03 Sep Why Do Some COVID-19 Patients Return to the Hospital After Discharge?

MedicalResearch.com Interview with:

Dr. Glicksberg

Benjamin Glicksberg, PhD
Assistant Professor of Genetics and Genomic Sciences
Member of the Mount Sinai COVID Informatics Center
Member of the Hasso Plattner Institute for Digital Healt
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study?

Response: Reports from health systems that detailed the clinical characteristics and outcomes of their COVID-19 patients were instrumental in helping other health systems rapidly adapt and know what to expect. There are few studies, however, that assess what happens to these patients after they were discharged from the hospital.

In our work, we address this gap by determining both how many individuals re-present to the hospital within 14 days, and what clinical characteristics of these patients differ from those who do not. Such information is critical in order to continue to refine optimal treatment plans and discharge decisions for patients of all backgrounds and clinical profiles. To provide more context to the question, we also determined if and how these factors changed between initial presentation and readmission to the hospital.

MedicalResearch.com: What are the main findings?

 Response: We found that around 4% of COVID-19 patients that were discharged after a hospitalization returned for emergency care after a median of 4.5 days, with around half of them required a readmission. We identified that the most common reason for the return to the hospital was respiratory distress, which was seen in 50% of these patients. We also found that patients that returned had higher rates of certain co-morbid conditions, specifically hypertension and chronic obstructive pulmonary disease (COPD). Fortunately, the hospital visits for the readmission of these patients were often shorter and had less frequent requirements for intensive care. 

MedicalResearch.com: What else should readers take away from your report?

Response: While the prevalence of those with COVID-19 re-presenting to the hospital after initial discharge is low, it is not negligible. These findings continue to reveal the complexity and nuance that is required in treating COVID-19 patients and hints that there is much more for us to learn. Reports such as these from other health systems around the world will be necessary to continue to refine how health systems treat their patients within the hospital and how to prepare for safe and efficient discharge that keep them from coming back. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: While patients within the Mount Sinai Health System are diverse, this report reflects only a single health system in one geographical area.  It is necessary to determine whether the patterns found in our study hold true in other systems around the world. Furthermore, in order to see direct impact from this work, there would need to be careful study of how discharge strategies and timing can be effectively tailored for the individuals with these risk factors and whether this adaptation truly helps in the long-term.

No conflicts of interest to disclose. 

Citation:

Somani SS, Richter F, Fuster V, et al. Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19 [published online ahead of print, 2020 Aug 19]. J Gen Intern Med. 2020;1-7. doi:10.1007/s11606-020-06120-6

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Last Updated on September 4, 2020 by Marie Benz MD FAAD