Mortality and re-admission after hospitalization with COVID-19

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 164
• Main Authors: Leijte, Wouter T, Wagemaker, Nicolaas M M, van Kraaij, Tom D A, de Kruif, Martijn D, Mostard, Guy J M, Leers, Math P G, Mostard, Rémy L M, Buijs, Jacqueline, van Twist, Daan J L
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 19.11.2020
• Subjects: Aged; Cohort Studies; Comorbidity; COVID-19 - mortality; COVID-19 - physiopathology; COVID-19 - therapy; Female; Humans; Male; Mortality; Netherlands - epidemiology; Outcome Assessment, Health Care; Patient Discharge; Patient Readmission - statistics & numerical data; Pulmonary Disease, Chronic Obstructive - epidemiology; Respiratory Insufficiency - etiology; Respiratory Insufficiency - mortality; Respiratory Insufficiency - therapy; Risk Factors; SARS-CoV-2 - isolation & purification; Venous Thrombosis - etiology; Venous Thrombosis - mortality; Venous Thrombosis - therapy; Netherlands
• ISSN: 0028-2162; 1876-8784

Hospitalization for corona virus disease 2019 (COVID-19) may be followed by complications after discharge. We aimed to evaluate mortality, readmission rate, and readmission characteristics after hospitalization with COVID-19. A retrospective cohort study METHODS: Inclusion of all patients hospitalized for COVID-19 between March 1, 2020, and June 1, 2020 in Zuyderland Medical Centre, The Netherlands. Main outcome measures were mortality and readmission after hospitalization. Univariate and multivariate regression analysis were performed to identify risk factors for death and readmission. A total of 769 patients hospitalized with COVID-19 (mean age 70 ± 14 years; 39% female) were included in the study. In-hospital mortality was 22.4% , as such 596 patients were discharged alive and followed after discharge with a median of 80 days (IQR 66-91). Total mortality after discharge was 6.4% (n=38) and readmission rate was 11.7% (n=70). Main reasons for readmission were respiratory insufficiency (31%), arterial and venous thrombotic events (16%) or related to a chronic comorbidity (14%). Mortality rates were higher in older patients and patients who experienced delirium during hospital stay. Risk factors for readmission were male sex, discharge to a long-term care facility and COPD. 1 out of 6 COVID-19 positive patients died or was readmitted after discharge. This shows an ongoing vulnerability of COVID-19 patients. Physicians and policy makers should consider this high rate when making decisions on discharge, hospital-capacity planning, and patient monitoring after discharge.