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Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program

BACKGROUND: Despite increasing vaccination rates, coronavirus disease 2019 (COVID-19) continues to overwhelm heath systems worldwide. Few studies follow outpatients diagnosed with COVID-19 to understand risks for subsequent admissions. We sought to identify hospital admission risk factors in individ...

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Autores principales: Sperring, Heather, Hofman, Melissa, Hsu, Heather E, Xiao, Yian, Keohane, Elizabeth A, Lodi, Sara, Marathe, Jai, Epstein, Rachel L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278211/
https://www.ncbi.nlm.nih.gov/pubmed/35899280
http://dx.doi.org/10.1093/ofid/ofac320
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author Sperring, Heather
Hofman, Melissa
Hsu, Heather E
Xiao, Yian
Keohane, Elizabeth A
Lodi, Sara
Marathe, Jai
Epstein, Rachel L
author_facet Sperring, Heather
Hofman, Melissa
Hsu, Heather E
Xiao, Yian
Keohane, Elizabeth A
Lodi, Sara
Marathe, Jai
Epstein, Rachel L
author_sort Sperring, Heather
collection PubMed
description BACKGROUND: Despite increasing vaccination rates, coronavirus disease 2019 (COVID-19) continues to overwhelm heath systems worldwide. Few studies follow outpatients diagnosed with COVID-19 to understand risks for subsequent admissions. We sought to identify hospital admission risk factors in individuals with COVID-19 to guide outpatient follow-up and prioritization for novel therapeutics. METHODS: We prospectively designed data collection templates and remotely monitored patients after a COVID-19 diagnosis, then retrospectively analyzed data to identify risk factors for 30-day admission for those initially managed outpatient and for 30-day re-admissions for those monitored after an initial COVID-19 admission. We included all patients followed by our COVID-19 follow-up monitoring program from April 2020 to February 2021. RESULTS: Among 4070 individuals followed by the program, older age (adjusted odds ratio [aOR], 1.05; 95% CI, 1.03–1.06), multiple comorbidities (1–2: aOR, 5.88; 95% CI, 2.07–16.72; ≥3: aOR, 20.40; 95% CI, 7.23–57.54), presence of fever (aOR, 2.70; 95% CI, 1.65–4.42), respiratory symptoms (aOR, 2.46; 95% CI, 1.53–3.94), and gastrointestinal symptoms (aOR, 2.19; 95% CI, 1.53–3.94) at initial contact were associated with increased risk of COVID-19-related 30-day admission among those initially managed outpatient. Loss of taste/smell was associated with decreased admission risk (aOR, 0.46; 95% CI, 0.25–0.85). For postdischarge patients, older age was also associated with increased re-admission risk (aOR, 1.04; 95% CI, 1.01–1.06). CONCLUSIONS: This study reveals that in addition to older age and specific comorbidities, the number of high-risk conditions, fever, respiratory symptoms, and gastrointestinal symptoms at diagnosis all increased odds of COVID-19-related admission. These data could enhance patient prioritization for early treatment interventions and ongoing surveillance.
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spelling pubmed-92782112022-07-18 Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program Sperring, Heather Hofman, Melissa Hsu, Heather E Xiao, Yian Keohane, Elizabeth A Lodi, Sara Marathe, Jai Epstein, Rachel L Open Forum Infect Dis Major Article BACKGROUND: Despite increasing vaccination rates, coronavirus disease 2019 (COVID-19) continues to overwhelm heath systems worldwide. Few studies follow outpatients diagnosed with COVID-19 to understand risks for subsequent admissions. We sought to identify hospital admission risk factors in individuals with COVID-19 to guide outpatient follow-up and prioritization for novel therapeutics. METHODS: We prospectively designed data collection templates and remotely monitored patients after a COVID-19 diagnosis, then retrospectively analyzed data to identify risk factors for 30-day admission for those initially managed outpatient and for 30-day re-admissions for those monitored after an initial COVID-19 admission. We included all patients followed by our COVID-19 follow-up monitoring program from April 2020 to February 2021. RESULTS: Among 4070 individuals followed by the program, older age (adjusted odds ratio [aOR], 1.05; 95% CI, 1.03–1.06), multiple comorbidities (1–2: aOR, 5.88; 95% CI, 2.07–16.72; ≥3: aOR, 20.40; 95% CI, 7.23–57.54), presence of fever (aOR, 2.70; 95% CI, 1.65–4.42), respiratory symptoms (aOR, 2.46; 95% CI, 1.53–3.94), and gastrointestinal symptoms (aOR, 2.19; 95% CI, 1.53–3.94) at initial contact were associated with increased risk of COVID-19-related 30-day admission among those initially managed outpatient. Loss of taste/smell was associated with decreased admission risk (aOR, 0.46; 95% CI, 0.25–0.85). For postdischarge patients, older age was also associated with increased re-admission risk (aOR, 1.04; 95% CI, 1.01–1.06). CONCLUSIONS: This study reveals that in addition to older age and specific comorbidities, the number of high-risk conditions, fever, respiratory symptoms, and gastrointestinal symptoms at diagnosis all increased odds of COVID-19-related admission. These data could enhance patient prioritization for early treatment interventions and ongoing surveillance. Oxford University Press 2022-06-30 /pmc/articles/PMC9278211/ /pubmed/35899280 http://dx.doi.org/10.1093/ofid/ofac320 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Sperring, Heather
Hofman, Melissa
Hsu, Heather E
Xiao, Yian
Keohane, Elizabeth A
Lodi, Sara
Marathe, Jai
Epstein, Rachel L
Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program
title Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program
title_full Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program
title_fullStr Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program
title_full_unstemmed Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program
title_short Risk Factors for Admission Within a Hospital-Based COVID-19 Home Monitoring Program
title_sort risk factors for admission within a hospital-based covid-19 home monitoring program
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278211/
https://www.ncbi.nlm.nih.gov/pubmed/35899280
http://dx.doi.org/10.1093/ofid/ofac320
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