Objectives
This study aimed to characterize the 30-day readmission in hospitalized COVID-19 patients.
Methods
We conducted an observational cohort study including adult hospitalized COVID-19 patients admitted between 07/01/2020 and 01/31/2021 using a large inpatient chargemaster (billing) linked with open administrative healthcare claims database. The first COVID-19 hospitalization in the study period was considered as the index hospitalization. Readmission was assessed within 30 days of discharge.
Results
We identified 111,624 COVID-19 patients admitted to 327 hospitals with 13% (N=14,763) mortality rate during index hospitalization. Among 61,182 patients discharged alive with ≥30-day follow-up, the overall all-cause readmission rate was 16% (N=9,748) and remained stable between 15% and 17% over the study period. 32% (N=19,770) of the discharged patients were treated with remdesivir (RDV) during their index hospitalization, and readmission was lower in RDV-treated patients (13%, N=2,627) compared to those not treated with RDV during their index hospitalization (17%, N=7,121). Among patients who received RDV in their initial hospitalization, those who started therapy upon admission (Day 1 or 2) had lower readmission rates (12%), compared to those who received RDV later in the hospitalization course, 15% (Day 3-5) and 27% (Day >5). The most frequent diagnoses upon readmission were COVID-19 (63%), other viral pneumonia (36%), and acute respiratory failure with hypoxia (34%). Compared to non-readmitted, readmitted patients were older (60 vs 65), had more comorbidities such as COPD (24% vs 37%) and congestive heart failure (28% vs 44%), and longer median LOS (6 vs 7 days) during index hospitalization.
Conclusions
This study of a large and geographically diverse population revealed substantial burden on patients beyond the initial COVID-19 hospitalization, as 16% of the patients were re-admitted within 30-days. Over the study period, lower readmission was observed in patients who were treated with RDV during their index hospitalization.