Background. COVID-19 infection has led to an overwhelming effort by health institutions to meet the high demand for hospital admissions. Aim. To analyse the clinical variables associated with readmission of patients who had previously been discharged after admission for COVID-19. Design and methods. We studied a retrospective cohort of patients with laboratory-confirmed SARS-CoV-2 infection who were admitted and subsequently discharged alive. We then conducted a nested case-control study paired (1:1 ratio) by age, sex and period of admission. Results. Out of 1368 patients who were discharged during the study period, 61 patients (4.4%) were readmitted. Immunocompromised patients were at increased risk for readmission. There was also a trend towards a higher probability of readmission in hypertensive patients (p=0.07). Cases had had a shorter hospital stay and a higher prevalence of fever during the 48 hours prior to discharge. There were no significant differences in oxygen levels measured at admission and discharge by pulse oximetry intra-subject or between the groups. Neutrophil/lymphocyte ratio at hospital admission tended to be higher in cases than in controls (p=0.06). The motive for readmission in 10 patients (16.4%), was a thrombotic event in venous or arterial territory (p<0.001). Neither glucocorticoids nor anticoagulants prescribed at hospital discharge were associated with a lower readmission rate. Conclusions. The rate of readmission after discharge from hospital for COVID-19 was low. Immunocompromised patients and those presenting with fever during the 48 hours prior to discharge are at greater risk of readmission to hospital.

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This study aimed to analyze temporal trends by gender and age in Clostridium difficile infection (CDI)-related hospitalization rates in the Autonomous Community of Madrid (Spain) over a 12-year period. A population-based cross-sectional study of all hospital admissions with a CDI diagnosis from 2003 to 2014 was carried out. Annual age-specific hospitalization rates were calculated by gender. All the analyses were performed separately for total hospitalizations and hospitalizations with CDI as the primary diagnosis. Joinpoint regression models were used to analyze time trends. A total of 13,526 hospital discharges were identified (26.8 % with CDI as the primary diagnosis). In both sexes, a gradient in age-specific rates was observed, ranging in 2014 from 5.92 hospitalizations per 100,000 person-years in patients <15 years of age to 378.96 in patients ≥85 years of age. Since 2009, in the age group of 15-44 years, both men and women presented an increasing trend of around 18 %. A significantly increasing trend was detected in women of age 45-84 years, with an estimated annual percentage of change of 7.6 % in the age group of 45-64 years, and rounding with 4.5 % in the age group of 65-84 years. In men of age 45-64 years, the average annual percentage of increase was 4.7 %, and it was 21.1 % between 2010 and 2014 in the age group of 65-74 years. No trends were identified in the 85 years and over age group. Surveillance methods to assess trends by age group should be implemented. Preventive and therapeutic initiatives should remain a priority.

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