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Study Examines Outcomes After Initial Hospitalization for Severe COVID-19 in VA Hospitals

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A study published in JAMA in December 2020 sought to examine outcomes after initial hospitalization for severe COVID-19, measuring the rate of readmission, reasons for readmission, and rate of death after hospital discharge among patients with COVID-19 in the nationwide Veterans Affairs (VA) health care system.

Researchers identified index hospitalizations for COVID-19 among veterans at 132 VA hospitals (admitted March 1–June 1, 2020; discharged March 1–July 1, 2020) in the VA’s Corporate Data Warehouse.

In this national cohort of VA patients, the study found 27% of survivors of COVID-19 hospitalization were readmitted or died by 60 days after discharge, and this rate was lower than matched survivors of pneumonia or heart failure. However, rates of readmission or death were higher than pneumonia or heart failure during the first 10 days after discharge following COVID-19 hospitalization, suggesting a period of heightened risk of clinical deterioration. Study limitations include the inability to measure readmissions to non-VA hospitals and an older, male-predominant study population, who may be at higher risk of severe manifestations of COVID-19.

The study concluded public health surveillance or clinical trials focused exclusively on inpatient mortality may substantially underestimate burdens of COVID-19.

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