"Delayed Mortality Syndrome" is of increasing concern to doctors around the world
COVID-19 continues to bring unpleasant surprises. “Recovered patients” are often not recovered at all. The largest study of patients hospitalized in the first wave of the pandemic, conducted by the University of Leicester and the UK Office for National Statistics, found that within five months after being discharged from the hospital with the consequences of COVID-19, one in three is hospitalized again. Experts called another terrible problem "delayed mortality": patients do not die immediately, but 2–5 months after illness. Russian doctors confirm this trend.
Photo: Natalia Gubernatorova
The University of Leicester and the UK's Office for National Statistics (ONS) conducted the largest study of people discharged from hospitals after being hospitalized with COVID-19. The study studied 47,780 former patients of the first wave of the pandemic (mean age 65 years, 55% men). Most often, people over 50 years old, living in disadvantaged areas, former smokers, as well as overweight or obese people with chronic diseases (hypertension, diabetes mellitus, respiratory diseases, coronary heart disease) were hospitalized.
The share of those who returned to hospitals with new diagnoses within 140 days was 29.4%. Many patients developed or worsened heart disease, diabetes, chronic liver and kidney disease. For example, respiratory diseases after coronavirus developed within five months in 14 140 people (29.6%) after discharge. 12.3% of discharged patients died within 140 days. Demographer Alexey Raksha recently spoke about delayed mortality in an interview with MK: according to his data, deaths are more often recorded among people who have received coronavirus infection in our country, not immediately, but several months after infection (from blood clots, vascular problems, problems with kidneys, etc.). And this suggests that excess mortality will persist for several months even after the end of the pandemic.
Coronavirus survivors were nearly three times more likely to be admitted to hospital and die within 140 days than other discharged patients, according to British researchers. “We don't know if this is because COVID-19 has destroyed the beta cells that make insulin, or that the person has diabetes, or the virus causes insulin resistance, but we are seeing these unexpected new diagnoses,” said a professor of diabetes and Vascular Medicine at the University of Leicester Kamlesh Khunti, one of the study authors.
Interestingly, the rate of adverse events compared to the average in the population was higher in people under 70 than in the group over 70. And the most serious differences were in the structure of mortality and respiratory diseases: the risk of dying or getting lung disease within five months after COVID-19 in the group under 70 was twice as high! Differences in the rates of adverse events in men and women were generally small.
A similar study was recently conducted in the United States among 1,775 veterans hospitalized with COVID-19: within 60 days of discharge, 20% were hospitalized again, and 9% died (in a British study during the same time, these figures were 23% and 9%, respectively ). Americans identified impairment in lung (33%), heart (32%), kidney (12%), and liver (10%) functions in patients within two months of discharge. In addition, American patients after suffering from coronavirus infection had an increased chance of acute renal failure, renal replacement therapy, insulin use, pulmonary embolism, stroke, myocarditis, arrhythmia, and myocardial infarction compared with patients after seasonal flu. A recent study by scientists from South Korea showed that 80% of recovered patients after coronavirus infection continue to experience at least one of the symptoms of the disease after six months, and almost a third of patients have more than three symptoms.
- Recently, we increasingly note situations when people have had coronavirus, left hospitals, and then they die or feel terrible a few months after the illness. Many are haunted by terrible weakness, chronic stress syndrome, heart disease, kidney disease, liver disease. It cannot be ruled out that the consequences of COVID-19 are an analogue of a new chronic disease, - says the head of the Department of Obstetrics, Gynecology, Perinatology and Reproductology of the First Moscow State Medical University. I.M.Sechenov, Academician of RAS and RAMS Gennady Sukhikh.
Researchers from the UK note that the epidemiology of PTSD is currently undefined. However, this diagnosis, which is also called longcovid, has already been included in the International Classifier of Diseases. As defined by the UK's National Institute for Health and Continuing Education (NICE), it refers to "signs and symptoms that develop during or after COVID-19 infection that last more than 12 weeks and are not attributable to an alternative diagnosis." We are talking about a whole complex of symptoms, behind which lies a multi-organ lesion, researchers from Britain emphasize.
At the same time, today many scientists and doctors note that the consequences of post-covid species can be no less dangerous than COVID-19 itself, both for the people themselves, and for the health systems and economies of countries. “Given that, at the time of writing, more than 3 million people in the UK have tested positive for COVID-19, and many who have had the disease have never had the test, our results suggest that the long-term burden of disease associated with COVID-19 is likely to be significant for hospitals and healthcare systems. Postcovid emerges against a backdrop of health problems stemming from the pandemic and insufficient resources. Therefore, urgent research is needed to determine the risk factors for postcovid species, ”the authors of the new work write with concern.
Professor Khunti believes that there is a need to organize monitoring of patients after discharge, as well as to ensure that they are prescribed protective drugs such as statins and thrombolytics.
- The consequences of the new coronavirus infection that we are seeing today can fundamentally change the waiting time for well-being after a pandemic. Therefore, one should not prematurely beat the fanfare when patients are discharged, says Academician Sukhikh.
