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Long-Term Mortality Following COVID-19 Infection: A National Cohort Study From Estonia

34 Pages Posted: 7 Feb 2022

See all articles by Anneli Uuskula

Anneli Uuskula

University of Tartu - Department of Family Medicine and Public Health

Tuuli Jürgenson

University of Tartu - Institute of Mathematics and Statistics

Heti Pisarev

University of Tartu - Department of Family Medicine and Public Health

Raivo Kolde

University of Tartu - Institute of Computer Science

Tatjana Meister

University of Tartu - Department of Family Medicine and Public Health

Anna Tisler

University of Tartu - Department of Family Medicine and Public Health

Kadri Suija

University of Tartu - Department of Family Medicine and Public Health

Ruth Kalda

University of Tartu - Department of Family Medicine and Public Health

Marko Piirsoo

University of Tartu - Institute of Technology

Krista Fischer

University of Tartu - Institute of Genomics

More...

Abstract

Background: The objective of this study was to describe 12-month mortality following COVID-19 compared with a reference population with no history of COVID-19.

Methods: Retrospective nationwide cohort study using electronic health care data on cases (n= 66,287 COVID-19 patients) and controls (n=254,969) with linkage to SARS-CoV-2 testing and death records.

Results: People infected with COVID-19 had more than three times the risk of dying over the following year compared with those who remained uninfected. Short-term mortality (up to 5 weeks post-infection) was significantly higher among COVID-19 patients (1623/10 000) than controls (118/10 000). For COVID-19 cases over 60 years old, increased mortality persisted until the end of the first year after infection, and was related to increased risk for cardiovascular (aHR 2·1, 95%CI 1·8-2·3), cancer (aHR 1·5, 95%CI 1·2-1·9), respiratory system diseases (aHR 1·9, 95%CI 1·2-3·0), and other causes of death (aHR 1·8, 95%CI 1·4-2·2).

Conclusions: Increased risk of death from COVID-19 is not limited to the acute illness· COVID-19 infection carries a substantially increased risk of death in the following 12 months. This excess death mainly occurs in older people and is driven by broad array of causes of death.

Funding Information: Research was carried out with the support of Estonian Research Council, European Regional Development Fund and European Social Fund via IT Academy program.

Declaration of Interests: The authors report no conflicts of interest.

Ethics Approval Statement: The study was approved by the Research Ethics Committee of the University of Tartu.

Keywords: COVID-19, mortality, Estonia, population-based, cardiovascular death, SARS-CoV-2.

Suggested Citation

Uuskula, Anneli and Jürgenson, Tuuli and Pisarev, Heti and Kolde, Raivo and Meister, Tatjana and Tisler, Anna and Suija, Kadri and Kalda, Ruth and Piirsoo, Marko and Fischer, Krista, Long-Term Mortality Following COVID-19 Infection: A National Cohort Study From Estonia. Available at SSRN: https://ssrn.com/abstract=4028547 or http://dx.doi.org/10.2139/ssrn.4028547

Anneli Uuskula (Contact Author)

University of Tartu - Department of Family Medicine and Public Health ( email )

Tuuli Jürgenson

University of Tartu - Institute of Mathematics and Statistics ( email )

Estonia

Heti Pisarev

University of Tartu - Department of Family Medicine and Public Health ( email )

Estonia

Raivo Kolde

University of Tartu - Institute of Computer Science ( email )

Estonia

Tatjana Meister

University of Tartu - Department of Family Medicine and Public Health ( email )

Estonia

Anna Tisler

University of Tartu - Department of Family Medicine and Public Health ( email )

Estonia

Kadri Suija

University of Tartu - Department of Family Medicine and Public Health ( email )

Estonia

Ruth Kalda

University of Tartu - Department of Family Medicine and Public Health ( email )

Estonia

Marko Piirsoo

University of Tartu - Institute of Technology ( email )

Estonia

Krista Fischer

University of Tartu - Institute of Genomics ( email )

Tartu
Estonia

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