Role of Treatment with Remdesivir on the Early Readmission of Patients Affected by Nosocomial Coronavirus Disease 2019
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Background The patients affected by hospital-acquired coronavirus disease 2019 (HA-COVID-19) who were readmitted in hospital within 60 days had worse prognosis and mortality. In this study the aim was the assessment of early readmission rate in HA-COVID-19 and the role of remdesivir treatment. Materials and Methods This observational retrospective study included patients with HA-COVID-19 hospitalized in different wards between Jan 2021 and Mar 2022. Early readmission rate was determined. A multivariate logistic regression was made to determine the predictive factors for re-hospitalization. Results A total of 190 patients with a confirmed diagnosis of HA-COVID-19 were included. Early readmission was documented in 22 patients (11.6%) with a consequent mortality rate of 22.7%. In multivariate analysis, the following factors were predictive of readmission: chronic pulmonary disease (odds ratio [OR], 3.187; 95% confidence interval [CI], 2.145–11.228; P<0.001), hospitalization time ≥11 days (OR, 3.556; 95% CI, 1.442–8.417; P=0.008), intensive care unit support (OR, 7.449; 95% CI, 3.901–14.782; P<0.001), and remdesivir use (OR, 0.729; 95% CI, 0.512–0.884; P=0.001). Conclusion Readmission cumulative rate was about one tenth with higher mortality. The remdesivir use in the first hospitalization leads to significant reduction in the odds of readmission.
Abstract
Background The patients affected by hospital-acquired coronavirus disease 2019 (HA-COVID-19) who were readmitted in hospital within 60 days had worse prognosis and mortality. In this study the aim was the assessment of early readmission rate in HA-COVID-19 and the role of remdesivir treatment. Materials and Methods This observational retrospective study included patients with HA-COVID-19 hospitalized in different wards between Jan 2021 and Mar 2022. Early readmission rate was determined. A multivariate logistic regression was made to determine the predictive factors for re-hospitalization. Results A total of 190 patients with a confirmed diagnosis of HA-COVID-19 were included. Early readmission was documented in 22 patients (11.6%) with a consequent mortality rate of 22.7%. In multivariate analysis, the following factors were predictive of readmission: chronic pulmonary disease (odds ratio [OR], 3.187; 95% confidence interval [CI], 2.145–11.228; P<0.001), hospitalization time ≥11 days (OR, 3.556; 95% CI, 1.442–8.417; P=0.008), intensive care unit support (OR, 7.449; 95% CI, 3.901–14.782; P<0.001), and remdesivir use (OR, 0.729; 95% CI, 0.512–0.884; P=0.001). Conclusion Readmission cumulative rate was about one tenth with higher mortality. The remdesivir use in the first hospitalization leads to significant reduction in the odds of readmission.