Factors associated with readmission to the Emergency Department in a cohort of COVID-19 hospitalized patients
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Romero Duarte, Álvaro; Rivera Izquierdo, Mario; Láinez Ramos-Bossini, Antonio Jesús; Redruello Guerrero, Pablo; Cárdenas Cruz, AntonioEditorial
MRE Press
Materia
COVID-19 Symptoms Emergency Hospitalization Post-discharge
Fecha
2022-01-08Referencia bibliográfica
Álvaro Romero-Duarte... [et al.]. Factors associated with readmission to the Emergency Department in a cohort of COVID-19 hospitalized patients. Signa Vitae. 2022. 18(1);47-54. DOI:[10.22514/sv.2021.106]
Patrocinador
'Artificial Intelligence for the diagnosis and prognosis of COVID-19' project - Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades CV20-29480; Junta de Andalucia European CommissionResumen
Introduction: The aim of this study was to describe the symptomatology and main
factors associated with readmission to the Emergency Department (ED) in COVID-19
patients discharged from hospital during the first wave of the pandemic at the San Cecilio
University Hospital, Granada, Spain.
Methods: An observational longitudinal study was conducted in a cohort of 441 patients
admitted to our hospital with confirmed SARS-CoV-2 polymerase chain reaction (PCR)
from 1 March to 15 April 2020. Patients were followed up through medical records
6 months after discharge. Sociodemographic, clinical and symptomatologic variables
were collected. Descriptive, bivariate and multivariate logistic regression analyses were
performed.
Results: The mean age of patients in the cohort was 66.4 years (s = 15.3), with 55.1%
men. In-hospital mortality was 18.1%. The presence of persistent symptomatology
was high (64.5%), especially respiratory (53.2%), systemic (46.3%) and neurological
(31.0%). A total of 75 (20.8%) patients were readmitted to the ED during the 6 months
following hospital discharge. The main factors associated with readmission to the
ED were polymedication (P = 0.031), living in a care home (P = 0.014), fever (P =
0.047), general malaise (P < 0.001), thoracic pain (P < 0.001), headache (P = 0.012),
hematological symptoms (P = 0.011), nephrological symptoms (P = 0.047), depressive
symptoms (P = 0.009), syncope or hypotension (P = 0.006) and superinfection (P =
0.018). After multivariate adjustment analysis, thoracic pain (OR: 4.45, 95% CI: 1.88–
10.52), general malaise and hematological symptoms (OR: 3.95, 95% CI: 1.12–13.89)
remained as risk factors.
Conclusions: The presence of persistent symptomatology after hospital discharge in our
cohort was common and varied. Polymedication and living in a care home made up the
most vulnerable profile of COVID-19 patients for returning to the ED. Thoracic pain,
general malaise and hematological symptoms were identified as potential markers of
severity, along with others predictors. These findings might be useful for optimizing
follow-up strategies. Future studies conducted in other geographical areas are necessary
to corroborate our results.