Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission — United States, March–August 2020

Lavery, Amy M.; Preston, Leigh Ellyn; Ko, Jean Y.; Chevinsky, Jennifer; DeSisto, Carla L.; Pennington, P Audrey F.; Kompaniyets, Lyudmyla; Datta, S. Deblina; Click, Eleanor S.; Golden, Thomas P.; Goodman, Alyson B.; Kenzie, William R. Mac; Boehmer, Tegan K.; Gundlapalli, Adi V.

doi:10.15585/mmwr.mm6945e2

Cited by 182 publications

(261 citation statements)

References 9 publications

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“…We found that nearly 1 in 10 patients with COVID-19 were readmitted within 30 days, which is consistent with reports from the US. 3,50 Compared with patients with influenza, patients with COVID-19 were more likely to be male and reside in long-term care, which is consistent with evidence that COVID-19 affects men more severely 51 and has burdened long-term care facilities in Ontario. 43,52 Patients from neighbourhoods with lower income were overrepresented in both the COVID-19 and influenza groups, reminding us that the socioeconomic gradients in COVID-19 53 are emblematic of those that exist for many diseases, including influenza.…”

Section: Discussionsupporting

confidence: 73%

Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area

Verma

Hora

Jung

et al. 2021

CMAJ

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I nternational studies report that patients admitted to hospital with coronavirus disease 2019 (COVID-19) have high rates of critical illness and mortality. 1-5 Two small Canadian case series have described care for critically ill patients with COVID-19 and found mortality rates of up to 25%. 6,7 However, outcomes of patients admitted to hospital for COVID-19 in Canada are not well described, particularly outside of intensive care units (ICUs). Case fatality rates for COVID-19 vary dramatically worldwide, 8 and outcomes of patients admitted to hospital for COVID-19 in Canada may differ from other countries because of differences in populations, public health and health care systems. Seasonal influenza is a useful comparator for COVID-19 9-11 as it is another respiratory virus, familiar to the general public, with high rates of morbidity and mortality. The purpose of this study was to describe patient characteristics, resource use, clinical care and outcomes for patients admitted to hospital with COVID-19 in Ontario, Canada, using influenza as a comparator. We also validated the performance of various prognostic risk scores for in-hospital mortality among patients with COVID-19.

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Section: Discussionsupporting

confidence: 73%

Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area

Verma

Hora

Jung

et al. 2021

CMAJ

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“… 11 With respect to our study, since it was community-based, most subjects were aged 45–65 years in contrast to hospital-based reports where patients were older. 12 Such a finding, and the higher percentage of women, concurs with the epidemiological data from the first COVID-19 wave in Spain. 13…”

Section: Discussionsupporting

confidence: 79%

Impact of isolating COVID-19 patients in a supervised community facility on transmission reduction among household members

López

Gallego

Abós‐Herràndiz

et al. 2021

Journal of Public Health

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Background Isolation of COVID-19 patients has been universally implemented to control transmission of the outbreak. Hotels and other facilities have been adapted to help appropriate isolation be achieved. Our study tested the efficacy of isolating patients in a reconditioned hotel versus isolation in their domiciles to reduce infection transmission. Methods Observational cohort study based on a survey to COVID-19 patients between April and June 2020. One cohort had been isolated in a hotel and the other in their domiciles. Multivariate regression models analyzed the factors related to the occurrence of COVID-19 infection among the household members. Results A total of 229 household members of COVID-19 patients were analyzed, 139 of them belonging to the group of hotel-isolated patients and 90 in the group of domicile-isolated ones. More than half of the household members became infected (53.7%). Higher risk of infection was found in the household members of domicile-isolated patients isolated and in those reporting overcrowding at home, (odds ratio [OR] 1.67, 95% confidence interval [CI] 0.89–3.12) and (OR 1.44, 95% CI 0.81; 2.56), respectively. Conclusions The isolation of COVID-19 patients in community-supervised facilities may protect their household members from transmission of the disease. Overcrowded homes may contribute to the transmission of the infection.

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“…The stratification by COVID-19 progression states used in this study is generally consistent with disease severity scales of randomized clinical trials of COVID-19 treatment interventions for hospitalized patients [24,25], the recommendations in the FDA Sentinel Master Protocol [19], and the health states used by the Institute for Clinical and Economic Review in their economic evaluation of remdesivir [26]. [13]. The lower observed in-hospital mortality rate in this study may in part be potentially attributed to improvements in the treatment of hospitalized COVID-19 patients and the increasing availability of treatments during the course of the pandemic.…”

Section: Measured Outcomes Of the Overall Study Populationmentioning

confidence: 64%

“…Among the hospitalized COVID-19 patients, the median hospital LOS was 5 days (mean: 8.3 days), in-hospital mortality was 13.6%, median hospital charges were $43,986, and median hospital costs were $12,046. Other studies of hospitalized COVID-19 patients in the US have reported similar proportions of patients admitted to the ICU and receiving IMV [11,13] [13]. The stratification by COVID-19 progression states used in this study is generally consistent with disease severity scales of randomized clinical trials of COVID-19 treatment interventions for hospitalized patients [24,25], the recommendations in the FDA Sentinel Master Protocol [19], and the health states used by the Institute for Clinical and Economic Review in their economic evaluation of remdesivir [26].…”

Section: Measured Outcomes Of the Overall Study Populationmentioning

confidence: 82%

“…The clinical presentation of COVID-19 ranges from mild to severe symptoms; critical illness is characterized by respiratory failure, septic shock, and other multiple organ dysfunction or failure [4,5]. Patient characteristics, clinical outcomes, and resource use of hospitalized COVID -19 patients have been described in several US studies [6][7][8][9][10][11][12][13]. However, limited data are available describing the direct healthcare costs associated with hospital resource utilization among hospitalized COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

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Health outcomes and economic burden of hospitalized COVID-19 patients in the United States

Fusco

Shea

Lin³

et al. 2021

Journal of Medical Economics

168

158

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Objective: To evaluate health outcomes and the economic burden of hospitalized COVID-19 patients in the United States. Methods: Hospitalized patients with a primary or secondary discharge diagnosis code for COVID-19 (ICD-10 code U07.1) from April 1-October 31, 2020 were identified in the Premier Healthcare COVID-19 Database. Patient demographics, hospitalization characteristics, and concomitant medical conditions were assessed. Hospital length of stay (LOS), in-hospital mortality, hospital charges, and hospital costs were evaluated overall and stratified by age groups, insurance types, and 4 COVID-19 disease progression states based on intensive care unit (ICU) and invasive mechanical ventilation (IMV) usage. Results: Of the 173,942 hospitalized COVID-19 patients, median age was 63 years, 51.0% were male, and 48.5% were covered by Medicare. The most prevalent concomitant medical conditions were cardiovascular disease (73.5%), hypertension (64.8%), diabetes (40.7%), obesity (27.0%), and chronic kidney disease (24.2%). Approximately one-fifth (21.9%) of the hospitalized COVID-19 patients were admitted to the ICU and 16.9% received IMV; most patients (73.6%) did not require ICU admission or IMV, and 12.4% required both. The median hospital LOS was 5 days, in-hospital mortality was 13.6%, median hospital charges were $43,986, and median hospital costs were $12,046. Hospital LOS and in-hospital mortality increased with ICU and/or IMV usage and age; hospital charges and costs increased with ICU and/or IMV usage. Patients with both ICU and IMV usage had the longest median hospital LOS (15 days), highest inhospital mortality (53.8%), and highest hospital charges ($198,394) and hospital costs ($54,402). Limitations: This retrospective administrative database analysis relied on coding accuracy and a subset of admissions with validated/reconciled hospital costs. Conclusions: This study summarizes the severe health outcomes and substantial hospital costs of hospitalized COVID-19 patients in the US. The findings support the urgent need for rapid implementation of effective interventions, including safe and efficacious vaccines.

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Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission — United States, March–August 2020

Cited by 182 publications

References 9 publications

Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area

Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area

Impact of isolating COVID-19 patients in a supervised community facility on transmission reduction among household members

Health outcomes and economic burden of hospitalized COVID-19 patients in the United States

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