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Factors associated with hospital readmissions among patients with COVID-19: A single-center experience
Geneva Guarin1, Kevin Bryan Lo1, Ruchika Bhargav1
1Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA.
Insights
Patients hospitalized with coronavirus disease 2019 (COVID-19) have significant readmission rates. Coronary artery disease (CAD) independently predicts 6-month readmission, highlighting the need for targeted post-discharge care.
Area of Science:
- Medical Research
- Infectious Diseases
- Cardiology
Background:
- Coronavirus disease 2019 (COVID-19) poses significant health risks, including post-hospitalization complications.
- Understanding readmission factors is crucial for managing patients with COVID-19, especially in underserved populations.
Purpose of the Study:
- To identify factors associated with readmission after hospitalization for COVID-19.
- To determine the impact of comorbidities like coronary artery disease (CAD) on readmission rates.
Main Methods:
- Retrospective descriptive study of 275 COVID-19 patients surviving index hospitalization.
- Multivariable logistic regression used to identify independent predictors of 1- and 6-month readmissions.
- Analysis included demographic data, chronic medical conditions, and clinical outcomes.
Main Results:
- The 6-month readmission rate was 24%, with 9% of readmitted patients subsequently dying.
- Coronary artery disease (CAD) was independently associated with increased 6-month readmission (OR, 2.15).
- Hispanic ethnicity was also linked to higher readmission rates (OR, 3.16).
Conclusions:
- A notable proportion of COVID-19 patients are readmitted post-hospitalization.
- Coronary artery disease is a significant independent predictor of 6-month readmission after COVID-19 hospitalization.
- Targeted interventions for patients with CAD may reduce readmission rates.
Abstract:
Identify factors associated with readmission after an index hospital admission for coronavirus disease 2019 (COVID-19) infection in a single center serving an underserved and predominantly minority population. This retrospective descriptive study included 275 patients who tested COVID-19 positive via reverse transcriptase-polymerase chain reaction assay at our institution and who survived the index hospitalization. The main outcomes were 1- and 6-month readmission rates after an index hospitalization for COVID-19. The mortality rate among the readmitted patients was also determined. Factors independently associated with readmission were investigated using multivariable logistic regression. A final sample of 275 patients was included. The mean age was 64.69 ± 14.64 (SD), 133 (48%) were female and 194 (70%) were African American. Their chronic medical conditions included hypertension 203 (74%) and diabetes mellitus 121 (44%). After the hospitalization, 1-month readmission rate was 7.6%, while 6-month readmission rate was 24%. Nine percent of patients who were readmitted subsequently died. Coronary artery disease (CAD) was significantly associated with 6-month readmission odds ratio (OR), 2.15 (95% confidence interval [CI]: 1.04-4.44; p = 0.039) after adjustment for age, gender, ethnicity, and comorbidities. Readmissions were due to cardiac, respiratory, and musculoskeletal symptoms. Hispanic ethnicity was associated with increased readmission OR, 3.16 (95% CI: 1.01-9.88; p = 0.048). No significant difference was found between inflammatory markers or clinical outcomes during the index hospitalization among patients who were readmitted compared to those who were not. A significant number of patients hospitalized for COVID-19 may be readmitted. The presence of CAD is independently associated with high rates of 6-month readmission.
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