tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Jun 30;9(7)
fac320.
doi: 10.1093/ofid/ofac320. eCollection 2022 Jul.
Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program
Heather Sperring[SUP] 1 [/SUP], Melissa Hofman[SUP] 2 [/SUP], Heather E Hsu[SUP] 3 [/SUP], Yian Xiao[SUP] 4 [/SUP], Elizabeth A Keohane[SUP] 5 [/SUP], Sara Lodi[SUP] 6 [/SUP], Jai Marathe[SUP] 7 [/SUP], Rachel L Epstein[SUP] 7 [/SUP]
Affiliations
Abstract
Background: Despite increasing vaccination rates, coronavirus disease 2019 (COVID-19) continues to overwhelm heath systems worldwide. Few studies follow outpatients diagnosed with COVID-19 to understand risks for subsequent admissions. We sought to identify hospital admission risk factors in individuals with COVID-19 to guide outpatient follow-up and prioritization for novel therapeutics.
Methods: We prospectively designed data collection templates and remotely monitored patients after a COVID-19 diagnosis, then retrospectively analyzed data to identify risk factors for 30-day admission for those initially managed outpatient and for 30-day re-admissions for those monitored after an initial COVID-19 admission. We included all patients followed by our COVID-19 follow-up monitoring program from April 2020 to February 2021.
Results: Among 4070 individuals followed by the program, older age (adjusted odds ratio [aOR], 1.05; 95% CI, 1.03-1.06), multiple comorbidities (1-2: aOR, 5.88; 95% CI, 2.07-16.72; ≥3: aOR, 20.40; 95% CI, 7.23-57.54), presence of fever (aOR, 2.70; 95% CI, 1.65-4.42), respiratory symptoms (aOR, 2.46; 95% CI, 1.53-3.94), and gastrointestinal symptoms (aOR, 2.19; 95% CI, 1.53-3.94) at initial contact were associated with increased risk of COVID-19-related 30-day admission among those initially managed outpatient. Loss of taste/smell was associated with decreased admission risk (aOR, 0.46; 95% CI, 0.25-0.85). For postdischarge patients, older age was also associated with increased re-admission risk (aOR, 1.04; 95% CI, 1.01-1.06).
Conclusions: This study reveals that in addition to older age and specific comorbidities, the number of high-risk conditions, fever, respiratory symptoms, and gastrointestinal symptoms at diagnosis all increased odds of COVID-19-related admission. These data could enhance patient prioritization for early treatment interventions and ongoing surveillance.
Keywords: COVID-19; SARS-CoV-2; hospitalization.
. 2022 Jun 30;9(7)
fac320.doi: 10.1093/ofid/ofac320. eCollection 2022 Jul.
Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program
Heather Sperring[SUP] 1 [/SUP], Melissa Hofman[SUP] 2 [/SUP], Heather E Hsu[SUP] 3 [/SUP], Yian Xiao[SUP] 4 [/SUP], Elizabeth A Keohane[SUP] 5 [/SUP], Sara Lodi[SUP] 6 [/SUP], Jai Marathe[SUP] 7 [/SUP], Rachel L Epstein[SUP] 7 [/SUP]
Affiliations
- PMID: 35899280
- PMCID: PMC9278211
- DOI: 10.1093/ofid/ofac320
Abstract
Background: Despite increasing vaccination rates, coronavirus disease 2019 (COVID-19) continues to overwhelm heath systems worldwide. Few studies follow outpatients diagnosed with COVID-19 to understand risks for subsequent admissions. We sought to identify hospital admission risk factors in individuals with COVID-19 to guide outpatient follow-up and prioritization for novel therapeutics.
Methods: We prospectively designed data collection templates and remotely monitored patients after a COVID-19 diagnosis, then retrospectively analyzed data to identify risk factors for 30-day admission for those initially managed outpatient and for 30-day re-admissions for those monitored after an initial COVID-19 admission. We included all patients followed by our COVID-19 follow-up monitoring program from April 2020 to February 2021.
Results: Among 4070 individuals followed by the program, older age (adjusted odds ratio [aOR], 1.05; 95% CI, 1.03-1.06), multiple comorbidities (1-2: aOR, 5.88; 95% CI, 2.07-16.72; ≥3: aOR, 20.40; 95% CI, 7.23-57.54), presence of fever (aOR, 2.70; 95% CI, 1.65-4.42), respiratory symptoms (aOR, 2.46; 95% CI, 1.53-3.94), and gastrointestinal symptoms (aOR, 2.19; 95% CI, 1.53-3.94) at initial contact were associated with increased risk of COVID-19-related 30-day admission among those initially managed outpatient. Loss of taste/smell was associated with decreased admission risk (aOR, 0.46; 95% CI, 0.25-0.85). For postdischarge patients, older age was also associated with increased re-admission risk (aOR, 1.04; 95% CI, 1.01-1.06).
Conclusions: This study reveals that in addition to older age and specific comorbidities, the number of high-risk conditions, fever, respiratory symptoms, and gastrointestinal symptoms at diagnosis all increased odds of COVID-19-related admission. These data could enhance patient prioritization for early treatment interventions and ongoing surveillance.
Keywords: COVID-19; SARS-CoV-2; hospitalization.