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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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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. |
format | Online Article Text |
id | pubmed-9278211 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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