Background The 30-day readmission rate is an important indicator of patient safety and hospital’s quality performance. In this study, we aimed to find out the 30-day readmission rate of mild and moderate severity COVID-19 patients discharged from a tertiary care university hospital and to demonstrate the possible factors associated with readmission. Methods This is an observational, single-center study. Epidemiological and clinical data of patients who were hospitalized with a diagnosis of COVID-19 were retrieved from a research database where patient information was recorded prospectively. Readmission data was sought from the hospital information management system and National Health Record System to detect if the patients were readmitted to any hospital within 30 days of discharge. Adult patients (≥18 years-old) hospitalized in COVID-19 wards with a diagnosis of mild or moderate COVID-19 between March 20, 2020 (when the first case was admitted to our hospital), and April 26, 2020 were included. Results From March 26 to May 1, there were 154 mild or moderate severity (non-critical) COVID-19 patients discharged from COVID-19 wards, of which 11 (7.1%) were readmitted The median time of readmission was 8.1 days (IQR=5.2). Two patients (18.1%) were categorized to have mild disease and the remaining 9 (81.9%) as moderate disease. Two patients who were over 65 years of age and had metastatic cancers and hypertension developed sepsis and died in the hospital during the readmission episode. Malignancy (18.7% vs 2.1%, P = 0.04) and hypertension (45.5% vs 14%, P = 0.02) were more common in those who were readmitted. Conclusions This is one of the first studies to report on 30-day readmission rate of COVID-19 in the literature. More comprehensive studies are needed to reveal the causes and predictors of COVID-19 readmissions.

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Aralık 2019'da Çin'de etiyolojisi bilinmeyen pnömoni vakaları bildirilmiş olup daha önce insanlarda tespit edilmemiş yeni bir coronavirusun hastalığa neden olduğu tespit edilmiştir. 2002 yılında salgın yapan SARS-CoV virusuna olan benzerliğinden dolayı SARS-CoV-2 olarak adlandırılmış, virusun yol açtığı klinik hastalığa da "coronavirus hastalığı-2019 (coronavirus disease -2019, COVID-19)" adı verilmiştir. Hastalığın patofizyolojisi üzerine yapılan ilk çalışmalarda SARS-CoV-2'nin hücreye giriş reseptörü olarak Anjiyotensin Dönüştürücü Enzim2 (ACE2)'yi kullandığı saptanmıştır. Hastalığın Renin Anjiyotensin Aldosteron Sistemi (RAAS) blokerlerinin sıklıkla kullanıldığı hasta gruplarında (hipertansiyon, kardiyovasküler hastalıklar) daha sık saptandığı ve daha ağır seyrettiğinin görülmesi RAAS blokeri olarak kullanılan Anjiyotensin Dönüştürücü Enzim İnhibitörleri(ACEI) ve Anjiyotensin Reseptör Blokörlerinin (ARB) kullanımı ile ilgili endişelere yol açmıştır. COVID-19 pandemisinin başından itibaren bilim dünyasında bu konu ile ilgili birçok farklı görüş bildirilmiş, çalışmalar yapılmış ve yapılmaya devam etmektedir. Bu yazıda, COVID-19 ve RAAS arasındaki ilişki ve COVID-19 hastalarında ACEI/ARB kullanımının potansiyel etkileri güncel literatür eşliğinde gözden geçirilmiştir.

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