ABSTRACT
SESSION TITLE: COVID-19 Infections: Issues During and After Hospitalization SESSION TYPE: Original Investigations PRESENTED ON: 10/17/2022 01:30 pm - 02:30 pm PURPOSE: To characterize the health care utilization (HCU) of patients after discharge from a hospitalization due to Coronavirus Disease 2019 (COVID-19). METHODS: Retrospective analysis from a national cohort using the Optum Clinformatics Data Mart. Included all adults hospitalized with a primary diagnosis of COVID-19 between April 2020 and March 2021, with prior 12 months of continuous enrollment. HCU of patients discharged to a home setting was evaluated in three periods (0-90 days;91-180 days;181-275 days post-discharge). HCU was defined as emergency department (ED) visits, inpatient (IP) admissions, rehabilitation/skilled nursing facility (SNF) admissions, outpatient (OP) and telemedicine visits and was expressed as the number of visits per 10,000 person-days to adjust for time from discharge. We also examined the distribution of office visits by provider specialty RESULTS: We identified 91,374 unique patients who were discharged alive after a hospitalization due to COVID-19. A greater percentage of patients was discharged to a home setting (n=63,674 or 65.6%: home 41.54%;home with home health services 14.65%: home with outpatient services 4.42%) than to a non-home setting (26.23%: i.e., SNF, hospice, rehabilitation facility, etc.). The patients discharged to a home setting were mostly white (58.8%), females (53.4%), whose mean age was 72.4 (SD± 12). The percentage of office visits to Primary care provider (57.8%;48.3%, 47.7%), Cardiology (7.7%;8.0%;7.4%) Pulmonary medicine (4.7%;3.9%;3.1%) varied in the 3 time periods evaluated. Additionally, the outpatient visits to endocrinology (1.3%, 1.6%, 1.7%), Neurology (1.1%, 1.5%, 1.5%), Physical Medicine & Rehabilitation (0.7%, 1.0%, 1.2%), Psychiatry (0.7%, 0.9%, 1.1%) and other mental health professionals (0.4%, 0.5%, 0.5%) increased over time. CONCLUSIONS: In our nationally representative study, health care utilization remains high among patients discharged to a home setting after a hospitalization due to COVID-19. Additionally, the use of mental health services increased overtime among survivors. CLINICAL IMPLICATIONS: Understanding post-discharge health care utilization of patients after an index hospitalization due to COVID-19 will help health systems prepare and allocate resources for the most likely to be used services. DISCLOSURES: No relevant relationships by Alexander Duarte No relevant relationships by Yong-Fang Kuo No relevant relationships by Shawn Nishi, value=Consulting fee Removed 04/03/2022 by Shawn Nishi No relevant relationships by Efstathia Polychronopoulou No relevant relationships by Daniel Puebla Neira No relevant relationships by Gulshan Sharma No relevant relationships by Mohammed Zaidan
ABSTRACT
RATIONALE: The association between smoking status and severe Coronavirus Disease 2019 (COVID-19) remains controversial. OBJECTIVE: To assess the risk of hospitalization (as a marker of severe COVID-19) in patients by smoking status: former, current and never smokers, who tested positive for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV2) at an academic medical center in the United States. METHODS: We conducted a retrospective cohort study in patients with SARS-COV2 between March-1-2020 and January-31-2021 to identify the risk of hospitalization due to COVID-19 by smoking status. RESULTS: We identified 10216 SARS-COV2-positive patients with complete documentation of smoking habits. Within 14 days of a SARS-COV2 positive test, 1150 (11.2%) patients were admitted and 188 (1.8%) died. Significantly more former smokers were hospitalized from COVID-19 than current or never smokers (21.2% former smokers;7.3% current smokers;10.4% never smokers, p<0.0001). In univariable analysis, former smokers had higher odds of hospitalization from COVID-19 than never smokers (OR 2.31;95% CI 1.94-2.74). This association remained significant when analysis was adjusted for age, race and gender (OR 1.28;95% CI 1.06-1.55), but became non-significant when analysis included Body Mass Index, previous hospitalization and number of comorbidities (OR 1.05;95% CI 0.86-1.29). In contrast, current smokers were less likely than never smokers to be hospitalized due to COVID-19. CONCLUSIONS: Significantly more former smokers were hospitalized and died from COVID-19 than current or never smokers. This effect is mediated via age and comorbidities in former smokers.