conditions (PCC) and the presence of comorbidities may have some association with late post discharge deaths; further research is warranted in this field,” the study said.
Similar trends were seen in participants in the 18-45 years age group.
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The study, however, cautions that the results relate to patients who had been hospitalised during their initial COVID-19 infection and could not be generalised for all COVID-19 patients.
The study observed that of the 14,419 participants contacted at least once in one year after discharge from hospital, 942 deaths or 6.5% all cause mortality was reported.
A nested matched case control analysis was conducted to evaluate the factors related to one-year post-discharge mortality.
The study also noted that the National Clinical Registry for the COVID-19 study team has conducted nested matched case control analyses to evaluate the factors related to one-year post-discharge mortality.
The ICMR has been maintaining the National Clinical Registry for COVID-19 at 31 centres across the country, where all hospitalised COVID-19 patients are periodically contacted by telephone till one year after discharge. Data collected till February 2023 were included in this analysis.
Meanwhile, other ongoing studies on COVID include the effect of the vaccine on thrombotic events in the 18-45 years population in India in 2022, and factors associated with sudden deaths in the same age bracket.
The study further states that in the present investigation, the history of PCC was associated with 2.7 times higher odds of post-discharge mortality.
The limitations of the current investigation include reliance on telephonic follow-up, which could have led to under reporting of the symptoms. The present analyses only included patients who were hospitalised due to COVID-19, and consequently, the findings cannot be generalised to all patients who had COVID-19.
Furthermore, the operational definition of PCC used in this study is not an exact match to either the World Health Organization (WHO) or the definition of the Centers for Disease Control (CDC) mentioned earlier. This variation of the definition for PCC may be a source of bias. In the first two nested case control analyses, it is possible that the participants could have died sometime after being contacted and were misclassified as controls rather than cases. “However, we do not expect any major bias to arise, as this misclassification would have made the analyses more conservative,’’ notes the study.
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