Factors Associated With Readmission in the United States Following Hospitalization With Coronavirus Disease 2019

Abstract

Background Patients hospitalized for COVID-19 may experience complications following hospitalization and require readmission. This analysis estimates the rate and risk factors associated with COVID-19-related readmission and inpatient mortality. Methods This is a retrospective cohort study utilizing deidentified chargemaster data from 297 hospitals across 40 US states on patients hospitalized with COVID-19 February 15-June 09, 2020. Demographics, comorbidities, acute conditions, and clinical characteristics of first hospitalization are summarized. Mulitvariable logistic regression was used to measure risk factor associations with 30-day readmission and in-hospital mortality. Results Among 29,659 patients, 1,070 (3.6%) were readmitted. Readmitted patients were more likely to have diabetes, hypertension, cardiovascular disease (CVD), chronic kidney disease (CKD) vs those not readmitted (p<0.0001) and to present on first admission with acute kidney injury (15.6% vs. 9.2%), congestive heart failure (6.4% vs. 2.4%), and cardiomyopathy (2.1% vs. 0.8%) (p<0.0001). Higher odds of readmission were observed in patients age >60 vs. 1840 (odds ratio [OR]=1.92, 95% confidence interval [CI]=1.48, 2.50), and admitted in the Northeast vs. West (OR=1.43, 95% CI=1.14, 1.79) or South (OR=1.28, 95% CI=1.11, 1.49). Comorbidities including diabetes (OR=1.34, 95% CI=1.12, 1.60), CVD (OR=1.46, 95% CI=1.23, 1.72), CKD stage 1-5 (OR=1.51, 95% CI=1.25,1.81) and stage 5 (OR=2.27, 95% CI=1.81, 2.86) were associated with higher odds of readmission. 12.3% of readmitted patients died during second hospitalization. Conclusions Among this large US population of patients hospitalized with COVID-19, readmission was associated with certain comorbidities and acute conditions during first hospitalization. These findings may inform strategies to mitigate risks of readmission due to COVID-19 complications.

Impact of tozinameran (BNT162b2) mRNA vaccine on kidney transplant and chronic dialysis patients: 3–5 months follow-up

“…The COVID-19 pandemic brought new challenges to the general population and even more so to patients with end-stage renal disease (ESRD), many of whom have comorbidities now acknowledged as risk factors for severe COVID-19 [ 5 ]. Aside from the logistic challenges summarized elsewhere [ 6 ], these patients, both dialysis-treated and kidney transplant patients, face morbidity and mortality risks that are significantly higher than the general population [ 7 , 8 ]. Unfortunately, it is known from existing vaccine preparations such as anti-hepatitis B virus and influenza [ 9 – 12 ], that both dialysis and kidney transplant patients require higher doses and repeat inoculations (i.e.…”

Readmission rates of patients with COVID-19 after hospital discharge

“…A study with more than 29,000 patients who had confirmed COVID-19 reported the length of hospitalization time as 8 days 13 . A Korean study reported the length of hospitalization due to COVID-19 as 17 days 14 .…”

Impact of tozinameran (BNT162b2) mRNA vaccine on kidney transplant and chronic dialysis patients: 3-5 months followup

“…The COVID-19 pandemic brought new challenges to the general population and even more so to patients with end-stage renal disease (ESRD), many of whom have comorbidities now acknowledged as risk factors for severe COVID-19. Aside from logistic challenges summarized elsewhere 3 , these patients, both dialysis-treated and kidney transplant patients, face morbidly and mortality risks that are significantly higher than the general population 4, 5 . Unfortunately, it is known from existing vaccine preparations such as anti-hepatitis B virus and the influenza 6-9 , that both dialysis and kidney transplant patients require higher doses and repeat inoculations (i.e.…”