A nationwide French cohort study found that patients hospitalized for COVID-19 had an increased long-term risk of death and multiple organ-related hospitalizations,

The authors of the study analyzed data from 63,990 COVID-19 survivors hospitalized between January and August 2020 matched against 319,891 controls from the general population. They found that the hospitalized group had a 30% increased risk of all-cause mortality (incidence rate ratio [IRR] = 1.30, 95% confidence interval [CI] = 1.27–1.33) and a 35% increased risk of all-cause hospitalization (IRR = 1.35, 95% CI = 1.33–1.37) compared to controls.

"The excess risk strongly decreased after the first 6 months for all outcomes but remained significantly increased up to 30 months for neurological, respiratory disorders, chronic renal failure, and diabetes," wrote Sarah Tubiana, PharmD, PhD, of Universite Paris Cite, IAME, INSERM, Paris, France, and colleagues.

COVID-19 survivors had significantly higher hospitalization rates for multiple organ-related conditions, including respiratory disorders (IRR = 1.99, 95% CI = 1.87–2.12), neurological disorders (IRR = 1.50, 95% CI = 1.41–1.61), psychiatric conditions (IRR = 1.41, 95% CI = 1.29–1.53), cardiovascular events (IRR = 1.22, 95% CI = 1.15–1.29), chronic renal failure (IRR = 1.79, 95% CI = 1.40–2.08), and diabetes (IRR = 1.89, 95% CI = 1.73–2.08) than controls. Among specific conditions, interstitial lung diseases, including fibrosis (IRR = 4.64, 95% CI = 3.86–5.63) and myocarditis (IRR = 3.91, 95% CI = 1.61–9.51) had the highest excess risks.

While the highest mortality risk occurred in the first 6 months postdischarge (adjusted hazard ratio [aHR] = 2.93, 95% CI = 2.79–3.06), excess mortality persisted through 30 months (aHR = 1.07, 95% CI = 1.00–1.14). Although hospitalization risks declined over time, they remained elevated at 30 months, particularly for renal (adjusted subdistibution-hazard ratio [aSHR] = 2.18, 95% CI = 1.47–3.25) and diabetic (aSHR = 1.85, 95% CI = 1.49–2.29) conditions.

The study authors emphasized the need for long-term follow-up of COVID-19 survivors, particularly those who required hospitalization. Given the large number of cases of the virus worldwide, the development of multidisciplinary post–COVID-19 follow-up clinics should continue, they advised.

Extending prior research that had largely been limited to 18- to 24-month follow-up, this study provides one of the longest follow-ups on post-acute sequelae of SARS-CoV-2 infection, further highlighting its long-term impact on multiple organ systems.

Authors declared no competing interests.