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Hospital Readmissions of Discharged Patients with COVID-19
Lina Marcela Parra1, Mireia Cantero1, Ignacio Morrás2
1Servicio de Medicina Preventiva, HU Puerta de Hierro-Majadahonda, Madrid, Spain.
Insights
The COVID-19 readmission rate after hospital discharge was low at 4.4%. Immunocompromised patients and those with fever before discharge faced higher risks of readmission.
Area of Science:
- Infectious Diseases
- Public Health
- Clinical Medicine
Background:
- Understanding post-discharge outcomes for COVID-19 patients is crucial for optimizing care.
- Readmission rates provide insights into the effectiveness of initial treatment and discharge planning.
Purpose of the Study:
- To determine the readmission rate among patients discharged after COVID-19 hospitalization.
- To identify clinical variables associated with COVID-19 patient readmission.
Main Methods:
- A nested case-control study was conducted at a university hospital in Madrid.
- Sixty-one patients readmitted within three weeks of discharge were compared to controls matched for age, sex, and admission period.
Main Results:
- The overall readmission rate was 4.4% (61 out of 1368 patients).
- Immunocompromised status (10.2%) and fever within 48 hours of discharge were significant risk factors for readmission.
- Higher D-dimer levels at discharge were noted in readmitted patients with thrombotic events.
Conclusions:
- The rate of hospital readmission following COVID-19 discharge is low.
- Identifying at-risk patients, such as the immunocompromised or those with pre-discharge fever, can guide targeted post-discharge monitoring and interventions.
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.
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