Thirty-Day Post-Discharge Outcomes Following COVID-19 Infection |
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| Authors: | Justin R. Kingery Paul BF Martin Ben R. Baer Laura C. Pinheiro Mangala Rajan Adrienne Clermont Sabrina Pan Khoi Nguyen Khalid Fahoum Graham T. Wehmeyer Mark N. Alshak Han A. Li Justin J. Choi Martin F. Shapiro Margaret L. McNairy Monika M. Safford Parag Goyal |
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| Affiliation: | 1.Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY 10065 USA ;2.Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY USA ;3.Department of Statistics and Data Science, Cornell University, Ithaca, NY USA ;4.School of Medicine, Weill Cornell Medicine, New York, NY USA ;5.Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York, NY USA |
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| Abstract: | BackgroundThe clinical course of COVID-19 includes multiple disease phases. Data describing post-hospital discharge outcomes may provide insight into disease course. Studies describing post-hospitalization outcomes of adults following COVID-19 infection are limited to electronic medical record review, which may underestimate the incidence of outcomes.ObjectiveTo determine 30-day post-hospitalization outcomes following COVID-19 infection.DesignRetrospective cohort studySettingQuaternary referral hospital and community hospital in New York City.ParticipantsCOVID-19 infected patients discharged alive from the emergency department (ED) or hospital between March 3 and May 15, 2020.MeasurementOutcomes included return to an ED, re-hospitalization, and mortality within 30 days of hospital discharge.ResultsThirty-day follow-up data were successfully collected on 94.6% of eligible patients. Among 1344 patients, 16.5% returned to an ED, 9.8% were re-hospitalized, and 2.4% died. Among patients who returned to the ED, 50.0% (108/216) went to a different hospital from the hospital of the index presentation, and 61.1% (132/216) of those who returned were re-hospitalized. In Cox models adjusted for variables selected using the lasso method, age (HR 1.01 per year [95% CI 1.00–1.02]), diabetes (1.54 [1.06–2.23]), and the need for inpatient dialysis (3.78 [2.23–6.43]) during the index presentation were independently associated with a higher re-hospitalization rate. Older age (HR 1.08 [1.05–1.11]) and Asian race (2.89 [1.27–6.61]) were significantly associated with mortality.ConclusionsAmong patients discharged alive following their index presentation for COVID-19, risk for returning to a hospital within 30 days of discharge was substantial. These patients merit close post-discharge follow-up to optimize outcomes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-06924-0.KEY WORDS: COVID-19, mortality, re-admission, discharge |
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