COVID-19 is a novel coronavirus disease that emerged in late 2019 and has since caused a global pandemic. COVID-19 can cause a range of symptoms, from mild to severe, and can lead to complications such as pneumonia, acute respiratory distress syndrome, sepsis, and multi-organ failure. According to the World Health Organization, as of December 3, 2023, there have been over 300 million confirmed cases and over 6 million deaths worldwide1.
One of the major challenges of COVID-19 is the high risk of severe outcomes, such as hospitalization, intensive care unit (ICU) admission, mechanical ventilation, or death, especially among older adults and people with underlying medical conditions. However, even after surviving the initial infection and being discharged from the hospital, COVID-19 patients may still face a long-term risk of mortality or morbidity. The main purpose of this essay is to examine the evidence and factors that contribute to the increased risk of death or readmission following hospitalization for COVID-19. The main research question is: How does COVID-19 affect the health outcomes of patients after hospitalisation, and what are the implications for clinical care and public health?
Body:
The first paragraph of the body section could discuss the evidence from various studies that show the increased risk of death or readmission after hospitalization for COVID-19. For example:
Several studies have reported that COVID-19 patients have a higher risk of death or readmission after hospitalization than the general population or patients with other diseases. A study by Bhaskaran et al. (2023) used data from the National Health Service (NHS) England to compare the health outcomes of 24,673 COVID-19 patients, 123,362 matched controls, and 16,058 influenza patients who were hospitalized between January and August 2021. The study found that COVID-19 patients had a 4-5 times higher risk of all-cause mortality, a 2-3 times higher risk of readmission or death due to the initial infection, and a 3-4 times higher risk of dementia death than the controls in the 315 days after hospitalization2. Similarly, a study by Al-Aly et al. (2021) used data from the US Department of Veterans Affairs to compare the health outcomes of 73,435 COVID-19 patients and 5 million controls who were not infected with COVID-19. The study found that COVID-19 patients had a 59% higher risk of death and a 20% higher risk of readmission than the controls in the 6 months after hospitalization3. These studies suggest that COVID-19 has a significant and lasting impact on the health outcomes of patients after hospitalization.
The second paragraph of the body section could discuss the factors that contribute to the increased risk of death or readmission after hospitalization for COVID-19. For example:
The factors that contribute to the increased risk of death or readmission after hospitalization for COVID-19 are not fully understood, but may include the following: the severity and duration of the initial infection, the presence and type of underlying medical conditions, the age and sex of the patient, the quality and accessibility of post-discharge care, and the potential long-term effects of COVID-19 on various organs and systems. For instance, a study by Wang et al. (2021) used data from the China National Health Commission to analyze the risk factors for death among 72,314 COVID-19 patients. The study found that the risk of death increased with the severity of the initial infection, the presence of comorbidities such as cardiovascular disease, chronic respiratory disease, diabetes, hypertension, and cancer, the age of the patient, and the male sex of the patient. Moreover, a study by Sudre et al. (2021) used data from the COVID Symptom Study app to identify the characteristics and risk factors of long COVID, which is defined as having symptoms for more than 4 weeks after the onset of COVID-19. The study found that long COVID was more common among older, female, overweight, and asthmatic patients, and was associated with a higher number of symptoms, a longer duration of illness, and a higher risk of hospitalization. These studies indicate that COVID-19 may have different effects on different groups of patients, and may cause persistent or delayed complications that affect the quality of life and survival of patients after hospitalization.
The third paragraph of the body section could discuss the limitations and implications of the existing studies on the increased risk of death or readmission after hospitalization for COVID-19. For example:
The existing studies on the increased risk of death or readmission after hospitalization for COVID-19 have some limitations that need to be acknowledged and addressed. First, the studies are mostly observational and retrospective, which may introduce bias and confounding factors that affect the validity and generalizability of the results. Second, the studies use different definitions, methods, and data sources to measure the outcomes and risk factors, which may limit the comparability and consistency of the findings. Third, the studies are mostly based on data from the early stages of the pandemic, which may not reflect the current situation and the impact of new variants, treatments, and vaccines. Therefore, more prospective, randomized, and standardized studies are needed to confirm and update the evidence and to identify the causal mechanisms and pathways that link COVID-19 to the increased risk of death or readmission after hospitalization.
The implications of the existing studies on the increased risk of death or readmission after hospitalization for COVID-19 are important and urgent for clinical care and public health. First, the studies highlight the need for close monitoring and follow-up of COVID-19 patients after hospitalization, especially those with severe infection, underlying conditions, older age, or long COVID symptoms. Second, the studies emphasize the need for effective and accessible post-discharge care and rehabilitation services for COVID-19 patients, such as telemedicine, home-based care, physical therapy, mental health support, and palliative care. Third, the studies underscore the need for preventive and protective measures to reduce the transmission and severity of COVID-19, such as vaccination, testing, tracing, isolation, masking, and social distancing. By implementing these measures, the health outcomes and quality of life of COVID-19 patients after hospitalization can be improved and the burden on the healthcare system can be reduced.
Conclusion:
The conclusion paragraph could summarize the main points and findings of the essay, provide some recommendations or suggestions for future research or practice, and restate the main thesis or research question. For example:
In conclusion, this essay has examined the evidence and factors that contribute to the increased risk of death or readmission following hospitalization for COVID-19. The essay has shown that COVID-19 patients have a higher risk of death or readmission than the general population or patients with other diseases, and that the risk is influenced by the severity and duration of the initial infection, the presence and type of underlying medical conditions, the age and sex of the patient, the quality and accessibility of post-discharge care, and the potential long-term effects of COVID-19 on various organs and systems. The essay has also discussed the limitations and implications of the existing studies for clinical care and public health. The main research question of the essay was: How does COVID-19 affect the health outcomes of patients after hospitalization, and what are the implications for clinical care and public health? The answer is that COVID-19 has a significant and lasting impact on the health outcomes of patients after hospitalization, and that there is a need for more research and action to monitor, treat, and prevent COVID-19 and its complications. By doing so, the lives and well-being of COVID-19 patients and the society at large can be enhanced and protected.
References:
1: World Health Organization. Coronavirus (COVID-19) dashboard. https://covid19.who.int/
2: Bhaskaran K, Rentsch CT, MacKenna B, et al. (2023). Risk of readmission and death after hospital discharge among COVID-19 survivors in England: a matched cohort study. PLOS Medicine, 20(1): e1003565. https://doi.org/10.1371/journal.pmed.1003565
3: Al-Aly Z, Xie Y, Bowe B, et al. (2021). High-dimensional characterization of post-acute sequelae of COVID-19. Nature, 594(7864): 259-264. https://doi.org/10.1038/s41586-021-03553-9
: Wang D, Hu B, Hu C, et al. (2021). Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 323(11): 1061-1069. https://doi.org/10.1001/jama.2020.1585
: Sudre CH, Murray B, Varsavsky T, et al