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Comment
. 2021 Jun;82(6):276-316.
doi: 10.1016/j.jinf.2021.03.002. Epub 2021 Mar 11.

Short durations of corticosteroids for hospitalised COVID-19 patients are associated with a high readmission rate

Zain Chaudhry  1 , Marianne Shawe-Taylor  1 , Tommy Rampling  1 , Tim Cutfield  1 , Gabriella Bidwell  1 , Xin Hui S Chan  2 , Anna Last  3 , Bryan Williams  4 , Sarah Logan  1 , Michael Marks  3 , Hanif Esmail  5
Affiliations
Comment

Short durations of corticosteroids for hospitalised COVID-19 patients are associated with a high readmission rate

Zain Chaudhry et al. J Infect. 2021 Jun.

Abstract

Objective: Our objective was to describe the characteristics of patients admitted, discharged and readmitted, due to COVID-19, to a central London acute-care hospital during the second peak, in particular in relation to corticosteroids use.

Methods: We reviewed patients admitted from the community to University College Hospital (UCH) with COVID-19 as their primary diagnosis between 1st-31st December 2020. Re-attendance and readmission data were collected for patients who re-presented within 10 days following discharge. Data were retrospectively collected.

Results: 196 patients were admitted from the community with a diagnosis of COVID-19 and discharged alive in December 2020. Corticosteroids were prescribed in hospital for a median of 5 days (IQR 3-8). 20 patients (10.2%) were readmitted within 10 days. 11/20 received corticosteroids in the first admission of which 10 had received 1-3 days of corticosteroids. Readmission rate in those receiving 1-3 days of corticosteroids was 25%.

Conclusions: Most international guidelines have recommended providing up to 10 days of corticosteroids for severe COVID-19 but stopping on discharge. Our findings show shorter courses of corticosteroids during admission are associated with an increased risk of being readmitted and support continuing the course of corticosteroids after hospital discharge monitored in the virtual ward setting.

Keywords: COVID-19; Corticosteroids; Dexamethasone; Hospital; Readmissions.

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Conflict of interest statement

Declaration of Competing Interest No conflicts of interests declared by an author.

Figures

Fig 1
Fig. 1
Survival plot showing the probability of being out of hospital in the 10 days following discharge by duration of corticosteroids received during initial admission. The line showing readmission in the group receiving steroids for 4–5 days is not visible as masked by the line for steroids for 6–8 days – i.e. there were no readmissions for this group.
See this image and copyright information in PMC

Comment on

References

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