Eleven percent of Canadian patients who were discharged after hospitalization for COVID-19 were readmitted to the hospital or died within 30 days of discharge, according to a study today in CMAJ (Canadian Medical Association Journal).
The retrospective cohort study was based on the medical records of all adults hospitalized in Alberta and Ontario for SARS-CoV-2 from Jan 1, 2020, to Sep 30, 2021. A total of 46,412 (5.5%) adults had a positive COVID-19 test 14 days prior or during their hospital admission. Of these, 8,496 died in hospital and 34,846 were discharged alive.
Of those discharged, 30,336 had a typical hospital stay — 30 days or less. A total of 4,510 had a stay greater than 30 days, and 14% required intensive care unit admission. The median length of hospital stay was 8 days.
"One in 9 discharged patients died or were readmitted within 30 days after discharge," the authors said, including 10.5% of those with a typical hospital stay, and 12.8% of those with a stay of more than 30 days.
Patients who were readmitted or died were more likely to be older, male, discharged to a long-term care facility, and have a medical history of multiple hospitalizations. Non-specific pneumonia was the most often cited reason for readmission (37.6%), followed by non-specified pneumonia or interstitial pulmonary disease (6.0%), heart failure (4.1%), pulmonary embolism (3.1%) and confusion (3.0%).
Of all patients admitted with COVID-19 in both provinces, 91% in Alberta and 95% in Ontario were unvaccinated.
"Identifying risk factors for early readmission or death is important for both the in-hospital clinical team and the primary care physician who reassumes care after discharge, as well as for transition coordinators deciding which patients may benefit from additional resources at discharge to optimize outcomes," said University of Alberta researcher Finlay McAlister, PhD, a coauthor of the study, in a press release.
Readmission rates similar to other illnesses
The study authors said the readmission rates for COVID-19 were similar to other respiratory tract illnesses which require hospitalization, suggesting the system for discharge in Alberta and Ontario hospitals did not need to be adjusted.
Length of hospital stay and in-hospital death rates were higher for COVID-19 patients, however.
One significant complication not included in the study was long COVID, the authors said, which typically does not require readmission to a hospital but may be a costly outcome for hospitalized patients.
"Future research should determine other system effects for COVID-19 survivors, particularly with respect to postacute COVID-19 symptomatology," the authors concluded.