Previous studies from the first years of the COVID-19 pandemic showed that, beyond high in-hospital mortality, many individuals hospitalized with severe COVID-19 died within a short time after discharge. Brazil was among the countries most affected by COVID-19, with more than 700,000 deaths recorded by the end of the pandemic in May 2023. However, little is known about survival after discharge among patients hospitalized with severe COVID-19 in the country. This study aimed to evaluate the prevalence of mortality after hospital discharge for COVID-19 among individuals hospitalized in a University Hospital across different phases of the pandemic.

A retrospective cohort study was conducted among individuals hospitalized for COVID-19 in a University Hospital in southern Brazil from March 2020 to May 2023. Eligible participants were adults (≥18 years), of both sexes, hospitalized for COVID-19 and requiring supplemental oxygen. Medical records were reviewed to obtain sociodemographic and clinical data and COVID-19 vaccination history. Post-discharge deaths were identified through consultation of the municipality’s computerized system. Patient characteristics are presented as mean ± SD for normally distributed variables and as median for non-normal variables, using the Kolmogorov–Smirnov normality test.

A total of 7,460 individuals were treated with a diagnosis of COVID-19, and 2,299 (30.8%) died during hospitalization. Among those discharged, 1,105 lived in the study municipality and were included in the research: 585 men and 520 women, with a median age of 58 years. After discharge, 83 (7.5%) died within one year; most (79.5%) died within six months, and 24 (28.9%) of these deaths occurred within the first 30 days after discharge. The median age among those who died was 75 years; 47 were men and 36 women.

This study reports the prevalence of deaths occurring after hospital discharge among individuals hospitalized for COVID-19 who required supplemental oxygen. The findings may indicate the need for individualized outpatient follow-up by healthcare units for patients discharged after an episode of severe COVID-19, especially older adults.