- About 10 percent of people hospitalized for COVID-19 are readmitted or die within 30 days, researchers report.
- They note that the initial hospitalization rate for COVID-19 is relatively, but the readmission rate is similar to other infectious diseases.
- They add that more than 90 percent of people who return to the hospital are unvaccinated.
About one in 10 people who are hospitalized with COVID-19 end up back in the hospital again or die within a month, according to a new Canadian study.
Researchers from the University of Alberta drew their conclusions from a review of data on all adults admitted to hospitals in Alberta and Ontario between January 1, 2020, and September 30, 2021. Records from 843,737 patients were examined.
The researchers say they found that of all adults who tested positive for COVID-19, about 5 percent were hospitalized, with an average length of stay of 8 days. Of these, 14 percent were admitted to intensive care units at some point. About 18 percent died during their initial hospitalization.
Among the people who were discharged from the hospital, 11 percent were either readmitted or died within 30 days, reported the researchers led by Dr. Finlay McAlister, a professor of medicine at the University of Alberta.
The most commonly cited reasons for readmission were COVID-19 (37 percent), nonspecified pneumonia or interstitial pulmonary disease (6 percent), heart failure (4 percent), pulmonary embolism (3 percent), and confusion (3 percent).
Researchers noted, however, that while hospital admissions for COVID-19 were higher than typical for other medical conditions, the readmission rates were not unusually high.
“Despite fears of high rates of readmission after COVID-19 hospitalizations, we found that outcomes in the 30 days after discharge were consistent with admissions for other medical diagnoses,” the study authors wrote. “Thus, current system approaches to transitioning patients from hospital to home do not appear to need adjustment.”
“Some studies looking at patients hospitalized with non-COVID pneumonia… report readmission rates can be as high as 25 percent, especially in older people or those with chronic illnesses,” noted Dr. Ryan Maves, a professor of infectious diseases at the Wake Forest School of Medicine in North Carolina and the chair of the COVID-19 Task Force at the American College of Chest Physicians. “Honestly, this rate is a little lower than I would have guessed, given the severity of illness in COVID-19 victims.”
Bernadette M. Boden-Albala, D.Ph., the director and founding dean of the Program in Public Health at the University of California at Irvine, told Healthline that the virulence of COVID-19 and the strain that the pandemic has put on the healthcare system also are likely factors in COVID-19 readmissions.
“As we’ve learned over the past three years, some strains of COVID, like the Delta variant, tend to produce more severe cases and send hospitalization rates skyrocketing,” she said.
People with COVID-19 who were at the highest risk for readmission to the hospital included those who were older, male, had multiple comorbidities, were discharged to home care or to a long-term care facility, and had more previous hospitalizations and emergency department visits.
“In general, there comes a point where the risk of continued hospitalization exceeds the risk of sending people home or to a rehabilitation center to help them get their strength back,” Maves told Healthline. “What I think this indicates is that severe COVID-19 can do an extraordinary amount of injury to people, and that physiologic injury can persist even after the virus has been cleared.”
The vast majority of people admitted to the hospital for COVID-19 in Alberta (91 percent) and Ontario (95 percent) were unvaccinated, the study authors noted.
“Unfortunately, many of the patients that are hospitalized due to COVID have comorbidities like hypertension, diabetes, chronic pulmonary disease, cancer, and more,” said Boden-Albala. “This can produce more severe cases of COVID, which in turn lead to events like respiratory distress, heart failure, and pneumonia that land the patient back in the hospital – or worse. This is especially true for the unvaccinated, whose bodies have to work harder to mount an immune response.”
Both Boden-Albala and Maves stressed that the best way to prevent readmissions for COVID-19 is to prevent coronavirus cases in the first place via vaccination.
Jason Gallagher, PharmD, a professor at the Temple University School of Pharmacy in Pennsylvania and a clinical pharmacy specialist in infectious diseases at Temple University Hospital, told Healthline that the research presents an opportunity for healthcare providers to review and improve treatment protocols for COVID-19.
“For example, one of the most common reasons that patients were readmitted was for heart failure,” said Gallagher. “We know that improving heart failure medication regimens can keep patients from being readmitted.”