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Many Severe Covid-19 Survivors Go on to Die Within a Year, Study Finds

Compared to people who tested negative for covid-19, those who survived severe illness were more than twice as likely to die within a year's time.

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A doctor tends to a patient in the covid-19 intensive care unit at University Hospital Leipzig on November 18, 2021 in Leipzig, Germany.
A doctor tends to a patient in the covid-19 intensive care unit at University Hospital Leipzig on November 18, 2021 in Leipzig, Germany.
Photo: Jens Schlueter (Getty Images)

New research this week finds that people who are hospitalized with severe covid-19 but survive often pay a heavy price afterward. The study concluded that these survivors were more than twice as likely to die in the subsequent 12 months compared to people who had tested negative for the virus. This relatively increased risk of death was even higher for people under the age 65.

While there remains much research to be done, studies thus far have made it clear that many covid-19 survivors can experience lingering symptoms even after the infection itself has cleared up. And those who are hospitalized are all the more vulnerable to these aftereffects. Severe covid often seriously damages the lungs and other organs, while life-saving interventions like steroids, ventilators, and life support devices like ECMO can take a toll on the body as well.


Researchers from the University of Florida had already published a study in July showing that hospitalized survivors were significantly more likely to be hospitalized again within six months, compared to those with mild to moderate covid-19. This new study of theirs, based on an examination of anonymous electronic health records, instead looked at the long-term mortality risk of patients up to a year later.

Nearly 14,000 patients in the same health care system were studied. These included 178 diagnosed with severe COVID-19 and 246 diagnosed with mild to moderate covid-19, as well as many others who tested negative for the virus but may have been sick for other reasons and received medical care in some way. Compared to covid-negative patients, and even after accounting for other factors like age and sex, those with severe covid were 2.5 times more likely to die in the next 12 months after their illness. Overall, just over 52% of severe covid patients died in a year’s time. There was no significant increased risk of mortality for mild to moderate cases, however.


“This study provides evidence that the increased risk of death from covid-19 is not limited to the initial episode of covid-19, but a severe episode of covid-19 carries with it a substantially increased risk of death in the following 12 months,” the authors wrote in their study, published Wednesday in the journal Frontiers in Medicine.

About 20% of the deaths among these patients post-infection were attributed to problems with either the respiratory or cardiovascular system, the authors noted, the areas of the body that tend to be affected directly by infection from the coronavirus. But it’s well known that the symptoms of severe covid are often the result of an overzealous immune response, one that can wreak havoc all throughout the body. And it’s this potential for widespread damage that is likely to blame for the majority of added deaths seen in these survivors.

“Since these deaths were not for a direct covid-19 cause of death among these patients who have recovered from the initial episode of covid-19, this data suggests that the biological insult from covid-19 and physiological stress from covid-19 is significant,” they wrote.

Older people are more likely to develop severe illness and die from covid-19. But among patients in this study, the associated risk of dying was actually relatively greater for survivors of severe covid under age 65 than it was for patients over 65. Compared to similarly aged but non-infected people, they were more than three times more likely to die in the months after their hospitalization.


The results are yet another reminder that the harms of the pandemic run deeper than any official death toll can illustrate. As many as 7.5 million Americans have been hospitalized by covid-19, the Centers for Disease Control and Prevention has estimated. Given the risks that hospitalized survivors will face even after their initial ordeal, the authors say it’s “clear that prevention of significant covid-19 infection is the most effective way to decrease the risk of death following covid-19.”