Characteristics of patients discharged and readmitted after COVID-19 hospitalisation within a large integrated health system in the United States

Infect Dis (Lond). 2021 Oct;53(10):800-804. doi: 10.1080/23744235.2021.1924398. Epub 2021 May 8.

Abstract

Background: Limited studies have explored post-discharge outcomes following Coronavirus Disease 2019 (COVID-19) hospitalisation. We sought to characterise patients discharged following a COVID-19 hospitalisation within a large integrated health system in the United States.

Methods: We performed a retrospective study of 2180 COVID-19 patients discharged between 1 April 2020 and 31 July 2020. The primary endpoint was all-cause observation stay or inpatient readmission within 30 days from discharge. Bivariate and multivariable logistic regression analyses were performed to estimate the association between key socio-demographic and clinical characteristics with risk of 30-day readmission.

Results: The 30-day readmission rate was 7.6% (n = 166); 30-day mortality rate was 1% (n = 19). Most readmissions were respiratory-related (58%) and occurred at a median time of 5 days post discharge. Adjusted models showed that prior hospitalisations (Odds Ratio = 2.36, [95% Confidence Interval: 1.59-3.50]), chronic pulmonary disease (1.57 [1.09-2.28]), and discharge to home health (1.46 [1.01-2.11]) were significantly associated with 30-day readmission. Longer duration from diagnosis to index admission was borderline associated with lower odds of readmission (0.95 [0.91-1.00]).

Conclusion: Readmission and mortality rates for COVID-19 following discharge are low. Most readmissions occur early and are due to respiratory causes and may reflect the prolonged acute disease course.

Keywords: COVID-19; hospitalisation; readmissions.

MeSH terms

  • Aftercare
  • COVID-19*
  • Delivery of Health Care, Integrated*
  • Hospitalization
  • Humans
  • Patient Discharge
  • Patient Readmission
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • United States / epidemiology