Short durations of corticosteroids for hospitalised COVID-19 patients are associated with a high readmission rate

Abstract

Objective Our objective was to describe the characteristics of patients admitted, discharged and readmitted, due to COVID-19, to a central London acute-care hospital during the second peak, in particular in relation to corticosteroids use. Methods We reviewed patients admitted from the community to University College Hospital (UCH) with COVID-19 as their primary diagnosis between 1st-31st December 2020. Re-attendance and readmission data were collected for patients who re-presented within 10 days following discharge. Data were retrospectively collected. Results 196 patients were admitted from the community with a diagnosis of COVID-19 and discharged alive in December 2020. Corticosteroids were prescribed in hospital for a median of 5 days (IQR 3-8). 20 patients (10.2%) were readmitted within 10 days. 11/20 received corticosteroids in the first admission of which 10 had received 1-3 days of corticosteroids. Readmission rate in those receiving 1-3 days of steroids was 25%. Conclusions Most international guidelines have recommended providing up to 10 days of corticosteroids for severe COVID-19 but stopping discharge. Our findings show shorter courses of corticosteroids during admission are associated with an increased risk of being readmitted and support continuing the course of corticosteroids after hospital discharge monitored in the virtual ward setting.

Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis

“…In the manual search of gray literature and preprints, 18 potentially related papers were included. After reviewing the titles and abstracts of the articles, 157 peer-reviewed papers or preprinted manuscripts were reviewed and a total of 91 articles were entered into the present meta-analysis [ 8 , [14] , [15] , [16] , [17] , [18] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] ,…”

Association of Treatment with Remdesivir and 30-day Hospital Readmissions in Patients Hospitalized with COVID-19

“…16 In studies reporting on rates of hospital readmissions after COVID-19 hospitalization, treatments included including hydroxychloroquine, lopinavir/ritonavir, corticosteroids, anticoagulants and remdesivir. 4,[17][18][19][20] A study with a small number of patients treated with remdesivir reported 0/22 patients readmitted within 30 days. 4 By comparison, other treatments such as hydroxychloroquine and corticosteroids, were not associated with a reduction in hospital readmissions.…”

Mucormycosis in COVID-19 pandemic: Risk factors and linkages

“…During COVID-19, many countries have reported remarkably high incidences of self-medication and home remedies among infected as well as uninfected people ( Fig 1 a), which may have had high probabilities of incorrect dosages. Extensive use of steroids during COVID-19 lockdown period has been observed in India, which seems to be the highest ever at the global level 29 . There has been a trend towards increased use of different antibiotics, steroids, vitamins, and Zn, etc.…”