537. Outpatient Parenteral Antimicrobial Therapy Readmissions from Post-Acute Care Facilities due to Coronavirus Disease 2019

Abstract

BackgroundRisk factors for morbidity and mortality in coronavirus disease 2019 (COVID-19) include older age, and cardiac and pulmonary comorbidities. In addition, nursing home residents have been one of the most heavily affected populations during this pandemic. Due to insurance reasons, patients requiring outpatient parenteral antimicrobial therapy (OPAT) may be discharged to a post-acute care facility (PACF) for the sole purpose of receiving intravenous antibiotics, placing these patients at higher risk of COVID-19 infection. This study evaluated hospital readmissions due to COVID-19 in OPAT patients.MethodsAdult patients who received OPAT between March 16 and May 31, 2020 were included. Patients were identified via an OPAT database and reason for readmission was reviewed via the electronic medical record. Patients with ongoing courses of OPAT as of May 31, 2020 were excluded. The primary outcome was readmission due to COVID while receiving OPAT. Results were analyzed using descriptive statistics.ResultsDuring the study period, 266 OPAT patients were identified, with 88 (31%) patients discharged to PACFs. There were 49 (18%) total readmissions, with 3 (6%) readmitted due to COVID-19. All 3 patients were readmitted from unique PACFs. This resulted in 3/16 (19%) readmissions due to COVID-19 in patients discharged to PACFs as compared to none for OPAT patients discharged to home.ConclusionPatients discharged to PACFs are at increased risk of COVID-19 infection. Efforts should be made to increase availability of home OPAT services for patients who have no need for skilled care other than intravenous antimicrobials.Disclosures All Authors: No reported disclosures