ArticlePloS one2026
Comparison of post-discharge mortality and medical expenditures in COVID-19 patients according to mechanical ventilation and extracorporeal membrane oxygenation use: The LIFE study.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Outcomes related to health status and economic burden among patients who experienced critical COVID-19 remain insufficiently studied. We examined 180-day post-discharge mortality and total medical expenditures in COVID-19 patients according to their use of mechanical ventilation (MV) or extracorporeal membrane oxygenation (ECMO) during hospitalization. Using medical claims data from a Japanese municipality, this retrospective cohort study analyzed hospitalized COVID-19 patients who were discharged between April 1, 2020 and September 30, 2021. Patients were categorized into an MV/ECMO group (indicating severe disease) or a non-MV/ECMO group. Their differences in mortality and expenditures were compared using the χ2 test and Mann-Whitney U test, respectively. A Cox regression analysis was performed to calculate the hazard ratios of MV/ECMO use for mortality, and a generalized linear model with gamma distribution was constructed to examine the association between MV/ECMO use and expenditures. The covariates included age, sex, comorbidities, and length of stay. The MV/ECMO group had significantly higher mortality (16.0% vs. 11.1%, p = 0.002) and expenditures ($8,732 vs. $3,460, p < 0.001) than the non-MV/ECMO group. MV/ECMO use was significantly associated with higher mortality (hazard ratio: 1.66, 95% confidence interval: 1.27-2.15); other risk factors included age (1.06, 1.05-1.07), dementia (1.48, 1.10-1.99), and cancer (1.92, 1.56-2.36). MV/ECMO use was also significantly associated with higher expenditures (Exp[β]: 1.49, 95% confidence interval: 1.29-1.73); other risk factors included kidney disease (1.60, 1.29-2.01), cerebrovascular disease (1.74, 1.56-1.94), and cancer (1.28, 1.14-1.44). Survivors of severe COVID-19 who required MV or ECMO during hospitalization were associated with higher post-discharge mortality and expenditures, suggesting a need for targeted care to reduce their clinical and economic burden.
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