After COVID-19 treatment: The risk of readmission and death is highest in the first ten days after discharge from the hospital, the study said

Even as that COVID-19 The pandemic continues to rage, with death rates from this disease falling in many parts of the world. And yet many patients recovering COVID-19 tend to have some complications even if they had a mild illness.

The concept of long COVID is rapidly gaining popularity as patients not only tend to have prolonged or persistent symptoms even after receiving two consecutive negative symptoms COVID-19 Test results, but also because re-hospitalizations and deaths from complications after COVID continue to occur.

A new study published in JAMA suggests that the highest risk for a COVID-19 The patient’s health is likely to be within 10 days of discharge from hospital. Therefore, proper care and monitoring of the patient’s health at this early stage of recovery is very important.

Peak of morbidity and mortality risks after COVID

The study was conducted by researchers from the University of Michigan and the Veteran Affairs Ann Arbor Healthcare Systems. Finding that there was limited data on initial outcomes after hospitalization, the researchers set out to measure patient readmission rates, reasons for readmission, and post-hospital death rates COVID-19 .

To do this, they used a two-pronged approach:

First, they collected data about the hospitalization of veterans COVID-19 of 132 VA hospitals. Patients admitted between March and June 2020 and discharged between March and July 2020 were included in this study.

Second, they identified veterans hospitalized for non-COVID-related pneumonia and heart failure during the same duration. Researchers focused on data on length of hospital stay, intensive care unit (ICU) use, reliance on invasive mechanical ventilation, and need for vasopressors (drugs used to treat very low blood pressure).

They then measured the risk of readmission and death up to 60 days after discharge COVID-19 Survivors and also calculated readmission risk rates for 10, 20, 20-40 and 40-60 days after discharge.

Common reasons for readmission and death

The researchers collected data on 2,179 hospitalizations for veterans COVID-19 Of those 678 patients treated in the intensive care unit, 279 were required to have access to mechanical ventilators, 307 were given vasopressors and 1,775 survived the disease to be discharged permanently. Among these survivors, 354 (19.9 percent) were readmitted, 162 (9.1 percent) died, and 479 (27 percent) were readmitted or died within 60 days of their release.

The most common reasons for readmission and death of survivors were COVID-19 Reinfection, sepsis, pneumonia and heart failure. During readmission, 22.6 percent of these patients had to be treated in intensive care units, 7.1 percent received mechanical ventilation and 7.9 percent received vasopressors.

In the other cohort of veterans with non-COVID hospitalizations, 2,156 patients had pneumonia and 4,269 heart failure, of which 97.8 percent and 98.3 percent respectively survived and were discharged after treatment. After excluding deceased patients, the health outcomes of 1,799 patients with pneumonia and 3,505 patients with heart failure were compared with those of the survivors COVID-19 and were released.

When comparing these two cohorts of surviving patients, the researchers found that COVID-19 Survivors had a lower rate of 60-day readmission or death compared to patients with pneumonia or heart failure. However, COVID-19 Survivors had the highest readmission and / or death rates compared to the same patients within the first 10 days after discharge.

Urgent need for critical care for the first 10 days after discharge

Although the forecast for COVID-19 Survivors after a 60 day discharge do not appear to be as bad for admission compared to patients with other potentially fatal causes. Findings on readmission or death rates in the first 10 days suggest an increased risk of clinical deterioration over the period.

The researchers therefore conclude that although their study has some limitations (both cohorts were predominantly male and old, and therefore at greater risk for serious consequences), public health monitoring and clinical care for the 10 day period after of discharge for everyone COVID-19 Patient is crucial.

If health systems and clinical trials for drugs, vaccines, etc., focus only on hospital mortality and do not consider this critical post-hospital time, they may underestimate the burden of COVID-19 and biased results to the detriment of the entire world population battling the pandemic.

For more information, see our post-COVID care article.

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