Life After COVID-19 Hospitalization
Within two months of leaving the hospital, nearly 7% of the patients had died, including more than 10% of the patients treated in an intensive care unit.
Fifteen percent had ended up back in the
hospital. The data come from more than 1,250 patients treated in 38 hospitals
across Michigan this spring and summer, when the state was one of the earliest
to experience a peak in cases.
When
researchers interviewed 488 of the surviving patients by phone, around 60 days
after their hospitalization, they heard a litany of health and life woes.
They’ve published their findings in the Annals of Internal Medicine.
“These data suggest that the burden of COVID-19 extends far beyond the hospital and far beyond health,” says Vineet Chopra, M.D., M.Sc., lead author of the study and chief of hospital medicine at Michigan Medicine, the University of Michigan’s academic medical center. “The mental, financial and physical tolls of this disease among survivors appear substantial.”
Lasting effects
More
than 39% of the patients interviewed said they hadn’t gotten back to normal
activities yet, two months after leaving the hospital. Twelve percent of the
patients said they couldn’t carry out basic care for themselves anymore, or as
well as before.
Nearly
23% said they became short of breath just climbing a flight of stairs.
One-third had ongoing COVID-like symptoms, including many who still had
problems with taste or smell.
Of
those who had jobs before their bout with COVID-19, 40% said they couldn’t
return to work; most because of their health and some because they’d lost their
job. And 26% of those who had gone back to work said they had to work fewer
hours or have reduced duties because of their health.
Nearly
half of those interviewed said they’d been emotionally affected by their
experience with COVID-19 – including a minority who said they’d sought mental
health care.
More
than a third – 37% – of those interviewed said their experience with COVID-19
had left them with at least a minor financial impact. Nearly 10% said they’d
used up most or all of their savings, and 7% said they were rationing food,
heat, housing or medications because of cost.
“The
sheer number of people struggling after COVID brings new urgency to developing
programs to better promote and support recovery after acute illness,”
says Hallie Prescott, M.D., M.Sc., senior
author and pulmonary/critical care physician at the University of Michigan and
the VA Ann Arbor Healthcare System.
More about the study
The
study used dates from the MI-COVID19 initiative,
which rapidly evolved in April as a way for Michigan hospitals to pool and
analyze data on their COVID-19 patients.
It
grew out of existing multi-hospital quality improvement efforts funded by Blue
Cross Blue Shield of Michigan, and drew on existing staff who are experienced
at analyzing medical records and interviewing patients. That gave researchers a
head start on studying COVID-19 patients treated in most of the hospitals that
received such patients in the early peak state of Michigan.
Details
obtained from patient medical records, and in-depth interviews conducted after
attempting to contact patients by phone multiple times, give a picture of what
life is like for post-COVID patients.
Nearly
52% of the patients in the study are Black, and 4% are Hispanic. The average
age is 62, and 83% lived at home before being hospitalized for COVID-19.
More
than 14% had no chronic conditions before COVID-19 landed them in the hospital,
and for many others the only condition they had was high blood pressure. The
well known risk factors of diabetes, cardiovascular disease and kidney disease
were present in about a quarter of patients.
While
hospital care for COVID-19 patients has improved since the early months of the
pandemic, the study shows that the 63% of patients who were ever treated in an
ICU had died during their hospital stay or within two months of leaving the hospital.
That’s more than twice the rate for patients hospitalized, but not admitted to
an ICU.
Chopra
and Prescott worked on the study with co-authors Scott Flanders, M.D., M.Sc., a hospitalist
and chief clinical strategy officer for Michigan Medicine, statistician Megan
O'Malley, Ph.D. and Anurag Malani, M.D., an infectious disease physician at St.
Joseph Mercy Health in Ypsilanti, Michigan.
Chopra,
Prescott and Flanders are members of the U-M Institute for Healthcare Policy
and Innovation.
Paper
cited: “Sixty-Day Outcomes Among Patients Hospitalized with
COVID-19,” Annals of Internal Medicine. DOI: 10.7326/M20-566