Analysis of lethal outcomes in COVID-19 convalescents in multidisciplinary hospital

Abstract

Health status of COVID-19 convalescents poses a serious burden on the healthcare system due to frequent decompensation of existing diseases and high mortality after episode of infection. This requires an analysis of not only the causes of death, but also the time of occurrence of complications in order to implement preventive measures and potentially reduce mortality Aim. The aim of the study was to carry out a clinical and pathoanatomical analysis of fatal outcomes in convalescents of COVID-19 in a multidisciplinary hospital.Material and Methods. The medical documentation of 67 deceased patients with a documented history of COVID-19 was analyzed. Patients were divided into five groups based on the nosological principle.Results. The study showed that the absolute majority of fatal outcomes occurred within one to two months (chi2 = 15.53; p = 0.001; df = 1); after that, the mortality rate gradually decreased over time. The rate of patients who died from acute and chronic decompensated cardiac diseases was 63%, which may be attributed to the specifics of the hospital. The number of neglected oncological diseases was 21% in our sample, which also should be considered a negative impact of the pandemic. In our study, the neglected oncological diseases were observed in 45% of patients, which was probably due to the profile of the hospital. The incidence rate of pulmonary embolism and other thrombotic complications was significantly higher in women (chi2 = 30.73; p < 0.001; df = 1). While comparing the time between recovery from COVID-19 and onset of death, we found that thrombotic complications occurred more often either immediately or within one to two months after recovery from COVID-19; sometimes patients already had a formed lung infarction, but in these cases the interval was longer (four to six months), which suggested the beginning of thrombosis during the acute stage of disease.Conclusion. At the early stage, it is necessary to analyze basic information about the epidemiology of post-COVID-19 syndrome taking into account patient age and comorbidities. Given the high frequency of deaths, most often associated with thrombotic events or disorders of the cardiovascular system, it is necessary to plan clinical and laboratory tests, appropriate registries and clinical trials in order to properly assess thee risks and prepare for the long-term consequences of COVID-19.