Post-Hospitalization Mortality in Covid-19 Patients

• 29 Aug 2023

For Prelims: Indian Council of Medical Research (ICMR), Covid-19

For Mains: How can healthcare systems address the post-covid-19 mortality

Source: DTE

Why in News?

Recently, a new study conducted by the Indian Council of Medical Research (ICMR) has shed light on the post-hospitalization mortality rate among former Covid-19 patients.

• The study's comprehensive examination of factors such as comorbidities(more than one disease or condition at the same time), age, and vaccination sheds light on vulnerabilities and emphasizes the importance of managing health conditions to reduce mortality risk.

What are the Key Highlights From the Study?

• Mortality Rate and Participant Demographics:
  • The study examined 14,419 former Covid-19 patients across 31 Indian medical centers.
    • The observed mortality rate one year after hospital discharge is 6.5%.
  • Around 50% of patients who died, passed away within 28 days of hospital discharge.
    • The risk of mortality decreases as time elapses after discharge.
  • The elderly age group (60+) with comorbidities is particularly vulnerable to mortality.
• Prevalence of Post-Covid-19 Conditions:
  • 17.1% of participants experienced Post-Covid-19 conditions, including lethargy, breathlessness, cognitive abnormalities, and difficulty in concentrating.
• Focus on All-Cause Mortality:
  • The study primarily concentrated on all-cause mortality, rather than attributing deaths solely to Covid-19.
  • All-cause mortality encompasses various causes of death, including comorbidities and other factors.
• Vaccination and Disease Severity:
  • Vaccination confers approximately 60% protection before Covid-19 infection.
  • Vaccines contribute to reducing disease severity during hospitalization.
• Vulnerabilities Leading to Higher Mortality:
  • Comorbidity, age, and gender were identified as factors influencing mortality risk.
  • Individuals with one comorbid condition are over 9 times more likely to die.
  • Men faced a 1.3-fold higher risk, and aged 60 and above were associated with a 2.6-fold higher risk.
  • The study underscores the importance of managing comorbidities to reduce mortality risk.
• Children's Vulnerability:
  • Children aged 0 to 18 faced a 5.6 times higher risk of death between four-week and one-year follow-ups.
    • Risk 1.7-fold higher in the first four weeks post hospitalization.
  • Children with serious health conditions like cancer and kidney disorders had a higher chance of passing away.
• Limitations of the Study:
  • The study did not examine long Covid symptoms.
  • The operational definition of Post Covid Condition (PCC) used in this study is not an exact match with the definitions provided by either the World Health Organization (WHO) or the Centers for Disease Control and Prevention(CDC), the national public health agency of the United States.
    • WHO definition for PCC says that we have to wait for three months and then check if the symptoms persist for two months, it says long covid symptoms persist post-three months after initial infection.
    • Long Covid-19, as defined by the CDC, encompasses various ongoing health problems post-Covid-19 infection, starting from at least four weeks after infection. However, the ICMR study only did a symptomatic assessment at four weeks’ time, not after that.

Indian Council of Medical Research (ICMR):

• ICMR is the apex body in India for the formulation, coordination, and promotion of biomedical research.
• ICMR was established in 1911 as the Indian Research Fund Association (IRFA) and was renamed as ICMR in 1949.
• ICMR is funded by the Government of India through the Department of Health Research, Ministry of Health and Family Welfare.
• Its mandate is to conduct, coordinate and implement medical research for the benefit of the Society; translating medical innovations into products/processes and introducing them into the public health system.
• ICMR also collaborates with international organizations, such as WHO, United Nations Children's Fund (UNICEF), etc., on various health research projects and programs.
• ICMR has also supported human resource development and capacity building in biomedical research through various schemes and programs.

Mains

Q. COVID-19 pandemic accelerated class inequalities and poverty in India. Comment. (2020)