Discharge characteristics and care transitions of hospitalized patients with COVID-19

• Type of Material: Article
• Authors: Leah B Loerinc, Emory University; Amy M Scheel, Emory University; Sean T Evans, Emory University; Julie M Shabto, Emory University; Ghazala O'Keefe, Emory University; James O'Keefe, Emory University
• Language: English
• Date: 2021-03-01
• Publisher: ELSEVIER
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Elsevier Inc.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.hjdsi.2020.100512
• Title of Journal or Parent Work: HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION
• Volume: 9
• Issue: 1
• Start Page: 100512
• End Page: 100512
• Grant/Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
• Keywords: OUTCOMES; Science & Technology; Health Care Sciences & Services; Transitions of care; Discharge; Life Sciences & Biomedicine; Health Policy & Services; Coronavirus disease 2019; Post-acute; Primary care; Readmission
• Research Categories: Health Sciences, Opthamology; Health Sciences, Medicine and Surgery; Health Sciences, General

Abstract

Little is known about the follow-up healthcare needs of patients hospitalized with coronavirus disease 2019 (COVID-19) after hospital discharge. Due to the unique circumstances of providing transitional care in a pandemic, post-discharge providers must adapt to specific needs and limitations identified for the care of COVID-19 patients. In this study, we conducted a retrospective chart review of all hospitalized COVID-19 patients discharged from an Emory Healthcare Hospital in Atlanta, GA from March 26 to April 21, 2020 to characterize their post-discharge care plans. A total of 310 patients were included in the study (median age 58, range: 23–99; 51.0% female; 69.0% African American). The most common presenting comorbidities were hypertension (200, 64.5%), obesity (BMI≥30) (138, 44.5%), and diabetes mellitus (112, 36.1%). The median length of hospitalization was 5 days (range: 0–33). Sixty-seven patients (21.6%) were admitted to the intensive care unit and 42 patients (13.5%) received invasive mechanical ventilation. The most common complications recorded at discharge were electrolyte abnormalities (124, 40.0%), acute kidney injury (86, 27.7%) and sepsis (55, 17.7%). The majority of patients were discharged directly home (281, 90.6%). Seventy-five patients (24.2%) required any home service including home health and home oxygen therapy. The most common follow-up need was an appointment with a primary care provider (258, 83.2%). Twenty-four patients (7.7%) had one or more visit to an ED after discharge and 16 patients (5.2%) were readmitted. To our knowledge, this is the first large study to report on post-discharge medical care for COVID-19 patients.