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Readmissions, Postdischarge Mortality, and Sustained Recovery Among Patients Admitted to Hospital With Coronavirus Disease 2019 (COVID-19)

Moestrup, Kasper S
Reekie, Joanne
Zucco, Adrian G
Jensen, Tomas Ø
Jensen, Jens Ulrik S
Wiese, Lothar
Ostrowski, Sisse R
Niemann, Carsten U
MacPherson, Cameron
Lundgren, Jens
Helleberg, Marie
Table of Contents

Abstract
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Many interventional in-patient coronavirus disease 2019 (COVID-19) trials assess primary outcomes through day 28 post-randomization. Since a proportion of patients experience protracted disease or relapse, such follow-up period may not fully capture the course of the disease, even when randomization occurs a few days after hospitalization.Among adults hospitalized with COVID-19 in eastern Denmark from 18 March 2020–12 January 2021 we assessed all-cause mortality, recovery, and sustained recovery 90 days after admission, and readmission and all-cause mortality 90 days after discharge. Recovery was defined as hospital discharge and sustained recovery as recovery and alive without readmissions for 14 consecutive days.Among 3386 patients included in the study, 2796 (82.6%) reached recovery and 2600 (77.0%) achieved sustained recovery. Of those discharged from hospital, 556 (19.9%) were readmitted and 289 (10.3%) died. Overall, the median time to recovery was 6 days (interquartile range [IQR]: 3–10), and 19 days (IQR: 11–33) among patients in intensive care in the first 2 days of admission.Postdischarge readmission and mortality rates were substantial. Therefore, sustained recovery should be favored to recovery outcomes in clinical COVID-19 trials. A 28-day follow-up period may be too short for the critically ill.

To cite this publication, please use the following BibTeX entry:

@article{moestrupReadmissionsPostdischargeMortality2022,
  abstract = {Many interventional in-patient coronavirus disease 2019 (COVID-19) trials assess primary outcomes through day 28 post-randomization. Since a proportion of patients experience protracted disease or relapse, such follow-up period may not fully capture the course of the disease, even when randomization occurs a few days after hospitalization.Among adults hospitalized with COVID-19 in eastern Denmark from 18 March 2020--12 January 2021 we assessed all-cause mortality, recovery, and sustained recovery 90 days after admission, and readmission and all-cause mortality 90 days after discharge. Recovery was defined as hospital discharge and sustained recovery as recovery and alive without readmissions for 14 consecutive days.Among 3386 patients included in the study, 2796 (82.6%) reached recovery and 2600 (77.0%) achieved sustained recovery. Of those discharged from hospital, 556 (19.9%) were readmitted and 289 (10.3%) died. Overall, the median time to recovery was 6 days (interquartile range [IQR]: 3--10), and 19 days (IQR: 11--33) among patients in intensive care in the first 2 days of admission.Postdischarge readmission and mortality rates were substantial. Therefore, sustained recovery should be favored to recovery outcomes in clinical COVID-19 trials. A 28-day follow-up period may be too short for the critically ill.},
  author = {Moestrup, Kasper S and Reekie, Joanne and Zucco, Adrian G and Jensen, Tomas Ø and Jensen, Jens Ulrik S and Wiese, Lothar and Ostrowski, Sisse R and Niemann, Carsten U and MacPherson, Cameron and Lundgren, Jens and Helleberg, Marie},
  doi = {10.1093/cid/ciac639},
  issn = {1058-4838},
  journal = {Clinical Infectious Diseases},
  month = {August},
  pages = {ciac639},
  title = {Readmissions, Postdischarge Mortality, and Sustained Recovery Among Patients Admitted to Hospital With Coronavirus Disease 2019 (COVID-19)},
  urldate = {2022-09-04},
  year = {2022}
}