COVID patients have increased rates of multi-organ dysfunction after hospital discharge, and almost a third are rehospitalized within four months, according to a new study published in the BMJ. But another new study has linked discharge with supplementary oxygen to fewer readmissions in those who experience COVID-19 pneumonia.
In one investigation involving 47,000 discharged COVID-19 patients, 29% were readmitted, and more than 10% died during a mean follow-up of 140 days. These rates were four times greater for readmittance and eight times greater for death than those in a matched acute-care control group. The patients also had significantly higher rates of respiratory disease, diabetes and cardiovascular disease than did the control group. Rates were greater for people aged fewer than 70 years and in ethnic minority groups compared with the white population.
The results are evidence of a post-COVID-19 syndrome, wrote corresponding author Amitava Banerjee, M.D., Ph.D., of Royal London Hospital in London.
“The diagnosis, treatment, and prevention of post-COVID syndrome requires integrated rather than organ- or disease-specific approaches, and urgent research is needed to establish the risk factors,” he and his colleagues said.
Oxygen support makes a difference
A study in Los Angeles-area hospitals, meanwhile, found that patients with COVID-19 pneumonia, 30-day readmission and mortality rates are low with discharge on supplemental oxygen.
Study participants received at least 3 L/min of oxygen and were discharged with home oxygen equipment, educational resources, and nursing telephone follow-up within 12 to 18 hours of discharge. Among 621 participants, the all-cause mortality rate was 1.3%, and the 30-day readmission rate was 8.5%. In the ambulatory setting, no deaths occurred, reported Josh Banerjee, M.D., M.P.H., of Los Angeles County and University of Southern California Medical Center.
“This expected practice may be considered part of a strategy to ensure right care, right place, and right time for patients with COVID-19 pneumonia, and to preserve acute care access during the pandemic,” the authors concluded.
The supplementary oxygen study was published in JAMA Network Open.