<p>Hospital Readmissions of Discharged Patients with COVID-19</p>

Abstract

Objective: To analyse the rate of occurrence and the clinical variables associated with readmission of patients who had previously been discharged after admission for COVID-19. Setting: University hospital in Madrid (Spain). Participants: Sixty-one patients (74% male) who presented COVID-19 were readmitted during the 3 weeks after discharge from hospital. Interventions: Nested case-control study paired (1:1 ratio) by age, sex and period of admission. Outcome Measures: Rate of readmission rate of patients discharged after suffering COVID-19 and identification of the clinical variables associated with it. Results: Out of 1368 patients who were discharged during the study period, 61 patients (4.4%) were readmitted. Immunocompromised patients (N=10.2%) were at increased risk for readmission (p=0.04). 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-to-lymphocyte ratio at hospital admission tended to be higher in cases than in controls (p=0.06). Neither glucocorticoids nor anticoagulants prescribed at hospital discharge were associated with a lower readmission rate. Patients who were readmitted due to a thrombotic event (8 patients, 13.1%) presented a higher level of D-dimer at discharge of initial admission. Conclusion: 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 were at greater risk of readmission to hospital.

Emergency department visits and readmissions after COVID-19 hospitalization: a cross-sectional analysis

“…Several key findings from our data warrant additional attention. First, we have corroborated the finding from previous studies [ 10 , 13 ] that shorter COVID-19 index hospital length of stay is associated with revisits after discharge. While the mechanism for this is not yet clear, it is possible either that there are unforeseen late-developing COVID-19 clinical changes that need to be better characterized and/or that system-level factors such as increased bed demand place strain on discharge decisions.…”

“…Our 30-day hospital readmission rate of 11% is higher than most reported comparisons both in the US (2.2% overall readmission rate in New York City [6], 6.8% 30-day hospital readmission in Rhode Island [7], 10.3% overall hospital readmission in Boston [8]) and globally (2.3% overall hospital readmission in Wuhan [9], 4.4% overall hospital readmission in Madrid [10], 4.5% overall hospital readmission in South Korea [11], 7.1% 30-day hospital readmission in Turkey [12]). This could reflect the fact that some studies defined readmissions more strictly as COVID-related presentation or that some were confounded by a large number of patients remaining hospitalized during the study time period.…”

Development and validation of prediction models for mechanical ventilation, renal replacement therapy, and readmission in COVID-19 patients

“… 10 In addition, while hospitals struggle to manage heavy COVID-19 caseloads, patients who would normally be admitted may be discharged home, leading to higher than expected readmission rates. 11 Each of these outcomes carries significant implications for patient outcomes, long-term sequelae, and utilization of scarce resources including hospital beds and the equipment and materials needed for mechanical ventilation and RRT. Clinical prediction models could be used effectively to assess patient prognosis, informing resource planning and triage decisions.…”

Potential contributors to increased pulmonary embolism hospitalizations during the Covid-19 pandemic

“…1 Potential contributors to this observation are unclear and could include undetected SARS-CoV-2 infection in pneumonia cases, more computed tomography use in suspected Covid-19 pneumonias, volume depletion due to the 2020 heat wave or complications of preceding Covid-19. [3][4][5] Therefore, we analyzed associations between changes in PE hospitalizations and ( 1 In order to associate the daily number of PE cases in 2020 with the number of preceding SARS-CoV-2 infections in Germany, 6 we calculated the average number of daily infections (divided by 10,000) occurring 14 up to 90 days with increasing window sizes before PE cases and modelled the data with Poisson regression.…”