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


Journal

The Journal of infection
ISSN: 1532-2742
Titre abrégé: J Infect
Pays: England
ID NLM: 7908424

Informations de publication

Date de publication:
06 2021
Historique:
received: 06 03 2021
accepted: 08 03 2021
pubmed: 16 3 2021
medline: 20 5 2021
entrez: 15 3 2021
Statut: ppublish

Résumé

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. 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. 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%. 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.

Identifiants

pubmed: 33716109
pii: S0163-4453(21)00115-8
doi: 10.1016/j.jinf.2021.03.002
pmc: PMC7948670
pii:
doi:

Substances chimiques

Adrenal Cortex Hormones 0

Types de publication

Letter Comment

Langues

eng

Sous-ensembles de citation

IM

Pagination

276-316

Subventions

Organisme : Medical Research Council
ID : MC_UU_00004/04
Pays : United Kingdom

Commentaires et corrections

Type : CommentOn

Informations de copyright

Copyright © 2021. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

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

Références

N Engl J Med. 2021 Feb 25;384(8):693-704
pubmed: 32678530
JAMA. 2020 Oct 6;324(13):1317-1329
pubmed: 32876697
J Infect. 2020 Sep;81(3):e18-e19
pubmed: 32652166
MMWR Morb Mortal Wkly Rep. 2020 Nov 13;69(45):1695-1699
pubmed: 33180754
BMJ. 2020 Sep 9;370:m3339
pubmed: 32907855

Auteurs

Zain Chaudhry (Z)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom.

Marianne Shawe-Taylor (M)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom.

Tommy Rampling (T)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom.

Tim Cutfield (T)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom.

Gabriella Bidwell (G)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom.

Xin Hui S Chan (XHS)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LG, United Kingdom.

Anna Last (A)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom; Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 6HT, United Kingdom.

Bryan Williams (B)

NIHR University College London Hospitals Biomedical Research Centre and University College London, W1T 7DN, United Kingdom; Health Data Research UK, United Kingdom.

Sarah Logan (S)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom.

Michael Marks (M)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom; Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 6HT, United Kingdom.

Hanif Esmail (H)

Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, United Kingdom; Institute for Global Health, University College London, London, WC1E 6BT, United Kingdom; MRC Clinical Trials Unit, University College London, London, WC1V 6LJ, United Kingdom. Electronic address: hanif.esmail@nhs.net.

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