Acute-care hospital reencounters (
ACHEs)-encompassing emergency department visits, observation stays, and
hospital readmissions-following
COVID-19 hospitalization may exacerbate health care system strain and impair recovery from illness. We sought to characterize these reencounters and factors associated with reencounters. We identified the first consecutive 509 patients hospitalized for
COVID-19 within an IL hospital network, and examined
ACHEs, experienced within 30 days and 4 months of index hospitalization. We identified independent predictors of reencounter using binary logistic regression. Of 509 patients, 466 (91.6%) were discharged alive from index
COVID-19 hospitalization. Within 30 days and 4 months, 12.4% and 21.5% of patients, respectively, experienced
ACHEs. The median time to first ACHE was 24.2 (IQR 6.5, 55) days.
COVID-19 symptom exacerbation was the leading reason for early ACHE (44.8%). Reencounters, both within 30 days and 4 months, were associated with a history of a
neurological disorder before
COVID-19 (OR 2.78 [95% CI 1.53, 5.03] and OR 2.75 [95% CI 1.67, 4.53], respectively). Older patients and those with
diabetes mellitus,
chronic obstructive pulmonary disease, or
organ transplantation tended towards more frequent
ACHEs.
Steroid treatment during
COVID-19 hospitalization demonstrated reduced odds of 30-day reencounter (OR 0.31 [95% CI 0.091, 0.79]). Forty-nine patients had repeat SARS-CoV-2 nasopharyngeal testing during a reencounter; twelve (24.5%) patients had positive reencounter tests and experienced more frequent reencounters than those testing negative.
COVID-19 symptom exacerbation is a leading cause of early ACHE after
COVID-19 hospitalization, and
steroid use during index hospitalization may reduce early reencounters. Neurologic illness before
COVID-19 predicts
ACHEs.