Assessment of thirty‐day readmission rate, timing, causes and predictors after hospitalization with COVID‐19

Abstract

Background There are limited data on the characteristics of 30‐day readmission after hospitalization with coronavirus disease 2019 (COVID‐19). Objectives To examine the rate, timing, causes, predictors and outcomes of 30‐day readmission after COVID‐19 hospitalization. Methods From 13 March to 9 April 2020, all patients hospitalized with COVID‐19 and discharged alive were included in this retrospective observational study. Multivariable logistic regression was used to identify the predictors of 30‐day readmission, and a restricted cubic spline function was utilized to assess the linearity of the association between continuous predictors and 30‐day readmission. Results A total of 1062 patients were included in the analysis, with a median follow‐up time of 62 days. The mean age of patients was 56.5 years, and 40.5% were women. At the end of the study, a total of 48 (4.5%) patients were readmitted within 30 days of discharge, and a median time to readmission was 5 days. The most common primary diagnosis of 30‐day readmission was a hypoxic respiratory failure (68.8%) followed by thromboembolism (12.5%) and sepsis (6.3%). The patients with a peak serum creatinine level of ≥1.29 mg/dL during the index hospitalization, compared to those with a creatinine of <1.29 mg/dL, had 2.4 times increased risk of 30‐day readmission (adjusted odds ratio: 2.41; 95% CI: 1.23–4.74). The mortality rate during the readmission was 22.9%. Conclusion With 4.5% of the thirty‐day readmission rate, COVID‐19 survivors were readmitted early after hospital discharge, mainly due to morbidities of COVID‐19. One in five readmitted COVID‐19 survivors died during their readmission.

Incidence and risk factors for early readmission after hospitalization for SARS-CoV-2 infection: results from a retrospective cohort study

“…Older age, high number of comorbidities, higher levels of acute-phase reactants, such as C-reactive protein (CRP), procalcitonin (PCT) and D-dimer, were associated with more severity of infection [4][5][6]. Unfortunately, limited studies have paid attention to the risk factors related to readmission after being discharged [7][8][9][10][11].…”

Potential contributors to increased pulmonary embolism hospitalizations during the Covid-19 pandemic

“…1 Potential contributors to this observation are unclear and could include undetected SARS-CoV-2 infection in pneumonia cases, more computed tomography use in suspected Covid-19 pneumonias, volume depletion due to the 2020 heat wave or complications of preceding Covid-19. [3][4][5] Therefore, we analyzed associations between changes in PE hospitalizations and ( 1 In order to associate the daily number of PE cases in 2020 with the number of preceding SARS-CoV-2 infections in Germany, 6 we calculated the average number of daily infections (divided by 10,000) occurring 14 up to 90 days with increasing window sizes before PE cases and modelled the data with Poisson regression.…”

COVID-19-related symptom clustering in a primary care vs internal medicine setting

“…In particular, Italy has been one of the first European countries to be hit by the pandemic, and internal medicine has played a pivotal role in facing this crisis. Since then, we have gained several novel insights into COVID-19 clinical manifestations, prognosis, and treatment [1,2]. COVID-19 clinical presentation widely varies, spacing from an asymptomatic disease course to interstitial pneumonia requiring invasive ventilation, passing through a proteiform spectrum of gastrointestinal, neurological, and systemic manifestations [1,2].…”

“…Since then, we have gained several novel insights into COVID-19 clinical manifestations, prognosis, and treatment [1,2]. COVID-19 clinical presentation widely varies, spacing from an asymptomatic disease course to interstitial pneumonia requiring invasive ventilation, passing through a proteiform spectrum of gastrointestinal, neurological, and systemic manifestations [1,2]. However, although of great interest, potential differences in clinical presentation between primary care vs. hospitalised patients are still poorly characterised.…”