University of Tartu study: COVID-19 infection linked to excess mortality

East Tallinn Central Hospital (ITK) COVID ward.
East Tallinn Central Hospital (ITK) COVID ward. Source: East Tallinn Central Hospital

The mortality rate of people over 60 years of age in the year following infection with the COVID-19 virus has increased significantly, it appears from the results of a recent study conducted by the University of Tartu focused on the effects of the COVID-19 pandemic on excess mortality.

"The results of our study indicated that the 12-month mortality rate of COVID patients was 4.8 times higher than those who had not been infected with COVID," Ruth Kalda, head of the Institute of Family Medicine and Public Health at the University of Tartu, said at a press briefing with the Scientific Advisory Board on Friday.

"There are things to consider here: it is clear that COVID is not a disease that causes mortality in hospitals; rather, mortality is increased over the following 12 months," Kalda explained.

The TÜ researchers' study compiled data on individuals who were diagnosed with COVID-19 between February 2020 and February 2021, the professor explained about the project, which was led by epidemiologist Anneli Uusküla.

"We tracked what happened to them over the course of the next year," Kalda said. "The sample size was 66,000,and in order to draw important conclusions, we compared them to a control group."

The results of the study indicated that nearly 61 percent of deaths over the next year were among those who had had a serious case of COVID-19. The mortality rate was especially high five weeks following diagnosis.

Age had a significant impact on mortality as well: there were significant differences in the mortality rates of those under and those over 60 years of age.

"Those over 60 years of age were more likely to die throughout the following year," Kalda said. "Premature deaths among those under 60 years of age were linked to the presence of cancer."

Primary causes of death in patients following infection with COVID-19 included cardiovascular and respiratory disease, the results of the study indicated.

Hospitals need systematic additional resources

According to Mait Altmets, director of Infection Control at North Estonia Medical Center (PERH), hospitals are currently seeing increasing patient numbers: there are currently 553 patients in hospitals across Estonia, and that number is expected to reach 600 by next week.

"Intensive care has remained stable thus far, but that will start to rise as well, as increases come with a couple weeks' delay," Altmets explained.

Hospitals in Estonia are under intense pressure, he said, and blaming them for COVID-related restrictions remaining in place is wrong.

"We lack experience with pandemics; we didn't have any contact with SARS or MERS, as Canada or countries in Asia did," Altmets stressed. "At the same time, our hospitals' spatial requirements date back to 2004. On that front, our hospitals need changes not just in terms of COVID, but also in terms of the multiresistance of antibiotics. Our emergency departments and general areas were not planned to handle viral infections at this scale."

The solution as he sees it is a social contract for a large-scale overhaul of hospital conditions. "If we want hospitals to not be the reason for restrictions, that will entail the allocation of significantly more resources to our hospitals," he said.

Click here (link in Estonian) for more information about the University of Tartu project.

Click here to access the preprint version of the research article, titled "Clinical Characteristics and Risk Factors for COVID-19 Infection and Disease Severity: A Nationwide Observational Study in Estonia."


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Editor: Aili Vahtla

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