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Original Research

Open Access Special Issue

Factors associated with readmission to the Emergency Department in a cohort of COVID-19 hospitalized patients

  • Álvaro Romero-Duarte1
  • Mario Rivera-Izquierdo2,3,4
  • Antonio Jesús Láinez-Ramos-Bossini5,6
  • Pablo Redruello-Guerrero1
  • Antonio Cárdenas-Cruz7,8

1Faculty of Medicine, University of Granada, 18016 Granada, Spain

2Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain

3Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain

4Instituto Biosanitario de Granada (ibs.GRANADA), 37007 España, Spain

5Department of Radiology, Virgen de las Nieves University Hospital, 18016 Granada, Spain

6PhD Programme in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain

7Department of Medicine, University of Granada, 18016 Granada, Spain

8Intensive Care Unit, Hospital de Poniente, El Ejido, 04003 Almería, Spain

DOI: 10.22514/sv.2021.106

Submitted: 12 April 2021 Accepted: 07 May 2021

Online publish date: 16 June 2021

*Corresponding Author(s): Mario Rivera-Izquierdo E-mail: mariorivera@ugr.es

Abstract

Introduction: The aim of this study was to describe the symptomatology and main factors associated with readmission to the Emergency Department (ED) in COVID-19 patients discharged from hospital during the first wave of the pandemic at the San Cecilio University Hospital, Granada, Spain.

Methods: An observational longitudinal study was conducted in a cohort of 441 patients admitted to our hospital with confirmed SARS-CoV-2 polymerase chain reaction (PCR) from 1 March to 15 April 2020. Patients were followed up through medical records 6 months after discharge. Sociodemographic, clinical and symptomatologic variables were collected. Descriptive, bivariate and multivariate logistic regression analyses were performed.

Results: The mean age of patients in the cohort was 66.4 years (s = 15.3), with 55.1%men. In-hospital mortality was 18.1%. The presence of persistent symptomatology was high (64.5%), especially respiratory (53.2%), systemic (46.3%) and neurological (31.0%). A total of 75 (20.8%) patients were readmitted to the ED during the 6 months following hospital discharge. The main factors associated with readmission to the ED were polymedication (P = 0.031), living in a care home (P = 0.014), fever (P = 0.047), general malaise (P < 0.001), thoracic pain (P < 0.001), headache (P = 0.012), hematological symptoms (P = 0.011), nephrological symptoms (P = 0.047), depressive symptoms (P = 0.009), syncope or hypotension (P = 0.006) and superinfection (P = 0.018). After multivariate adjustment analysis, thoracic pain (OR: 4.45, 95% CI: 1.88–10.52), general malaise and hematological symptoms (OR: 3.95, 95% CI: 1.12–13.89) remained as risk factors.

Conclusions: The presence of persistent symptomatology after hospital discharge in our cohort was common and varied. Polymedication and living in a care home made up the most vulnerable profile of COVID-19 patients for returning to the ED. Thoracic pain, general malaise and hematological symptoms were identified as potential markers of severity, along with others predictors. These findings might be useful for optimizing follow-up strategies. Future studies conducted in other geographical areas are necessary to corroborate our results.


Keywords

COVID-19; Symptoms; Emergency; Hospitalization; Post-discharge


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Álvaro Romero-Duarte,Mario Rivera-Izquierdo,Antonio Jesús Láinez-Ramos-Bossini,Pablo Redruello-Guerrero,Antonio Cárdenas-Cruz. Factors associated with readmission to the Emergency Department in a cohort of COVID-19 hospitalized patients. Signa Vitae. 2021.doi:10.22514/sv.2021.106.

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