36. Clinical Features of and Risk Factors for 30-day Readmission after an Initial Hospitalization with COVID-19

Abstract

Background Little is known about risk factors for readmission after COVID-19 hospitalizations. Knowledge of these factors may help to identify patients at increased risk and may help to prevent these rehospitalizations. Methods This historical cohort study was conducted at a tertiary care academic medical center. We included COVID-19 cases diagnosed by reverse-transcriptase polymerase-chain-reaction (RT-PCR) assay between March 8th and June 14th, 2020. Patients readmitted within 30 days were identified. Using the electronic medical record, we collected data on demographic and clinical information. Data were analyzed using Student’s t-test, the chi-squared test and multivariable logistic regression. Results We included 391 patients who survived after the index hospitalization for COVID-19. The readmission rate was 13.3% (52/391). The mean time to readmission was 9.2 ± 7.9 days. The mean age (±SD) was 66.3 ± 18.6 years, 44.2% were male, and 78.8% were black/African-American. The most common presenting complaint was shortness of breath (50%). The most frequent diagnosis during the readmission was infectious process (57.7%). The mortality rate on readmission was 11.5%. Patients with a 30-day readmission were older than those not readmitted, mean age (±SD) 66.3 ± 18.6 vs. 61.0 ± 16.0, respectively (p=0.03). Readmitted patients also had a higher prevalence of heart failure and renal disease as comorbidities. Elevated alanine aminotransferase (AST) and low albumin level were also associated with readmission (Table 1). Intensive care unit (ICU) admission or mechanical ventilation during the index admission did not increase the risk of readmission. From multivariable analysis, independent predictors of 30-day readmission were higher Charlson score (p=0.004), higher creatinine on admission in the index hospitalization (p=0.009), and presence of rhabdomyolysis during the index hospitalization (p=0.039) (Table 2). Table 1. Univariable Analysis of Predictors for Readmission within 30 days from COVID-19 Infection Table 2. Multivariable Analysis of Predictors for Readmission within 30 days from COVID-19 Infection Conclusion In our cohort, infectious etiologies were common among those readmitted within 30 days of COVID-19. A higher Charlson score, acute renal failure, and rhabdomyolysis during the index admission were independent predictors of a 30-day readmission. Further studies are required to investigate these contributing factors. Disclosures All Authors: No reported disclosures

Event Rate and Predictors of Post-Acute COVID-19 Sequalae and the Average Time to Diagnosis in General Population

“…Like in this study subject to comorbidities generally predicting post-acute COVID-19 sequalae at 14 % (R 2 =0.14), another study established overall severity of comorbidities as one the strongest risk factors for post-acute COVID-19 sequelea 72 . Hospital re-admission contributing to over 17 % of post-acute COVID-19 sequalae as per this study, similar findings have shown some consistency where patients (19.9%) who survived COVID-19 hospitalization were readmitted 78 , and another, the readmission rate was 13.3% 79 .…”

“…Hospital re-admission contributing to over 17 % of post-acute COVID-19 sequalae as per this study, similar findings have shown some consistency where patients (19.9%) who survived COVID-19 hospitalization were readmitted 78 , and another, the readmission rate was 13.3% 79 .…”