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Residual Risk Seen for Death, Postacute Sequelae in Third Year After COVID-19 Hospitalization

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Risk for death remains significantly elevated in third year, as is risk for incident postacute sequelae of COVID-19

By Elana Gotkine HealthDay Reporter

THURSDAY, June 13, 2024 (HealthDay News) — For individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the risks for death and postacute sequelae of COVID-19 (PASC) reduce over three years but persist, especially among hospitalized individuals, according to a study published online May 30 in Nature Medicine.

Miao Cai, Ph.D., from the Veterans Affairs St. Louis Health Care System, and colleagues followed a cohort of 135,161 people with SARS-CoV-2 infection and 5,206,835 controls from the U.S. Department of Veterans Affairs who were followed for three years to estimate the risks for death and PASC.

The researchers found that the increased risk for death was no longer seen after the first year of infection among nonhospitalized individuals. The risk for incident PASC declined over three years, but in the third year, it still accounted for 9.6 disability-adjusted life years (DALYs) per 1,000 persons in year 3. The risk for death decreased among hospitalized individuals, but in the third year after infection, it remained significantly elevated (incidence rate ratio, 1.29). Over the three years, the risk for incident PASC decreased, but substantial residual risk persisted in the third year, resulting in 90.0 DALYs per 1,000 persons.

“That a mild SARS-CoV-2 infection can lead to new health problems three years down the road is a sobering finding,” Ziyad Al-Aly, M.D., also from the Veterans Affairs St. Louis Health Care System, said in a statement. “The problem is even worse for people with severe SARS-CoV-2 infection. It is very concerning that the burden of disease among hospitalized individuals is astronomically higher.”

Several authors disclosed ties to the pharmaceutical industry; one author reported ties to Guidepoint.

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