Predictors of COVID-19 Readmission Among Patients Previously Hospitalized for SARS-CoV-2.

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases and Therapy Pub Date : 2025-01-21 DOI:10.1007/s40121-024-01107-w

Marta Colaneri, Marta Canuti, Ginevra Torrigiani, Lucia Dall'Olio, Chiara Bobbio, Sante L Baldi, Alessandro Nobili, Massimo Puoti, Giulia Marchetti, Simone Piva, Pierluigi Plebani, Mario Raviglione, Andrea Gori, Danilo Cereda, Olivia Leoni, Ida Fortino, Maria Luisa Ojeda-Fernandez, Marta Baviera, Mauro Tettamanti, Alessandra Bandera

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引用次数: 0

Abstract

Introduction: Predictors of coronavirus disease 2019 (COVID-19)-related rehospitalization remain underexplored. This study aims to identify the main risk factors associated with rehospitalizations due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections among residents of Lombardy, northern Italy.

Methods: A retrospective observational study was conducted using two linked administrative databases covering demographic data, comorbidities, hospital records, and COVID-19 data of Lombardy residents. The study population included patients hospitalized for COVID-19 between February 2020 and August 2021. Rehospitalization was defined as a second COVID-19-related hospitalization occurring at least 90 days after the first admission. The Fine-Gray subdistribution hazard model was used to identify risk factors, accounting for death as a competing risk.

Results: Out of 98,369 patients hospitalized for COVID-19 between February 1, 2020 and August 31, 2021, 72,593 were alive 90 days after admission and 610 of these (0.8%) were rehospitalized. A higher rehospitalization risk was observed in older male patients with multiple comorbidities. Renal failure, liver disease, and use of diuretics were significantly associated with rehospitalization risk, while female biological sex and the use of lipid-lowering drugs were associated with a lower risk.

Conclusions: This is the first study conducted on regional administrative databases to investigate COVID-19 rehospitalizations. Through the availability of a huge cohort, it provides a groundwork for optimizing care for individuals at higher risk for COVID-19-related rehospitalizations. It underlines the need for patient-management approaches that extend beyond the initial recovery. This stresses the importance of ongoing monitoring and personalized interventions for those at heightened risk not only of SARS-CoV-2 reinfection but also related rehospitalizations.

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先前因SARS-CoV-2住院的患者中COVID-19再入院的预测因素

导言：2019冠状病毒病（COVID-19）相关再住院的预测因素仍未得到充分研究。本研究旨在确定意大利北部伦巴第居民因严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）再感染而再次住院的主要危险因素。方法：采用两个关联的行政数据库，包括伦巴第居民的人口统计数据、合并症、医院记录和COVID-19数据，进行回顾性观察研究。研究人群包括2020年2月至2021年8月期间因COVID-19住院的患者。再入院定义为首次入院后至少90天内发生的第二次与covid -19相关的住院。细灰色亚分布风险模型用于识别风险因素，将死亡作为竞争风险。结果：在2020年2月1日至2021年8月31日期间因COVID-19住院的98,369例患者中，72,593例在入院后90天存活，其中610例（0.8%）再次住院。有多种合并症的老年男性患者再住院风险较高。肾功能衰竭、肝脏疾病和使用利尿剂与再住院风险显著相关，而女性生理性别和使用降脂药物与再住院风险较低相关。结论：这是首次在区域行政数据库中调查COVID-19再住院情况。通过提供一个庞大的队列，它为优化与covid -19相关的再住院风险较高的个体的护理提供了基础。它强调需要采取超越最初恢复的病人管理办法。这强调了持续监测和个性化干预的重要性，这些干预不仅对SARS-CoV-2再感染风险高，而且对相关的再住院风险高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infectious Diseases and Therapy Medicine-Microbiology (medical)

CiteScore

8.60

自引率

1.90%

发文量

136

审稿时长

6 weeks

期刊介绍： Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.