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ICU Admission and Post-Discharge Mortality in COVID-19: Different Risk Factors Across Clinical Phases
Fernanda Leite1,2,3, André Santos Silva4, Sara Ferreira1
1Department of Transfusion Medicine, Santo António University Hospital Center, 4099-001 Porto, Portugal.
Medical Sciences (Basel, Switzerland)
|May 27, 2026
Summary
Risk factors for severe COVID-19 differ from those predicting post-discharge mortality. Obesity increases early severity risk, while malignancy warrants closer follow-up after hospital discharge for better patient outcomes.
Area of Science:
- * Infectious Diseases
- * Epidemiology
- * Critical Care Medicine
Background:
- * While risk factors for severe COVID-19 and in-hospital mortality are known, predictors of mortality post-discharge remain unclear.
- * Differentiating risk profiles across clinical phases of COVID-19 is crucial for optimizing patient management and follow-up strategies.
Purpose of the Study:
- * To identify distinct risk factors for mortality during hospitalization versus post-discharge in adult patients with COVID-19.
- * To compare predictors of acute disease severity with those associated with long-term mortality.
Main Methods:
- * Retrospective observational cohort study of 595 adult patients hospitalized with SARS-CoV-2 infection.
- * Primary outcome: All-cause mortality during hospitalization and up to 120 days post-discharge.
- * Regression analyses (logistic and linear) were used to identify predictors for various outcomes, including ICU admission, disease severity, and mortality.
Main Results:
- * Overall mortality was 22.5%, with 37.3% of deaths occurring after hospital discharge.
- * Obesity and male sex were associated with ICU admission, while longer hospital stay and malignancy predicted post-discharge mortality.
- * Oxygen supplementation was the strongest predictor of 120-day mortality; pulmonary diseases and obesity predicted maximum disease severity.
Conclusions:
- * Risk factors for acute COVID-19 severity differ significantly from those predicting post-discharge mortality.
- * Patients with obesity face higher risks of early respiratory deterioration.
- * Patients with malignancy may require enhanced post-discharge follow-up irrespective of ICU admission status.
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