COVID patients have increased rates of multi-organ dysfunction after discharge from hospital, and nearly a third are readmitted within four months, according to a new study published in the BMJ. But another new study has linked discharge with supplemental oxygen to fewer readmissions in those with COVID-19 pneumonia.
In a survey of 47,000 discharged COVID-19 patients, 29% were readmitted and more than 10% died during an average 140-day follow-up. These rates were four times higher for readmissions and eight times higher for deaths than those of a matched acute care control group. The patients also had significantly higher rates of respiratory disease, diabetes and cardiovascular disease than the control group. Rates were higher for people under the age of 70 and in ethnic minority groups compared to the white population.
The results are evidence of post-COVID-19 syndrome, wrote corresponding author Amitava Banerjee, MD, Ph.D., of the Royal London Hospital in London.
“Diagnosis, treatment and prevention of post-COVID syndrome requires integrated rather than organ or disease specific approaches, and urgent research is needed to establish risk factors,” he and his colleagues said.
The oxygen supply makes the difference
A study in Los Angeles area hospitals, meanwhile, found that patients with COVID-19 pneumonia, 30-day readmission and mortality rates are low with supplemental oxygen discharge.
Study participants received at least 3 L / min of oxygen and were discharged with home oxygen equipment, educational resources, and telephone nursing follow-up within 12 to 18 hours of discharge. Among 621 participants, the all-cause mortality rate was 1.3% and the 30-day readmission rate was 8.5%. In the outpatient setting, no deaths occurred, reported Josh Banerjee, MD, MPH, of Los Angeles County and University of Southern California Medical Center.
“This expected practice can be seen as part of a strategy to ensure the right care, the right place and the right time for patients with COVID-19 pneumonia, and to preserve access to acute care during the pandemic. », Concluded the authors.
The supplemental oxygen study was published in JAMA network open.