Post-discharge mortality in the first wave of COVID-19 in Turkey

Objective:To determine post-discharge mortality and associated factors of the first-wave multicenter Turkish Thoracic Society(TTD)-TURCOVID study.Methods:In this retrospective cohort study,we analyzed the data of 18 of 26 centers included in the first TTD-TURCOVID study,and 1112 cases diagnosed with COVID-19 between 11 March and 31 July 2020 participated in the study.All causes of death after COVID-19 discharge were recorded.Results:The mean age of the patients was(51.07±16.93)years,with 57.6%male patients.In the cohort group,89.1%of COVID-19 treatment locations were hospital wards,3.6%were intensive care units(ICUs),and 7.2%were community outpatients.In the longterm follow-up,the in-hospital mortality rate was 3.6%(95%CI 2.6-4.8),the post-discharge mortality rate was 2.8%(95%CI 1.9-3.9),and the total mortality was 6.3%(95%CI 5.0-7.8).After discharge,63.3%of mortality overall occurred during the first six months.Mortality rates in post-discharge follow-ups were 12.7%(95%CI 8.0-30.6)in cancer patients,10.8%(95%CI 6.3-22.9)in chronic obstructive pulmonary disease patients,11.1%(95%CI 4.4-22.7)in heart failure patients,7.8(95%CI 3.8-14.3)in atherosclerotic heart disease patients,and 2.3%(95%CI 0.8-5.6)in diabetes mellitus patients.In smokers/ex-smokers,the all-mortality rates were higher than in non-smokers.Conclusions:This multicenter study showed that patients over 65 years of age,males,former/active smoker,ICU stay,lung,heart disease,and malignancy should be followed up for at least the first six months after discharge due to COVID-19.

The predictors of long-COVID in the cohort of Turkish Thoracic Society-TURCOVID multicenter registry:One year follow-up results

Objective:To evaluate long-term effects of COVID-19,and to determine the risk factors in long-COVID in a cohort of the Turkish Thoracic Society(TTS)-TURCOVID multicenter registry.Methods:Thirteen centers participated with 831 patients;504 patients were enrolled after exclusions.The study was designed in three-steps:(1)Phone questionnaire;(2)retrospective evaluation of the medical records;(3)face-to-face visit.Results:In the first step,93.5%of the patients were hospitalized;61.7%had a history of pneumonia at the time of diagnosis.A total of 27.1%reported clinical symptoms at the end of the first year.Dyspnea(17.00%),fatigue(6.30%),and weakness(5.00%)were the most prevalent long-term symptoms.The incidence of long-term symptoms was increased by 2.91 fold(95%CI 1.04-8.13,P=0.041)in the presence of chronic obstructive pulmonary disease and by 1.84 fold(95%CI 1.10-3.10,P=0.021)in the presence of pneumonia at initial diagnosis,3.92 fold(95%CI 2.29-6.72,P=0.001)of dyspnea and 1.69 fold(95%CI 1.02-2.80,P=0.040)fatigue persists in the early-post-treatment period and 2.88 fold(95%CI 1.52-5.46,P=0.001)in the presence of emergency service admission in the post COVID period.In step 2,retrospective analysis of 231 patients revealed that 1.4%of the chest X-rays had not significantly improved at the end of the first year,while computed tomography(CT)scan detected fibrosis in 3.4%.In step 3,138(27.4%)patients admitted to face-to-face visit at the end of first year;at least one symptom persisted in 49.27%patients.The most common symptoms were dyspnea(27.60%),psychiatric symptoms(18.10%),and fatigue(17.40%).Thorax CT revealed fibrosis in 2.4%patients.Conclusions:COVID-19 symptoms can last for extended lengths of time,and severity of the disease as well as the presence of comorbidities might contribute to increased risk.Long-term clinical issues should be regularly evaluated after COVID-19.