Intern Med J. 2021 Sep 6. doi: 10.1111/imj.15350. Online ahead of print.
ABSTRACT
OBJECTIVE: To investigate the incidence, characteristics, and outcomes of patients who were readmitted to hospital emergency departments or required re-hospitalization following an index hospitalization with a diagnosis of COVID-19.
DATA SOURCES: A systematic review of PubMed, EMBASE, and pre-print websites was conducted between January 1 and December 31, 2020.
STUDY SELECTION: Studies reporting on the incidence, characteristics, and outcomes of patients with COVID-19 who represent or require hospital admission were included.
DATA EXTRACTION: Two authors independently performed study selection and data extraction. Study quality was assessed with the Newcastle-Ottawa Scale. Discrepancies were resolved by consensus or through an independent third reviewer. Data were synthesized according to the Preferred Reporting Items for Systematic Reviews guidelines.
RESULTS: Six studies reporting on 547 readmitted patients were included. The overall incidence was 4.4%; more commonly in male (57.2%), due to respiratory distress or prolonged COVID-19. Readmitted patients had a shorter initial hospital length of stay (LOS) compared to those with a single hospitalisation (8.1±10.6 vs. 13.9±10.2 days). The mean time to readmission was 7.6±6.0 days; the mean LOS upon re-hospitalisation was 6.3±5.6 days. Hypertension (OR=2.08; 95%-CI 1.69-2.55; p<0.001; I2 =0%), diabetes (OR=1.77; 95%-CI 1.38-2.27; p<0.001; I2 =0%) and renal failure (OR=2.37; 95%-CI 1.09-5.14; p<0.001; I2 =0%) were more common in these patients. Intensive care admission rates were similar between the two groups. 12.8% of readmitted patients (22/172) died.
CONCLUSIONS: Readmitted patients following an index hospitalization for COVID-19 were more commonly male with multiple comorbidities. Shorter initial hospital LOS and unresolved primary illness may have contributed to readmission. This article is protected by copyright. All rights reserved.
PMID:34487424 | DOI:10.1111/imj.15350