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Patient outcomes following emergency admission to hospital for COVID-19 compared with influenza: retrospective cohort study

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Title: Patient outcomes following emergency admission to hospital for COVID-19 compared with influenza: retrospective cohort study
Authors: Woodcock, T
Greenfield, G
Lalvani, A
Majeed, A
Aylin, P
Item Type: Journal Article
Abstract: Background We examine differences in posthospitalisation outcomes, and health system resource use, for patients hospitalised with COVID-19 during the UK’s first pandemic wave in 2020, and influenza during 2018 and 2019. Methods This retrospective cohort study used routinely collected primary and secondary care data. Outcomes, measured for 90 days follow-up after discharge were length of stay in hospital, mortality, emergency readmission and primary care activity. Results The study included 5132 patients admitted to hospital as an emergency, with COVID-19 and influenza cohorts comprising 3799 and 1333 patients respectively. Patients in the COVID-19 cohort were more likely to stay in hospital longer than 10 days (OR 3.91, 95% CI 3.14 to 4.65); and more likely to die in hospital (OR 11.85, 95% CI 8.58 to 16.86) and within 90 days of discharge (OR 7.92, 95% CI 6.20 to 10.25). For those who survived, rates of emergency readmission within 90 days were comparable between COVID-19 and influenza cohorts (OR 1.07, 95% CI 0.89 to 1.29), while primary care activity was greater among the COVID-19 cohort (incidence rate ratio 1.30, 95% CI 1.23 to 1.37). Conclusions Patients admitted for COVID-19 were more likely to die, more likely to stay in hospital for over 10 days and interact more with primary care after discharge, than patients admitted for influenza. However, readmission rates were similar for both groups. These findings, while situated in the context of the first wave of COVID-19, with the associated pressures on the health system, can inform health service planning for subsequent waves of COVID-19, and show that patients with COVID-19 interact more with healthcare services as well as having poorer outcomes than those with influenza.
Issue Date: 15-Jun-2023
Date of Acceptance: 7-Jun-2022
URI: http://hdl.handle.net/10044/1/98586
DOI: 10.1136/thoraxjnl-2021-217858
ISSN: 0040-6376
Publisher: BMJ
Start Page: 706
End Page: 712
Journal / Book Title: Thorax
Volume: 78
Issue: 7
Copyright Statement: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Publication Status: Published
Online Publication Date: 2022-07-27
Appears in Collections:Department of Infectious Diseases
National Heart and Lung Institute
Faculty of Medicine
Institute of Global Health Innovation
Imperial College London COVID-19
School of Public Health

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