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Hospital Readmissions of Discharged Patients with COVID-19

Authors Parra LM, Cantero M, Morrás I, Vallejo A, Diego I, Jiménez-Tejero E, Múñez E, Asensio, Fermández-Cruz A, Ramos-Martinez A

Received 11 August 2020

Accepted for publication 2 October 2020

Published 2 December 2020 Volume 2020:13 Pages 1359—1366


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Lina Marcela Parra,1 Mireia Cantero,1 Ignacio Morrás,2 Alberto Vallejo,1 Itziar Diego,2 Elena Jiménez-Tejero,1 Elena Múñez,3 Ángel Asensio,1 Ana Fermández-Cruz,3,4 Antonio Ramos-Martinez3,4 On behalf of Puerta de Hierro Hospital Admission Study Group

1Servicio de Medicina Preventiva, HU Puerta de Hierro-Majadahonda, Madrid, Spain; 2Servicio de Medicina Interna, HU Puerta de Hierro-Majadahonda, Madrid, Spain; 3Servicio de Medicina Interna, HU Puerta de Hierro-Majadahonda, Unidad de Enfermedades Infecciosas, UAM, Madrid, Spain; 4Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHSA), Madrid, Spain

Correspondence: Antonio Ramos-Martinez
Servicio de Medicina Interna, HU Puerta de Hierro-Majadahonda, Unidad de Enfermedades Infecciosas, Calle Joaquín Rodrigo 2, Majadahonda, Madrid 28222, Spain
Tel +34 638 211 120
Fax +34 91191 6807
Email [email protected]

Objective: To analyse the rate of occurrence and the clinical variables associated with readmission of patients who had previously been discharged after admission for COVID-19.
Setting: University hospital in Madrid (Spain).
Participants: Sixty-one patients (74% male) who presented COVID-19 were readmitted during the 3 weeks after discharge from hospital.
Interventions: Nested case–control study paired (1:1 ratio) by age, sex and period of admission.
Outcome Measures: Rate of readmission rate of patients discharged after suffering COVID-19 and identification of the clinical variables associated with it.
Results: Out of 1368 patients who were discharged during the study period, 61 patients (4.4%) were readmitted. Immunocompromised patients (N=10.2%) were at increased risk for readmission (p=0.04). There was also a trend towards a higher probability of readmission in hypertensive patients (p=0.07). Cases had had a shorter hospital stay and a higher prevalence of fever during the 48 hours prior to discharge. There were no significant differences in oxygen levels measured at admission and discharge by pulse oximetry intra-subject or between the groups. Neutrophil-to-lymphocyte ratio at hospital admission tended to be higher in cases than in controls (p=0.06). Neither glucocorticoids nor anticoagulants prescribed at hospital discharge were associated with a lower readmission rate. Patients who were readmitted due to a thrombotic event (8 patients, 13.1%) presented a higher level of D-dimer at discharge of initial admission.
Conclusion: The rate of readmission after discharge from hospital for COVID-19 was low. Immunocompromised patients and those presenting with fever during the 48 hours prior to discharge were at greater risk of readmission to hospital.

Keywords: coronavirus, pneumonia, viral, patient readmission, pulmonary embolism, heparin

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