Respiratory distress the cause of most post-COVID hospital readmissions

This published article in the Journal of General Internal Medicine (August 2020) describes a retrospective cohort study of COVID-19 positive patients who were hospitalized between February 27 and April 12, 2020. The main measures were readmission or return to the emergency department following discharge for COVID-19 infection. Of the 2864 discharged patients, 103 (3.6%) returned for emergency care after a median of 4.5 days, with 56 requiring inpatient readmission. The most common reason for return was respiratory distress (50%). Compared to patients who did not return, the patients who returned more likely had COPD and hypertension, shorter length-of-stay (LOS) and lower rates of in-hospital treatment with anticoagulation.

A separate published article in Chronic Disease and Translational Medicine states that pulmonary rehabilitation is crucial for both admitted and discharged patients infected with COVID-19. This is especially crucial for patients with COVID-19 complicated by COPD, bronchial asthma and pulmonary fibrosis. Since patients with COVID-19 suffer from various degrees of respiratory, physical, and psychological dysfunction, pulmonary rehabilitation is equally important for both admitted and discharged patients for the treatment of the disease.

Although pulmonary rehabilitation is an efficacious and cost-effective intervention for improving functional performance and quality of life, and decreasing health care utilization among patients with COPD, these programs are greatly underutilized. It is estimated that only 1.5% of patients who could benefit from the therapy initiate it within 90 days of discharge, according to an article published in JAMA. Researchers found that risk of re-hospitalization or death was 33% lower among those patients with COPD who engaged in pulmonary rehabilitation within 90 days following hospitalization.