Abstract

Background and AimsHospital readmissions among COVID‐19 patients have increased the load on the healthcare systems and added more pressure to hospital capacity. This affects the ability to accommodate newly diagnosed COVID‐19 patients and other non‐COVID‐19 patients who require hospitalization. Therefore, this systematic review aims to understand the rates of and risk factors for hospital readmissions and all‐cause mortality among COVID‐19 patients who were hospitalized after being discharged following index hospitalization.MethodsOur systematic review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021232324) and prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis Protocols (PRISMA‐P) 2015 statement. We will search MEDLINE (Ovid), EMBASE (Ovid), MedRxiv, Web of Science (Science Citation Index), ProQuest Coronavirus research database, Cochrane Covid‐19 study register, and WHO COVID‐19: Global literature on coronavirus disease will be identified from December 31, 2019, to May 31, 2021. Two investigators will independently screen titles and abstracts and select studies reporting hospital readmissions among COVID‐19 patients. Further, data extraction and risk of bias assessment will be carried out separately by these independent reviewers. We will extract data on demographics, readmissions, all‐cause mortality, emergency department visits, comorbidities, and factors associated with hospitalization among COVID‐19 patients. Random‐effect meta‐analysis will be performed if homogeneous groups of studies are found. The combined evidence will be further stratified according to important background characteristics if the data allow.DiscussionThis systematic review will summarize the available epidemiological evidence regarding rates of hospital readmissions, comorbidities, and related factors among COVID‐19 patients who were readmitted after index hospitalization. A better understanding of the relationship between patient profiles and the rate of hospitalization will be helpful in the development of guidelines for patient management.

Highlights

  • As of September 7, 2021, the COVID-19 pandemic has resulted in more than 222 million cases and 4.5 million deaths worldwide and will continue to have far reaching impacts on healthcare systems for many years.[1]

  • Specific questions to be answered in this systematic review are as follows: 1. What are the rates of and risk factors for hospital readmission, and emergency department visits among COVID-19 patients who were discharged after index hospitalization? 2

  • The synthesis of the current literature for COVID-19 related readmissions is vital in developing mechanisms to mitigate this costly event

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Summary

| INTRODUCTION

As of September 7, 2021, the COVID-19 pandemic has resulted in more than 222 million cases and 4.5 million deaths worldwide and will continue to have far reaching impacts on healthcare systems for many years.[1]. There is limited systematic evidence available on patient readmission after initial hospital discharge. What are the rates of and risk factors for hospital readmission (or inpatient hospitalization), and emergency department visits among COVID-19 patients who were discharged after index hospitalization? 2. What are the common comorbidities and other factors (demographic and clinical) associated with hospital readmission after a patient's initial COVID-19 hospitalization and discharge? 3. What is the all-cause mortality rate among COVID-19 patients who were hospitalized after being discharged following index hospitalization?

| METHODS
| Study design
Findings
| DISCUSSION
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