ABSTRACT
Introduction There is little described in the current COVID-19 literature about the outcomes of patients discharged from hospital following COVID-19 pneumonia. We describe the rapid establishment of a 'virtual ward' (VW) for followup of patients with a suspected or confirmed diagnosis of COVID-19 pneumonia or pneumonitis upon hospital discharge, characteristics and outcomes for the first 300 patient referrals. Methods Admitted patients with a confirmed/suspected diagnosis of COVID-19 pneumonia/pneumonitis were referred electronically to the VW on discharge. Pulse oximeters were provided if oxygen saturations were <92%. The 'tracking board' was reviewed daily and phone calls carried out to assess patients for symptom improvement, stability or deterioration. If cause for concern was raised, same-day review for the patient at home was arranged via predetermined community pathways or patients were transferred urgently to hospital. Results The M:F ratio was 2:1 and 25% of patients were of black and minority ethnic origin. 71% of patients had at least 1 co-morbidity. 31% of patients were SARS-CoV-2 PCR negative on respiratory tract samples but had high clinical suspicion of COVID-19. 70% of patients had radiological changes on CXR/CT formally reported as being consistent with COVID-19. Median Length of stay (LOS) on the VW was 3.5 days [range 0-19], 85% of patients had a LOS £7 days. Around half (158, 53%) of patients had required oxygen during admission. Pulse oximeters were provided to 31 (10%) of patients. Outcomes are shown in figure 1. Thirty-eight (13%) patients re-attended the Emergency Department;28 were readmitted;of these, 3 were ventilated for respiratory failure, 5 had increasing oxygen requirements and 8 had confirmed pulmonary embolism. 12 had other reasons for admission. 2 patients readmitted by the VW died, both had underlying terminal diagnoses. Conclusions To our knowledge, this is the first description of the characteristics of patients discharged from UK hospitals with COVID-19. We have demonstrated that a virtual COVID-19 ward allowed early discharge of patients, offering a safety net and reassurance for patients and clinicians at the time of discharge. Use of pulse oximeters allowed for early identification of clinical deterioration, enabling prompt readmission when required.