Factors Associated With Readmission in the United States Following Hospitalization With Coronavirus Disease 2019

Verna, Elizabeth C.; Landis, Charles; Brown, Robert S.; Mospan, Andrea R.; Crawford, Julie M.; Hildebrand, Janet S.; Morris, Heather; Muñoz, Breda; Fried, Michael; Reddy, K. Rajender

doi:10.1093/cid/ciab464

Cited by 27 publications

(49 citation statements)

References 22 publications

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“…The COVID-19 pandemic brought new challenges to the general population and even more so to patients with end-stage renal disease (ESRD), many of whom have comorbidities now acknowledged as risk factors for severe COVID-19 [ 5 ]. Aside from the logistic challenges summarized elsewhere [ 6 ], these patients, both dialysis-treated and kidney transplant patients, face morbidity and mortality risks that are significantly higher than the general population [ 7 , 8 ]. Unfortunately, it is known from existing vaccine preparations such as anti-hepatitis B virus and influenza [ 9 – 12 ], that both dialysis and kidney transplant patients require higher doses and repeat inoculations (i.e.…”

Section: Introductionmentioning

confidence: 99%

Impact of tozinameran (BNT162b2) mRNA vaccine on kidney transplant and chronic dialysis patients: 3–5 months follow-up

et al. 2022

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Background Determining the humoral immunogenicity of tozinameran (BNT162b2) in patients requiring chronic renal replacement therapy, and its impact on COVID-19 morbidity several months after vaccination, may guide risk assessment and changes in vaccination policy. Methods In a prospective post-vaccination cohort study with up to 5 months follow-up we studied outpatient dialysis and kidney transplant patients and respective healthcare teams. Outcomes were anti S1/S2 antibody responses to vaccine or infection, and infection rate during follow-up. Results One hundred seventy-five dialysis patients (40% women, 65 ± 15 years), 252 kidney transplant patients (33% women, 54 ± 14 years) and 71 controls (65% women, 44 ± 14 years) were followed. Three months or longer after vaccination we detected anti S1/S2 IgG antibodies in 79% of dialysis patients, 42% of transplant recipients and 100% of controls, whereas respective rates after infection were 94%, 69% and 100%. Predictors of non-response were older age, diabetes, history of cancer, lower lymphocyte count and lower vitamin-D levels. Factors associated with lower antibody levels in dialysis patients were modality (hemodialysis vs peritoneal) and high serum ferritin levels. In transplant patients, hypertension and higher calcineurin or mTOR inhibitor drug levels were linked with lower antibody response. Vaccination was associated with fewer subsequent infections (HR 0.23, p < 0.05). Moreover, higher antibody levels (particularly above 59 AU/ml) were associated with fewer events, with a HR 0.41 for each unit increased in log 10 titer (p < 0.05). Conclusions Dialysis patients, and more strikingly kidney transplant recipients, mounted reduced antibody response to COVID-19 mRNA vaccination. Lesser humoral response was associated with more infections. Measures to identify and protect non-responsive patients are required. Graphic abstract Supplementary Information The online version contains supplementary material available at 10.1007/s40620-021-01210-y.

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Section: Introductionmentioning

confidence: 99%

Impact of tozinameran (BNT162b2) mRNA vaccine on kidney transplant and chronic dialysis patients: 3–5 months follow-up

et al. 2022

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“…A study with more than 29,000 patients who had confirmed COVID-19 reported the length of hospitalization time as 8 days 13 . A Korean study reported the length of hospitalization due to COVID-19 as 17 days 14 .…”

Section: Discussionmentioning

confidence: 99%

Readmission rates of patients with COVID-19 after hospital discharge

Alanlı

Küçükay

Yalcin

2021

Rev. Assoc. Med. Bras.

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OBJECTIVE:The purpose of this study was to inspect return and readmission reasons and rates of discharged patients with coronavirus disease 2019 .METHODS: This is an observational descriptive retrospective study that was conducted with patients who had confirmed COVID-19 diagnosed with severe respiratory syndrome coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR) and hospitalized between April 2020 and June 2021 in a tertiary care university hospital. Patients returning to the hospital after treatment for COVID-19, with symptoms related to COVID-19 within 30 days, were included. Patients under 18 years of age and who were hospitalized in the intensive care unit were excluded. RESULTS:It was determined that of 369 discharged patients, 87 (23.5%) returned to the hospital, 9 (2.4%) were readmitted, and 1 (0.02%) was deceased within 30 days. The most frequent reasons for returning to the hospital were dyspnea and cough complaints.Existence of pneumonia at first admission, levels of aspartate aminotransferase, lactate dehydrogenase, C-reactive protein, d-dimer, neutrophil counts, lymphocyte counts, and neutrophil-to-lymphocyte count ratios were found to be higher in patients who returned to hospital, compared with the patients who did not return.CONCLUSIONS: Return rate of patients to hospital after discharge with COVID-19 was comparatively high, but readmissions to hospital and mortality rate were low. Comparatively, the higher rate of return to hospital within 30 days of discharge was thought to be resulting from prolonged signs and symptoms related to COVID-19. Since COVID-19 is a new and enigmatic disease and its long-term effects still need to be elucidated, long-term follow-ups of discharged patients will be adequate.

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“…The COVID-19 pandemic brought new challenges to the general population and even more so to patients with end-stage renal disease (ESRD), many of whom have comorbidities now acknowledged as risk factors for severe COVID-19. Aside from logistic challenges summarized elsewhere 3 , these patients, both dialysis-treated and kidney transplant patients, face morbidly and mortality risks that are significantly higher than the general population 4, 5 . Unfortunately, it is known from existing vaccine preparations such as anti-hepatitis B virus and the influenza 6-9 , that both dialysis and kidney transplant patients require higher doses and repeat inoculations (i.e.…”

Section: Introductionmentioning

confidence: 99%

Impact of tozinameran (BNT162b2) mRNA vaccine on kidney transplant and chronic dialysis patients: 3-5 months followup

Ben‐Dov

Oster

Tzukert

et al. 2021

Preprint

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Background: Determining the humoral immunogenicity of tozinameran (BNT162b2) vaccine in patients requiring chronic renal replacement therapy, and its impact on COVID-19 morbidity several months after vaccination, will guide risk assessment and subsequent changes in vaccination policy. Methods: In a prospective post-vaccination cohort study with up to 5 months follow-up we studied outpatient dialysis and kidney transplant patients and respective healthcare teams. Outcomes were anti S1/S2 antibody response to vaccine or infection and infection rate during followup. Results: 175 dialysis patients (40% women, 65+/-15 years), 252 kidney transplant patients (33% women, 54+/-14 years) and 71 controls (65% women, 44+/-14 years) were followed. Three months or longer after vaccination we detected anti S1/S2 IgG antibodies in 80% of dialysis patients, 44% of transplant recipients and 100% of controls, whereas respective rates after infection were 94%, 75% and 100%. Predictors of non-response were age, diabetes, history of cancer, lower lymphocyte count and lower vitamin-D levels. Factors associated with lower titers in dialysis patients were modality (hemodialysis vs peritoneal) and serum ferritin levels. In transplant patients, hypertension and higher calcineurin or mTOR inhibitor drug levels were linked with diminished antibody response. Vaccination associated with fewer subsequent infections (HR=0.23, p<0.05). Moreover, higher antibody titers associated with fewer events, HR 0.41 for each unit increased in log10titer (p<0.05). Conclusions: Dialysis patients, and more so kidney transplant recipients, mounted delayed and reduced antibody response to COVID-19 mRNA vaccination, and lesser humoral response associated with more infections. Measures to identify and protect non-responsive patients are urgently required.

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Factors Associated With Readmission in the United States Following Hospitalization With Coronavirus Disease 2019

Cited by 27 publications

References 22 publications

Impact of tozinameran (BNT162b2) mRNA vaccine on kidney transplant and chronic dialysis patients: 3–5 months follow-up

Impact of tozinameran (BNT162b2) mRNA vaccine on kidney transplant and chronic dialysis patients: 3–5 months follow-up

Readmission rates of patients with COVID-19 after hospital discharge

Impact of tozinameran (BNT162b2) mRNA vaccine on kidney transplant and chronic dialysis patients: 3-5 months followup

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