1368. In-hospital and post-discharge mortality among adults with COVID-19 associated hospitalization, COVID-NET, March 2020–April 2021.

BACKGROUND: Since the COVID-19 pandemic began in 2020, > 1 million persons have died in the US due to COVID-19. While various research illustrated in-hospital mortality in detail, post-discharge mortality has not been well described. Data from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) were used to describe in-hospital and post-discharge mortality among adults hospitalized with COVID-19 in the US during the first year of the pandemic. METHODS: COVID-NET is a population-based surveillance system in 14 states that captures laboratory-confirmed COVID-19-associated hospitalizations, defined as any patient residing in the catchment areas with a positive SARS-CoV-2 test during hospitalization or ≤ 14 days prior to admission. Detailed chart reviews were conducted by trained surveillance officers on a representative sample stratified by age group, state, and month. Cases were linked to death certificate data to identify those who died ≤ 60 days after hospital discharge. Data were restricted to adults ages ≥ 18 years admitted from March 2020–April 2021. Proportions of mortality and hospitalization rate (per 100,000) were calculated by month to investigate trends in adults aged ≥ 75 years. RESULTS: 176,044 hospitalized adults met the COVID-NET case definition during the study period; 26,149 underwent full chart review. Overall, 9.7% died in-hospital and 6% died post-discharge; among those ≥ 75 years, these proportions were 18.1% and 16.2%, respectively (Figure 1). Among adults who died post-discharge, 47.5%, 33.1% and 28.3 were discharged to another facility, hospice, and private residence +/- services, respectively. Post-discharge mortality among those ≥ 75 years exceeded in-hospital mortality during October 2020 and December 2020 – February 2021. Hospitalization rates among those ≥ 75 years peaked in December 2020; the following month, January 2021, had the highest proportion of post-discharge mortality (22.6%) in this age group (Figure 2). Mortality among hospitalized adults ages ≥18 years with laboratory-confirmed COVID-19, COVID-19-Associated Hospitalization Surveillance Network, March 2020–April 2021 [Figure: see text] Figure 1 Hospitalization Rate and Mortality among laboratory-confirmed COVID-19 among adults ages ≥75 years, COVID-19 Associated Hospitalization Surveillance Network, March 2020–April 2021 [Figure: see text] Figure 2 CONCLUSION: Among all deaths in adults with a COVID-19-associated hospitalization, two-thirds occurred in-hospital and one-third occurred ≤ 60 days post-discharge. Increases in post-discharge mortality followed a period of high COVID-19-associated hospitalization rates among ≥ 75 years. DISCLOSURES: All Authors: No reported disclosures