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- Title
Discharge Clinical Characteristics and Post-Discharge Events in Patients with Severe COVID-19: A Descriptive Case Series.
- Authors
Saab, Faysal G.; Chiang, Jeffrey N.; Brook, Rachel; Adamson, Paul C.; Fulcher, Jennifer A.; Halperin, Eran; Manuel, Vladimir; Goodman-Meza, David
- Abstract
<bold>Background: </bold>As the SARS-CoV-2 pandemic continues, little guidance is available on clinical indicators for safely discharging patients with severe COVID-19.<bold>Objective: </bold>To describe the clinical courses of adult patients admitted for COVID-19 and identify associations between inpatient clinical features and post-discharge need for acute care.<bold>Design: </bold>Retrospective chart reviews were performed to record laboratory values, temperature, and oxygen requirements of 99 adult inpatients with COVID-19. Those variables were used to predict emergency department (ED) visit or readmission within 30 days post-discharge.<bold>Patients (or Participants): </bold>Age ≥ 18 years, first hospitalization for COVID-19, admitted between March 1 and May 2, 2020, at University of California, Los Angeles (UCLA) Medical Center, managed by an inpatient medicine service.<bold>Main Measures: </bold>Ferritin, C-reactive protein, lactate dehydrogenase, D-dimer, procalcitonin, white blood cell count, absolute lymphocyte count, temperature, and oxygen requirement were noted.<bold>Key Results: </bold>Of 99 patients, five required ED admission within 30 days, and another five required readmission. Fever within 24 h of discharge, oxygen requirement, and laboratory abnormalities were not associated with need for ED visit or readmission within 30 days of discharge after admission for COVID-19.<bold>Conclusion: </bold>Our data suggest that neither persistent fever, oxygen requirement, nor laboratory marker derangement was associated with need for acute care in the 30-day period after discharge for severe COVID-19. These findings suggest that physicians need not await the normalization of laboratory markers, resolution of fever, or discontinuation of oxygen prior to discharging a stable or improving patient with COVID-19.
- Subjects
UNIVERSITY of California, Los Angeles; COVID-19; COVID-19 pandemic; LEUKOCYTE count; BIOMARKERS; LYMPHOCYTE count
- Publication
JGIM: Journal of General Internal Medicine, 2021, Vol 36, Issue 4, p1017
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-020-06494-7