Ethnic, clinical, and pharmacological predictors of high social dependence in COVID-19 patients admitted to post-acute care

Author:

Fiorini Gianfrancesco1,Pellegrini Giacomo23,Franchi Matteo23,Perrone Chiara1,Rigamonti Antonello E4,Corrao Giovanni23,Cella Silvano G4

Affiliation:

1. Istituti Clinici Zucchi, Monza, Italy

2. National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy

3. Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano Bicocca, Milan, Italy

4. Laboratory of Clinical Pharmacology and Pharmacoepidemiology, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

Abstract

The COVID-19 epidemic affected both acute hospitals and post-acute care, which experienced various degrees of overcrowding. We evaluated all the patients admitted to a post-acute care facility during the second wave of the epidemic to detect features possibly associated with social frailty. We analyzed the socio-demographic characteristics and comorbidities of the patients and the pattern of their previous hospitalization as available in their discharge letter. In addition, we evaluated their clinical features and tests on admission to post-acute care. We found that COVID-19 patients without social problems had distinctive features. Those with a higher need for specific pharmacological treatments during their stay in an acute hospital were less likely to be admitted to post-acute care for concomitant social problems ( p < 0.05 for all types of medication). They were also more likely to be native (p = 0.02), obese (p = 0.009), and with hypertension (p = 0.03). Patients with social problems usually stayed longer and were less frequently discharged home with a negative swab (p = 0.0009). In COVID-19 patients, recognition of distinctive features predicting that their need for a longer hospital stay is due to social problems can lead to more appropriate discharge and to more appropriate use of post-acute care.

Publisher

SAGE Publications

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