tetano
Editor, Senior Moderator
Int J Gen Med
. 2020 Dec 2;13:1359-1366.
doi: 10.2147/IJGM.S275775. eCollection 2020.
Hospital Readmissions of Discharged Patients with COVID-19
Lina Marcela Parra[SUP] 1 [/SUP], Mireia Cantero[SUP] 1 [/SUP], Ignacio Morr?s[SUP] 2 [/SUP], Alberto Vallejo[SUP] 1 [/SUP], Itziar Diego[SUP] 2 [/SUP], Elena Jim?nez-Tejero[SUP] 1 [/SUP], Elena M??ez[SUP] 3 [/SUP], ?ngel Asensio[SUP] 1 [/SUP], Ana Ferm?ndez-Cruz[SUP] 3 4 [/SUP], Antonio Ramos-Martinez[SUP] 3 4 [/SUP], Puerta de Hierro Hospital Admission Study Group
Affiliations
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.
Keywords: coronavirus; heparin; patient readmission; pneumonia; pulmonary embolism; viral.
. 2020 Dec 2;13:1359-1366.
doi: 10.2147/IJGM.S275775. eCollection 2020.
Hospital Readmissions of Discharged Patients with COVID-19
Lina Marcela Parra[SUP] 1 [/SUP], Mireia Cantero[SUP] 1 [/SUP], Ignacio Morr?s[SUP] 2 [/SUP], Alberto Vallejo[SUP] 1 [/SUP], Itziar Diego[SUP] 2 [/SUP], Elena Jim?nez-Tejero[SUP] 1 [/SUP], Elena M??ez[SUP] 3 [/SUP], ?ngel Asensio[SUP] 1 [/SUP], Ana Ferm?ndez-Cruz[SUP] 3 4 [/SUP], Antonio Ramos-Martinez[SUP] 3 4 [/SUP], Puerta de Hierro Hospital Admission Study Group
Affiliations
- PMID: 33299342
- PMCID: PMC7719438
- DOI: 10.2147/IJGM.S275775
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.
Keywords: coronavirus; heparin; patient readmission; pneumonia; pulmonary embolism; viral.