Image of John P. Donnelly, Ph.D.

A hospital discharge is not an all-clear for recovering COVID-19 patients, a new study finds.

When compared with their peers hospitalized for heart failure and pneumonia, discharged COVID-19 patients had a 40% to 60% higher chance of readmission or death within 10 days, reported lead author John P. Donnelly, Ph.D., and colleagues.

What’s more, in the first two months, 9% of the COVID-19 patients who survived hospitalization died, and almost 20% had a setback that sent them back to the hospital, said Donnelly, of the University of Michigan.

The researchers did find one silver lining for these patients. After 60 days, their overall risk of readmission or death was lower than that for the heart failure and pneumonia patients.

“Unfortunately, this is yet more evidence that COVID-19 is not ‘one-and-done,’” said study co-author Theodore Iwashyna, M.D., Ph.D. “For many patients, COVID-19 seems to set off cascades of problems that are every bit as serious as those we see in other diseases. But too little of our healthcare response … is designed to help these patients as they continue for days, weeks, even months to recover from COVID-19.”

“Now, the question is what to do about it,” added Donnelly. “How can we design better discharge plans for these patients? How can we tailor our communication and post-hospital care to their needs?”

The study followed outcomes in 2,200 veterans who survived hospitalization for COVID-19 at 132 Veterans Administration hospitals in the spring and early summer. Older age was linked to readmission after 60 days, and the most common readmission diagnoses were COVID-19 (30.2%), and sepsis (8.5%), followed by pneumonia and heart failure.

An earlier study of COVID-19 patients discharged from and readmitted to five New York City hospitals found that respiratory complications were these patients’ chief complaint. They also had higher rates of chronic obstructive pulmonary disease and hypertension than their peers who did not return to the hospital, reported Girish Nadkarni, M.D., from the Mount Sinai COVID Informatics Center.

The current study was published in a JAMA Network research letter.