Covid-19 post-discharge mortality rate in a london district general hospital

IntroductionDue to the novelty of COVID-19, uncertainty about the factors contributing to mortality, unavailability of definitive treatment options, limited access to medical, social support and rehabilitation in the community during the covid-19 peak;compounded with anxiety and reluctance to seek medical help in timely manner, it was anticipated that vulnerable patients would be affected the worst We report post-discharge mortality and the associated risk factors MethodThis is a retrospective study of all the patients admitted at a busy district general hospital during the peak period of the COVID-19 pandemic i e 1st March to 20 June 2020 We included all patients aged 18 and above in data analysis ResultsA total of 628 patients were admitted during the study period with 481 having positive swab PCR Of these, 389 (62%) patients had two or more comorbidities, 311 (49 5%) hypertensive and 166 (26 4%) diabetic In-hospital mortality: 226/628 (35 9%) patient died in hospital, of which 194 (85 8%) had a positive Coronavirus nasopharyngeal swab This was statistically significant with p-value of 0 001 Post-discharge mortality of patients: 54/402 (13 4%) of those patients discharged home following hospitalisation died within 28 days of discharge 42/54 (77 7%) were swab positive Swab positive patients 42/54 (77 8%) had a higher risk of death Two thirds of swab positive patient were older than 75 years and 81% had two or more pre-existing co-morbidities There was no difference in length of stay between the survivors and non-survivors ConclusionAs expected, age, male gender, COVID-19 PCR-positivity, multiple comorbidities, high BMI and raised CRP were associated with higher in-hospital and post-discharge mortality It is unsurprising that antibiotic treatment without bacterial infection was associated with higher but statistically insignificant mortality rate, while therapeutic anticoagulation and steroids were associated with better outcomes There is an urgent need for further analysis of root cause to mitigate the modifiable factors and devise a robust post-discharge management plan in collaboration with all stakeholders ReferenceDeaths involving COVID-19, England and Wales: deaths occurring inJune 2020: https://www ons gov uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsinvolvingcovid19englandandwales/deathsoccurringinjune2020