One-Year Survival and Changes in Care Needs Among Hospitalized Older Patients With Coronavirus Disease 2019 in Japan:...

The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected older populations globally. However, limited data are available on the long-term survival and evolving care needs of older patients with COVID-19 in Japan. We evaluated 1-year survival rates and long-term care needs in this vulnerable population.

This population-based cohort study analyzed 2175 hospitalized patients with COVID-19 aged ≥ 65 years using data from the Nara Kokuho Database between February 2020 and August 2022. The database contains administrative claims data from the National Health Insurance and Late Elders' Health Insurance systems, incorporating information on care needs levels. We examined 1-year survival and changes in care needs levels.

The overall 1-year survival rate was 80.9%. Age significantly influenced survival, with rates of 93.6% for patients aged 65-69 years and 56.6% for those ≥ 90 years. Disease severity had a substantial impact: patients not requiring oxygen therapy had a survival rate of 87.5%, compared to 74.0% for those with supplemental oxygen and 49.9% for those receiving invasive mechanical ventilation. Despite a decline in severe cases following the Delta and Omicron-predominant waves, survival among severely ill patients remained lower. While most patients without prior care needs retained independence, approximately 23% developed new care requirements after COVID-19. Higher care needs levels were associated with significantly higher mortality, with patients at care needs level ≥ 2 experiencing mortality rates exceeding 35%.

This study highlights the importance of comprehensive management of the long-term survival and care needs of older patients with COVID-19.