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One-year mortality and associated factors in older hospitalized COVID-19 survivors: a Nationwide Cohort Study in Korea

Kim et al., Scientific Reports, doi:10.1038/s41598-024-76871-3
Oct 2024  
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Mortality 15% Improvement Relative Risk HCQ for COVID-19  Kim et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 63,369 patients in South Korea (Oct 2020 - Dec 2021) No significant difference in mortality c19hcq.org Kim et al., Scientific Reports, October 2024 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,000+ studies for 104 treatments. c19hcq.org
Retrospective 63,369 hospitalized COVID-19 survivors aged 60 years or older in Korea, showing lower 1-year mortality with macrolides (including azithromycin), higher 1-year mortality with corticosteroids (including dexamethasone and methylprednisolone), and no significant difference with HCQ (only used for 0.2% of patients).
risk of death, 15.0% lower, OR 0.85, p = 0.62, treatment 135, control 63,234, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kim et al., 22 Oct 2024, retrospective, South Korea, peer-reviewed, 7 authors, study period 8 October, 2020 - 31 December, 2021. Contact: wido21@cau.ac.kr.
This PaperHCQAll
One-year mortality and associated factors in older hospitalized COVID-19 survivors: a Nationwide Cohort Study in Korea
Eunji Kim, Jeong-Yeon Kim, Kyoung Min Moon, Tae Wan Kim, Won-Young Kim, Sun‑young Jung, Moon Seong Baek
Scientific Reports, doi:10.1038/s41598-024-76871-3
This study aimed to evaluate the 1-year mortality rate among older patients with COVID-19 discharged from hospital and to identify risk factors associated with this outcome. Using a COVID-19 dataset from the Korean National Health Insurance System, this study's evaluation period spanned from October 8, 2020, through December 31, 2021. The primary outcome was the 1-year mortality rate following hospital discharge. A logistic regression model was employed for multivariable analysis to estimate the odds ratios for the outcomes, and the Kaplan-Meier method was used to analyze differences in 1-year survival rates. Among the 66,810 COVID-19 patients aged 60 years or older who were hospitalized during the study period, the in-hospital mortality rate was 4.8% (n = 3219). Among the survivors (n = 63,369), the 1-year mortality rate was 4.9% (n = 3093). Non-survivors, compared to survivors, were significantly older (79.2 ± 9.5 vs. 68.9 ± 7.8, P < 0.001) and exhibited a lower rate of COVID-19 vaccination (63.0% vs. 91.7%, P < 0.001). Additionally, non-survivors experienced a higher incidence of organ dysfunction, along with a greater proportion of required mechanical ventilation (14.6% vs. 1.0%, P < 0.001) and extracorporeal membrane oxygenation (4.0% vs. 0.1%, P < 0.001). Multivariable logistic regression analysis identified older age, male sex, cardiovascular disease, immunosuppression, organ dysfunction, illness severity, and corticosteroid use during hospitalization as factors associated with death within 1 year after hospital discharge. However, vaccination was found to have a long-term protective effect against death among COVID-19 survivors. The 1-year mortality rate after hospital discharge for older COVID-19 patients was comparable to the in-hospital mortality rate for these patients in Korea. The long-term mortality rate among hospitalized older COVID-19 patients was influenced by demographic factors and the severity of illness experienced during hospitalization.
Author contributions MSB and SYJ conceived and designed the study. EK, JYK, SYJ, and MSB collected the primary data and conducted data analyses. EK, KMM, TWK, WYK, SYJ, and MSB interpreted the results and prepared the first draft. All the authors revised the draft for important intellectual content and approved the final manuscript submitted for publication. Declarations Competing interests The authors declare no competing interests. Ethics approval and consent to participate The study protocol was approved by the Institutional Review Board of Chung-Ang University (1041078-20221111-BR-010). Informed consent was waived because data analyses were performed retrospectively using anonymized data from the South Korean NHIS database. All procedures in this study were performed according to the relevant guidelines and regulations. Consent for publication Not applicable. Additional information Supplementary Information The online version contains supplementary material available at https://doi. org/10.1038/s41598-024-76871-3 .
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Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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