P-1915. Factors Associated with Post-discharge Mortality among SARS-CoV-2-infected Adult Patients with Severe Acute Respiratory Infection in Bangladesh during 2020–2023

Abstract Background To better understand the true mortality burden among SARS-CoV-2-infected patients with severe respiratory illnesses, in resource-limited settings in Bangladesh, it is crucial to consider post-discharge deaths along with in-hospital deaths. We estimated the proportion of SARS-CoV-2-associated adult SARI patients who died after discharge and identified factors associated with these deaths. Methods From March 2020–December 2023, we analyzed WHO defined severe acute respiratory infection (SARI) patient data from nine tertiary-level hospitals participating in national hospital-based influenza surveillance in Bangladesh. We estimated the proportion of SARS-CoV-2-associated deaths that occurred within 30 days after hospital-discharge and compared demographics, clinical characteristics between SARS-CoV-2-associated decedents and SARS-CoV-2 survivors. Logistic regression analyses were performed to determine for factors associated with SARS-CoV-2-infected post-discharge deaths. Results We identified 7,816 SARI patients with a median age of 50 years (IQR: 32–60), 62% were male, and 16.4% (1,280) were laboratory-confirmed SARS-CoV-2-infected patients. Of the SARS-CoV-2-infected patients, 9.8% (126) died during their hospital stay. Of 1,154 patients who were alive at discharge, we followed 1,108 (96%) patients, and 111 (10%) died within 30 days after discharge. Patients aged 40-60 (aOR: 8.3, 95% CI: 2.45-27.70) and those aged ≥60 (aOR: 26.3, 95% CI: 8.01-86.2) compared to 18-40 years, residents of rural areas (aOR: 1.91, 95% CI: 1.10-3.31), and individuals with difficulty breathing (aOR: 4.13, 95% CI: 1.75-9.75) or kidney diseases (aOR: 4.62, 95% CI: 1.32-16.14) were significantly associated with a higher risk of post-discharge death. Conclusion Almost half of the deaths among SARS-CoV-2-infected SARI patients in Bangladesh occurred within 30 days post-discharge. To improve post-discharge recovery among vulnerable patients with potential risk attributes, hospitals in resource-limited settings could develop safe-discharge algorithms, strengthen post-discharge care plans, and establish outpatient monitoring of recently discharged patients. Disclosures All Authors: No reported disclosures