As a user of Keepass I am having difficulty with the recommendation of exporting to CSV and then worrying about safety and security of the resulting file and/or print out.
That is a fair amount of extra effort with its own security risks. The print out strikes me as being just short of useless: My passwords are all long random strings generated by my password manager and I can’t even successfully type them in with less than a few tries. And the important accounts also have TOTP setup so there would have to be accurate typing for that too. Trying to recover more than a couple of accounts by typing in those long random passwords and TOTP recovers information would be so difficult as to send me off to try some other method.
I share my Keepass file between my devices using my NextCloud server so at a minimum a current copy is present on my laptop, my NextCloud server, and my phone. My laptop is backed up each hour with encrypted backups to my local NAS. In addition, I do a monthly copy to a hidden and encrypted partition on a USB drive I keep on keyring that holds my house and car keys so it is always with me and the file is also written to a USB drive kept in a fireproof box. It seems exceedingly unlikely that I will lose access to all of them at the same time. The sharing between devices and laptop backup are automatic so no effort there. The monthly backup is via a script and only takes a minute or so to do. So the ongoing effort to keep things backed up is minimal.
Advantages of local encrypted password file like Keepass include, at least in the more recent versions of the various apps that support that file format is that they support TOTP in addition to passwords, so backing up my passwords also backs up the TOTP information. Using a cloud service to keep current copies on your various devices is pretty easy. I use my own server but since the password file is encrypted the risk of using a cloud service not under your own control is probably okay for many threat models, at least if you use a long enough pass phrase for your password.
One more thing to think about is succession planning. All my financial accounts can really only be accessed using the information stored in Keepass. In addition to passwords and TOTP codes, I use different random made up answers to the security questions that some sites require. I have to lookup the answers in Keepass to those idiotic question myself. So, near as I can set things up, even I can’t social engineer my way into my accounts.
If something happens to me the executor of my estate will have a much easier job if they can get access to a copy of that file. In my case the executor lives in a different state, so I made a QR code with the Keepass password, sliced it in half. Verified that neither half of the QR code would work by itself but by placing them together would still work. One half was mailed to the executor, the other half is under my control but the executor has been informed about where they can find it if I pass away. I haven’t seen too much on how one should deal with secure passwords and succession planning, so maybe my method is not as good as it should be. But you should think about how your setup will deal with it.