The first 10 days after discharge from hospital are especially risky for COVID survivors – Consumer Health News



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TUESDAY, December 22, 2020 (HealthDay News) – Being released from hospital following a severe episode of COVID-19 is far from impeccable health, new research warns, and risk of rehospitalization or death peaks early.

In the study, more than a quarter of these patients returned to hospital or died within weeks of discharge. Researchers followed nearly 2,200 American veterans discharged to 132 hospitals in Virginia in the spring and summer. All had been hospitalized for COVID-19, and their post-hospital experience was compared to 5,300 peers who had been released after hospitalization for non-COVID-related pneumonia or heart failure.

The results showed that patients with COVID-19 were 40% to 60% more likely to be readmitted or die within 10 days of discharge compared to other patients.

In absolute terms, 9% of patients released from COVID-19 eventually died within two months, while a fifth were readmitted to hospital.

“We found a very high rate of readmission or death among patients with COVID-19 who survived to discharge within the first 60 days after leaving hospital,” said the author of the John Donnelly study. He is a Research Fellow in the Health Sciences Learning Department at the University of Michigan, Ann Arbor.

While COVID-19 patients fared better two months than patients with heart failure or pneumonia, the big concern appears to be “a period of extremely high risk in the first 10 days after discharge,” said explained Donnelly.

“This trend was somewhat surprising as we could have expected ever worse outcomes for COVID-19 patients at 60 days. But it was not,” he said.

So what is going on? “COVID-19 patients who were readmitted or died within 60 days tended to be older,” Donnelly said. Other factors “could influence the results after discharge, but nothing beyond age emerged from our results,” he noted.

The study was published online Dec. 14 in the Journal of the American Medical Association.

Almost all of the study veterans were male (95%), and about half were black. Among COVID-19 patients, nearly a third had been in an intensive care unit (ICU) when they were first hospitalized, and 13% had been placed on a ventilator. In all, just over 80% survived their initial stay.

After discharge, nearly a quarter of those readmitted to hospital ended up in intensive care and 7% needed ventilators.

Donnelly stressed that the vast majority of coronavirus patients do not have any symptoms or symptoms that can be managed at home. “And we would expect the results to be much more favorable for people who have tested positive for COVID-19 but who did not have symptoms severe enough to merit hospitalization,” he added.

But for those who do, are there ways to minimize risk in the period immediately following leave?

Donnelly said the study was unable to answer the question of whether readmissions after COVID-19 are preventable or not, and it is difficult to give an overall recommendation for all patients.

But his team suggested post-discharge vigilance was definitely needed. “And when in doubt, contacting a doctor for advice on the most appropriate treatment would help patients and their loved ones best decide whether [rehospitalization] it makes sense or not, ”Donnelly advised.

In New York City, a good place to turn is the Post-COVID Recovery Center at Staten Island University Hospital (SIUH) at Northwell Health. Established last September, its director is Dr Thomas Gut, holder of the Associate Chair of Medicine at SIUH.

“We created a space especially for COVID patients seeking additional care after discharge, as there really was no resource for patients who are no longer sick enough to be in the hospital, but their doctor. primary care may not be familiar enough with a disease that we really learn as we go, ”explained Gut.

“Of course, not everyone will be able to access a center like ours,” he noted. “But I would say that COVID patients who are out of hospital are right to be concerned about any persistence or worsening of symptoms, like persistent fatigue or brain fog. Because we know that during that 10-day period, you’re at high risk for the types of things – like heart attacks and strokes – that you wouldn’t normally see with other types of viral infections, suggesting that COVID may inflict long-term damage to the heart, lungs or brain. “

Gut’s conclusion: “If your condition seems to get worse after discharge, regardless of the measurable amount, you should see a doctor again.”

More information

There is more information on the symptoms of COVID-19 in the United States Centers for Disease Control and Prevention.

SOURCES: John Donnelly, PhD, researcher, Department of Health Sciences Learning, University of Michigan, Ann Arbor; Thomas Gut, DO, associate president, medicine, Northwell Health, Staten Island University Hospital, and director, SIUH Post-COVID Recovery Center, New York City; Journal of the American Medical Association, Dec. 14, 2020, online

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