A new large cohort study in Israel suggests that adults who survive a COVID hospitalization face significantly higher long-term mortality than their uninfected peers, with elevated risk persisting for 2 years after hospitalization. The findings were published in the International Journal of Infectious Diseases.
Drawing on electronic health records from Clalit Health Services, one of the largest healthcare organizations in Israel, researchers tracked 16,445 matched pairs aged 40 and older who were hospitalized for COVID between March 2020 and December 2021 and who survived at least 30 days after being discharged. Each patient was matched to an uninfected individual by age, sex, and comorbidities.
COVID survivors had a 69% higher mortality risk than their uninfected peers. All-cause mortality was 4.91 deaths per 1,000 person-months among COVID survivors, compared with 2.63 among controls.
Younger adults experienced the largest relative impact. Individuals aged 40 to 64 had more than double the mortality risk of their matched peers. Multiple chronic conditions, such as cancer, heart failure, and renal disease, further increased mortality risk.
Vaccination appeared to confer meaningful protection in middle-aged adults: receiving two or more COVID vaccine doses was associated with a 48% reduction in mortality risk in the those aged 40 to 64. The association was weaker and not statistically significant in adults 65 and older.
The findings underscore the need for preventive strategies and targeted follow-up of previously hospitalized patients, note the authors, with particular attention paid to cardiovascular, renal, and oncologic complications that may emerge or worsen after severe infection.
