Long-term mortality of Dutch COVID-19 patients admitted to the intensive care medicine: a retrospective analysis from a national quality registry
Authors: Wortel Safira A. , Bakhshi-Raiez Ferishta , Abu-Hanna Ameen , Dongelmans Dave A. , Keizer Nicolette F. de , Houwink Aletta , Dijkhuizen Allard , Draisma Annelies , Rijkeboer Annemiek , Cloïn Arjan , Meijer Arthur de , Reidinga Auke , Festen-Spanjer Barbara , van Bussel Bas , Eikemans Bob , Jacobs Cretièn , Moolenaar David , Ramnarain Dharmanand , Koning Dick , Boer Dirk , Verbiest Dirk , van Slobbe-Bijlsma Eline , van Koppen Ellen , Rengers Els , van Driel Erik , Verweij Eva , van Iersel Freya , Brunnekreef Gert , Kieft Hans , Kreeftenberg Herman , Hené Ilanit , Janssen Inge , Drogt Ionana , van der Horst Iwan , Spijkstra Jan Jaap , Rozendaal Jan , Mehagnoul-Schipper Jannet , Erasmus Jelle Epker , Holtkamp Jessica , Lutisan Johan , van Oers Jos , Lens Judith , van Gulik Laura , van den Berg Lettie , Urlings-Strop Louise , Georgieva Lyuba , van Lieshout Maarten , Hoogendoorn Marga , Mos Marissa Vrolijk-de , Graaff Mart de , Bruin Martha de , Hoeksema Martijn , van Tellingen Martijn , Barnas Michel , Erkamp Michiel , Gritters Niels , Kusadasi Nuray , Elbers Paul , Koetsier Peter , Spronk Peter , van der Voort Peter , Pruijsten Ralph , Jong Remko de , Bosman Robert-Jan , Wesselink Ronald , Schnabel Ronny , van den Berg Roy , Waal Ruud de , Arbous Sesmu , Knape Silvia , Hendriks Stefaan , Frenzel Tim , Dormans Tom , Rijpstra Tom , Silderhuis Vera , Ruijter Wouter de 
Published: February 2025

ABSTRACT Objective: To describe the 12-month mortality of Dutch COVID-19 intensive care unit patients, the total COVID-19 population and various subgroups on the basis of the number of comorbidities, age, sex, mechanical ventilation, and vasoactive medication use. Methods: We included all patients admitted with COVID-19 between March 1, 2020, and March 29, 2022, from the Dutch National Intensive Care (NICE) database. The crude 12-month mortality rate is presented via Kaplan-Meier survival curves for each patient subgroup. We used Cox regression models to analyze the effects of patient characteristics on 12-month mortality after hospital discharge. Results: We included 16,605 COVID-19 patients. The in-hospital mortality rate was 28.1%, and the 12-month mortality rate after intensive care unit admission was 29.8%. Among hospital survivors, 12-month mortality after hospital discharge was 2.5% (300/11,931). The hazard of death at 12 months after hospital discharge was greater in patients between 60 and 79 years (HR 4.74; 95%CI 2.23 - 10.06) and ≥ 80 years (HR 22.77; 95%CI 9.91 - 52.28) than in patients < 40 years of age; in male patients than in female patients (HR 1.38; 95%CI 1.07 - 1.78); and in patients with one (adjusted HR 1.95; 95%CI 1.5 - 2.53), two (adjusted HR 4.49; 95%CI 3.27 - 6.16) or more than two comorbidities (adjusted HR 4.99; 95%CI 2.62 - 9.5) than in patients with no comorbidities. Neither vasoactive medication use nor mechanical ventilation resulted in statistically significant results. Conclusion: For Dutch COVID-19 intensive care unit patients, most deaths occurred during their hospital stay. For hospital survivors, the crude 12-month mortality rate was low. Patient age (older than 60), sex and the number of comorbidities were associated with a greater hazard of death at 12 months after hospital discharge, whereas mechanical ventilation and vasoactive medication were not.