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Meta-Analysis
. 2022 Jan:51:267-279.
doi: 10.1016/j.ajem.2021.10.059. Epub 2021 Nov 6.

Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis

Zhian Salah Ramzi  1
Affiliations
Meta-Analysis

Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis

Zhian Salah Ramzi. Am J Emerg Med. 2022 Jan.

Abstract

Objective: The present study aimed to perform a systematic review and meta-analysis on the prevalence of one-year hospital readmissions and post-discharge all-cause mortality in recovered COVID-19 patients. Moreover, the country-level prevalence of the outcomes was investigated.

Methods: An extensive search was performed in Medline (PubMed), Embase, Scopus, and Web of Science databases until the end of August 3rd, 2021. A manual search was also performed in Google and Google Scholar search engines. Cohort and cross-sectional studies were included. Two independent reviewers screened the papers, collected data, and assessed the risk of bias and level of evidence. Any disagreement was resolved through discussion.

Results: 91 articles were included. 48 studies examined hospital readmissions; nine studies assessed post-discharge all-cause mortality, and 34 studies examined both outcomes. Analyses showed that the prevalence of hospital readmissions during the first 30 days, 90 days, and one-year post-discharge were 8.97% (95% CI: 7.44, 10.50), 9.79% (95% CI: 8.37, 11.24), and 10.34% (95% CI: 8.92, 11.77), respectively. The prevalence of post-discharge all-cause mortality during the 30 days, 90 days and one-year post-discharge was 7.87% (95% CI: 2.78, 12.96), 7.63% (95% CI: 4.73, 10.53) and 7.51% (95% CI, 5.30, 9.72), respectively. 30-day hospital readmissions and post-discharge mortality were 8.97% and 7.87%, respectively. The highest prevalence of hospital readmissions was observed in Germany (15.5%), Greece (15.5%), UK (13.5%), Netherlands (11.7%), China (10.8%), USA (10.0%) and Sweden (9.9%). In addition, the highest prevalence of post-discharge all-cause mortality belonged to Italy (12.7%), the UK (11.8%), and Iran (9.2%). Sensitivity analysis showed that the prevalence of one-year hospital readmissions and post-discharge all-cause mortality in high-quality studies were 10.38% and 4.00%, respectively.

Conclusion: 10.34% of recovered COVID-19 patients required hospital readmissions after discharge. Most cases of hospital readmissions and mortality appear to occur within 30 days after discharge. The one-year post-discharge all-cause mortality rate of COVID-19 patients is 7.87%, and the majority of patients' readmission and mortality happens within the first 30 days post-discharge. Therefore, a 30-day follow-up program and patient tracking system for discharged COVID-19 patients seems necessary.

Keywords: COVID-19; Hospital readmission; Mortality; Re-infection.

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Conflict of interest statement

Declaration of Competing Interest There is no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for present studies.
Fig. 2
Fig. 2
Forest plot for prevalence of hospital readmission during one-year after recovery of COVID-19 patients. CI: Confidence interval.
Fig. 3
Fig. 3
Post-discharge all-cause mortality of COVID-19 patients during one-year after recovery. CI: Confidence interval.
Fig. 4
Fig. 4
Country-level hospital readmission and post-discharge mortality of COVID-19 patients.
See this image and copyright information in PMC

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References

    1. Jangra S., Ye C., Rathnasinghe R., Stadlbauer D., Alshammary H., Amoako A.A., et al. SARS-CoV-2 spike E484K mutation reduces antibody neutralisation. Lancet Microbe. 2021;2(7):E283–E284. - PMC - PubMed
    1. Harvey W.T., Carabelli A.M., Jackson B., Gupta R.K., Thomson E.C., Harrison E.M., et al. SARS-CoV-2 variants, spike mutations and immune escape. Nat Rev Microbiol. 2021;19(7):409–424. - PMC - PubMed
    1. Hafeez S., Din M., Zia F., Ali M., Shinwari Z.K. Emerging concerns regarding COVID-19; second wave and new variant. J Med Virol. 2021;93(7):4108. - PMC - PubMed
    1. Cherian S., Potdar V., Jadhav S., Yadav P., Gupta N., Das M., et al. SARS-CoV-2 Spike Mutations, L452R, T478K, E484Q and P681R, in the Second Wave of COVID-19 in Maharashtra, India. Microorganisms. 2021;9(7) 1542-1542. - PMC - PubMed
    1. Lin S.-N., Rui J., Chen Q.-P., Zhao B., Yu S.-S., Li Z.-Y., et al. Effectiveness of potential antiviral treatments in COVID-19 transmission control: a modelling study. Infect Dis Poverty. 2021;10(1):53. - PMC - PubMed