TY - JOUR
T1 - Hospital readmissions and emergency department re-presentation of COVID-19 patients
T2 - a systematic review
AU - Peiris, Sasha
AU - Nates, Joseph L.
AU - Toledo, Joao
AU - Ho, Yeh Li
AU - Sosa, Ojino
AU - Stanford, Victoria
AU - Aldighieri, Sylvain
AU - Reveiz, Ludovic
N1 - Funding Information:
Acknowledgments. We would like to thank Dr. Ariel Izcovich for his advice on the presentation of results when drafting the manuscript and Dr. Gisela Alarcón for her comments and suggestions on the results and discussion sections. Editorial support was provided by Bryan Tutt, Scientific Editor, Research Medical Library, MD Anderson Cancer Center.
Publisher Copyright:
© 2022 Pan American Health Organization. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Objective. To characterize the frequency, causes, and predictors of readmissions of COVID-19 patients after discharge from heath facilities or emergency departments, interventions used to reduce readmissions, and outcomes of COVID-19 patients discharged from such settings. Methods. We performed a systematic review for case series and observational studies published between January 2020 and April 2021 in PubMed, Embase, LILACS, and MedRxiv, reporting the frequency, causes, or risk factors for readmission of COVID-19 survivors/patients. We conducted a narrative synthesis and assessed the methodological quality using the JBI critical appraisal checklist. Results. We identified 44 studies including data from 10 countries. The overall 30-day median readmission rate was 7.1%. Readmissions varied with the length of follow-up, occurring <10.5%, <14.5%, <21.5%, and <30%, respectively, for 10, 30, 60, and 253 days following discharge. Among those followed up for 30 and 60 days, the median time from discharge to readmission was 3 days and 8–11 days, respectively. The significant risk factor associated with readmission was having shorter length of stay, and the important causes included respiratory or thromboembolic events and chronic illnesses. Emergency department re-presentation was >20% in four studies. Risk factors associated with mortality were male gender, advanced age, and comorbidities. Conclusions. Readmission of COVID-19 survivors is frequent, and post-discharge mortality is significant in specific populations. There is an urgent need to further examine underlying reasons for early readmission and to prevent additional readmissions and adverse outcomes in COVID-19 survivors.
AB - Objective. To characterize the frequency, causes, and predictors of readmissions of COVID-19 patients after discharge from heath facilities or emergency departments, interventions used to reduce readmissions, and outcomes of COVID-19 patients discharged from such settings. Methods. We performed a systematic review for case series and observational studies published between January 2020 and April 2021 in PubMed, Embase, LILACS, and MedRxiv, reporting the frequency, causes, or risk factors for readmission of COVID-19 survivors/patients. We conducted a narrative synthesis and assessed the methodological quality using the JBI critical appraisal checklist. Results. We identified 44 studies including data from 10 countries. The overall 30-day median readmission rate was 7.1%. Readmissions varied with the length of follow-up, occurring <10.5%, <14.5%, <21.5%, and <30%, respectively, for 10, 30, 60, and 253 days following discharge. Among those followed up for 30 and 60 days, the median time from discharge to readmission was 3 days and 8–11 days, respectively. The significant risk factor associated with readmission was having shorter length of stay, and the important causes included respiratory or thromboembolic events and chronic illnesses. Emergency department re-presentation was >20% in four studies. Risk factors associated with mortality were male gender, advanced age, and comorbidities. Conclusions. Readmission of COVID-19 survivors is frequent, and post-discharge mortality is significant in specific populations. There is an urgent need to further examine underlying reasons for early readmission and to prevent additional readmissions and adverse outcomes in COVID-19 survivors.
KW - COVID-19
KW - emergency service, hospital
KW - mortality
KW - patient readmission
KW - SARS-CoV-2
KW - systematic review
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U2 - 10.26633/RPSP.2022.142
DO - 10.26633/RPSP.2022.142
M3 - Review article
C2 - 36245904
AN - SCOPUS:85144294290
SN - 1020-4989
VL - 46
JO - Revista Panamericana de Salud Publica/Pan American Journal of Public Health
JF - Revista Panamericana de Salud Publica/Pan American Journal of Public Health
M1 - e142
ER -