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Cited by 723COVID-19 Clinical Research StudiesLong-Term Effects of COVID-19COVID-19 and healthcare impacts

Sixty-day outcomes among patients hospitalized with COVID-19

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Chopra, Vineet, Flanders, Scott A., O’Malley, Megan, Malani, Anurag N., Prescott, Hallie C.·2021·Annals of Internal Medicine
DOI 10.7326/m20-5661PMC PMC7707210
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Abstract

Letters11 November 2020Sixty-Day Outcomes Among Patients Hospitalized With COVID-19FREEVineet Chopra, MD, MSc, Scott A. Flanders, MD, Megan O’Malley, PhD, Anurag N. Malani, MD, and Hallie C. Prescott, MD, MScVineet Chopra, MD, MScUniversity of Michigan Health System and The Michigan Hospital Medicine Safety Collaborative, Ann Arbor, MichiganSearch for more papers by this author, Scott A. Flanders, MDUniversity of Michigan Health System and The Michigan Hospital Medicine Safety Collaborative, Ann Arbor, MichiganSearch for more papers by this author, Megan O’Malley, PhDUniversity of Michigan Health System and The Michigan Hospital Medicine Safety Collaborative, Ann Arbor, MichiganSearch for more papers by this author, Anurag N. Malani, MDSt. Joseph Mercy Health System and The Michigan Hospital Medicine Safety Collaborative, Ann Arbor, MichiganSearch for more papers by this author, and Hallie C. Prescott, MD, MScUniversity of Michigan Health System and The Michigan Hospital Medicine Safety Collaborative, Ann Arbor, MichiganSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-5661 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Although characteristics and in-hospital outcomes for persons with coronavirus disease 2019 (COVID-19) have been well described, less is known about the longer-term outcomes of hospitalized patients.Objective: To describe 60-day postdischarge clinical, financial, and mental health outcomes of patients with COVID-19.Methods: This observational cohort study looked at patients hospitalized with COVID-19 (discharged between 16 March and 1 July 2020) at 38 hospitals participating in the MI-COVID19 initiative. The aim of MI-COVID19, a Michigan statewide collaboration sponsored by Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network, is to improve care for patients hospitalized with COVID-19. Trained quality abstractors (often registered nurses) collect data from patient medical records using structured templates. For hospitals unable to abstract all COVID-19 hospitalizations, a sample is selected for inclusion by using a pseudo-randomization procedure (minute of hospital discharge).At 60 days after discharge, abstractors review the medical record to collect data on clinical events, including readmission (to the index hospital or any hospital viewable in the medical record) and postdischarge death. In addition, for all patients alive and not residing in a health care or correctional facility, abstractors contact patients by telephone to complete a survey about primary care follow-up, ongoing cardiopulmonary symptoms, return to normal activity, financial impact, and emotional and mental health outcomes. At least 3 attempts are made to contact patients. The study was deemed “not regulated” by the University of Michigan institutional review board (HUM 00179611).Findings: Of 1648 patients with COVID-19 admitted to 38 hospitals, 398 (24.2%) died during hospitalization and 1250 (75.8%) survived. Of 1250 patients discharged alive, 975 (78.0%) went home whereas 158 (12.6%) were discharged to a skilled nursing or rehabilitation facility (Table 1). By 60 days after discharge, an additional 84 patients (6.7% of hospital survivors and 10.4% of intensive care unit [ICU]-treated hospital survivors) had died, bringing the overall mortality rate for the cohort to 29.2%, and 63.5% for the 405 patients who received treatment in an ICU. Within 60 days of discharge, 189 patients (15.1% of hospital survivors) were rehospitalized.Table 1. Demographic and Clinical Characteristics of 1250 Survivors of COVID-19 HospitalizationOf patients alive 60 days after discharge, 488 (41.8%) were successfully contacted and completed the 60-day postdischarge telephone survey. Of these, 265 reported seeing a primary care physician within 2 weeks (Table 2). Most follow-up visits (304 of 382) occurred virtually by videoconference (161 of 382) or telephone (143 of 382), whereas 77 occurred in person and 1 was of unknown format.Table 2. 60-Day Outcomes Among 1250 Survivors of COVID-19 Hospitalization, 488 of Whom Completed the Telephone SurveyCardiopulmonary symptoms (such as cough and dyspnea) were reported by 159 patients, including 92 with new or worsening symptoms and 65 with persistent loss of taste or smell. Fifty-eight patients reported new or worsening difficulty completing activities of daily living. Among 195 patients who were employed before hospitalization, 117 had returned to work whereas 78 could not because of ongoing health issues or job loss. Of the 117 patients who returned to work, 30 reported reduced hours or modified duties due to health reasons.Nearly half of all patients (238 of 488) reported being emotionally affected by their health, and 28 sought care for mental health after discharge. Moreover, 179 patients reported at least a mild financial im

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  • Long COVID negatively impacts quality of life and patient work ability and social relationships.

    “Nevertheless, what emerges from preliminary data is the negative impact of long COVID on quality of life and its effects on patient work ability and social relationships [1,4,19].”

    From Female gender is associated with long COVID syndrome: a prospective cohort study (2022) · cites this paper as [19]

  • The proportion of patients with long COVID in this study matched figures from earlier reports.

    “The high incidence of long COVID within our cohort was similar to that previously reported: more than half of patients reported symptoms lasting more than 2 months after symptom onset [4,5,16,18,19].”

    From Female gender is associated with long COVID syndrome: a prospective cohort study (2022) · cites this paper as [19]

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Authors
Chopra, V., Flanders, S. A., O’Malley, M., Malani, A. N., & Prescott, H. C.
Affiliations
  • Michigan Medicine (US)
  • Trinity Health Ann Arbor Hospital (US)
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2021-04
Volume
174
Issue
4
Pages
576-578
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/m20-5661
PMC
PMC7707210
OpenAlex
W3103726915
Cited by
723
References
4
Citations by year
2026: 10 · 2025: 30 · 2024: 74 · 2023: 151 · 2022: 215 · 2021: 240 · 2020: 2 · 2018: 1
FWCI
19.86
Type
journal article
Language
en
Open access
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
Keywords
COVID-19 pandemic, long-term outcomes, hospital readmission, mortality, mental health, financial burden, health care costs, quality improvement, Michigan hospitals, post-discharge care
MeSH terms
COVID-19, SARS-CoV-2, Aged, Female, Hospitalization, Humans, Male, Michigan, Middle Aged, Patient Readmission, Survival Analysis, Hospital Mortality, Outcome Assessment, Health Care

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