Health progression for Covid-19 survivors hospitalized in geriatric clinics in Sweden

• Published in: PloS one 2023-03, Vol.18 (3), p.e0283344
• Main Authors: Kananen, Laura, Hong, Xu, Annetorp, Martin, Mak, Jonathan K L, Jylhävä, Juulia, Eriksdotter, Maria, Hägg, Sara, Religa, Dorota
• Format: Article
• Language: English
• Subjects: Age; Aged; Aged patients; Care and treatment; Codes; Cohort Studies; Comorbidity; COVID-19; COVID-19 - epidemiology; Disease; Electronic health records; Electronic medical records; Frailty; Geriatrics; Health aspects; Health risks; Hospitalization; Hospitals; Humans; Infections; Medical records; Medicin och hälsovetenskap; Medicine and Health Sciences; Mortality; Mortality risk; Older people; Pandemics; Patients; Quality of life; Retrospective Studies; Risk factors; Severe acute respiratory syndrome coronavirus 2; Sex; Statistical analysis; Survival; Sweden - epidemiology; Vaccination
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0283344

To analyse if the health progression of geriatric Covid-19 survivors three months after an acute Covid-19 infection was worse than in other geriatric patients. Specifically, we wanted to see if we could see distinct health profiles in the flow of re-admitted Covid-19 patients compared to re-admitted non-Covid-19 controls. Matched cohort study. Electronic medical records of geriatric patients hospitalised in geriatric clinics in Stockholm, Sweden, between March 2020 and January 2022. Patients readmitted three months after initial admission were selected for the analysis and Covid-19 survivors (n = 895) were compared to age-sex-Charlson comorbidity index (CCI)-matched non-Covid-19 controls (n = 2685). We assessed using binary logistic and Cox regression if a previous Covid-19 infection could be a risk factor for worse health progression indicated by the CCI, hospital frailty risk score (HFRS), mortality and specific comorbidities. The patients were mostly older than 75 years and, already at baseline, had typically multiple comorbidities. The Covid-19 patients with readmission had mostly had their acute-phase infection in the 1st or 2nd pandemic waves before the vaccinations. The Covid-19 patients did not have worse health after three months compared to the matched controls according to the CCI (odds ratio, OR[95% confidence interval, CI] = 1.12[0.94-1.34]), HFRS (OR[95%CI] = 1.05[0.87-1.26]), 6-months (hazard ratio, HR[95%CI] = 1.04[0.70-1.52]) and 1-year-mortality risk (HR[95%CI] = 0.89[0.71-1.10]), adjusted for age, sex and health at baseline (the CCI and HFRS). The overall health progression of re-hospitalized geriatric Covid-19 survivors did not differ dramatically from other re-hospitalized geriatric patients with similar age, sex and health at baseline. Our results emphasize that Covid-19 was especially detrimental for geriatric patients in the acute-phase, but not in the later phase. Further studies including post-vaccination samples are needed.