Affiliation:
1. St Petersburg State University
2. St Petersburg State University; St George City Hospital
3. St George City Hospital
4. St George City Hospital; Pavlov First Saint Petersburg State Medical University
Abstract
Introduction. On average, 10% of patients hospitalized due to new coronavirus infection (COVID-19) will be readmitted. To date, the reasons for readmission and the characteristics of these cases are not fully presented.The aim of the study was to analyze readmissions of COVID-19 patients to identify the causes of readmission, clinical features, examination data and treatment outcomes.Materials and methods. The study was performed retrospectively by using electronic records of the medical cases of the St. Petersburg City Hospital of St. George. Inclusion criteria: 1) the presence of two or more hospitalizations during 2020–2021; 2) COVID-19 confirmed by polymerase chain reaction within 14 days before or during the first hospitalization, or the detection of changes in the lungs with a high probability associated with COVID-19 during primary computed tomography. One hundred and two people met the specified criteria.Results. In 85% of cases, the cause of re-admission was symptoms of respiratory infection; in 13% – thrombotic events (pulmonary embolism, acute cerebrovascular accident, deep vein thrombosis of the lower extremities); 12% – severe pain syndrome of various localizations; 11% - infectious and inflammatory processes; 9% – antibiotic-associated diarrhea; 5% – atrial fibrillation and less often other pathologies. Patients with respiratory symptoms had a high degree of respiratory failure, an increase in the volume of affected lung tissue and an increase in the content of various markers of inflammation in the blood when compared with the data of the initial examination. Nine percent of patients died during hospitalization.Conclusions. The leading cause of repeated inpatient treatment of COVID-19 patients were symptoms of reactivation of the infection with a number of indicators of a greater severity of this “second wave” of the disease. Further studies are required to reduce the risk of repeated inpatient treatment.
Reference31 articles.
1. Menni C., Valdes A.M., Polidori L., Antonelli M., Penamakuri S., Nogal A. et al. Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study. Lancet. 2022;399(10335):1618–1624. https://doi.org/10.1016/S0140-6736(22)00327-0.
2. Català M., Coma E., Alonso S., Andrés C., Blanco I., Antón A. et al. Transmissibility, hospitalization, and intensive care admissions due to omicron compared to delta variants of SARS-CoV-2 in Catalonia: A cohort study and ecological analysis. Front Public Health. 2022;(10):961030. https://doi.org/10.3389/fpubh.2022.961030.
3. Akbari A., Fathabadi A., Razmi M., Zarifian A., Amiri M., Ghodsi A., Vafadar Moradi E. Characteristics, risk factors, and outcomes associated with readmission in COVID-19 patients: A systematic review and meta-analysis. Am J Emerg Med. 2022;(52):166–173. https://doi.org/10.1016/j.ajem.2021.12.012.
4. Ramzi Z.S. Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis. Am J Emerg Med. 2022;(51):267–279. https://doi.org/10.1016/j.ajem.2021.10.059.
5. Haji Aghajani M., Miri R., Sistanizad M., Toloui A., Madani Neishaboori A., Pourhoseingholi A., Asadpoordezaki Z. et al. Risk factors of readmission in COVID-19 patients; a Retrospective 6-Month Cohort Study. Arch Acad Emerg Med. 2022;10(1):48. https://doi.org/10.22037/aaem.v10i1.1514.