University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, and Visiting Nurse Service of New York, New York, New York (K.H.B.).
Visiting Nurse Service of New York, New York, New York (M.M., Y.B.).
Ann Intern Med. 2021 Mar;174(3):316-325. doi: 10.7326/M20-5206. Epub 2020 Nov 24.
Little is known about recovery from coronavirus disease 2019 (COVID-19) after hospital discharge.
To describe the home health recovery of patients with COVID-19 and risk factors associated with rehospitalization or death.
Retrospective observational cohort.
New York City.
1409 patients with COVID-19 admitted to home health care (HHC) between 1 April and 15 June 2020 after hospitalization.
Covariates and outcomes were obtained from the mandated OASIS (Outcome and Assessment Information Set). Cox proportional hazards models were used to estimate the hazard ratio (HR) of risk factors associated with rehospitalization or death.
After an average of 32 days in HHC, 94% of patients were discharged and most achieved statistically significant improvements in symptoms and function. Activity-of-daily-living dependencies decreased from an average of 6 (95% CI, 5.9 to 6.1) to 1.2 (CI, 1.1 to 1.3). Risk for rehospitalization or death was higher for male patients (HR, 1.45 [CI, 1.04 to 2.03]); White patients (HR, 1.74 [CI, 1.22 to 2.47]); and patients with heart failure (HR, 2.12 [CI, 1.41 to 3.19]), diabetes with complications (HR, 1.71 [CI, 1.17 to 2.52]), 2 or more emergency department visits in the past 6 months (HR, 1.78 [CI, 1.21 to 2.62]), pain daily or all the time (HR, 1.46 [CI, 1.05 to 2.05]), cognitive impairment (HR, 1.49 [CI, 1.04 to 2.13]), or functional dependencies (HR, 1.09 [CI, 1.00 to 1.20]). Eleven patients (1%) died, 137 (10%) were rehospitalized, and 23 (2%) remain on service.
Care was provided by 1 home health agency. Information on rehospitalization and death after HHC discharge is not available.
Symptom burden and functional dependence were common at the time of HHC admission but improved for most patients. Comorbid conditions of heart failure and diabetes, as well as characteristics present at admission, identified patients at greatest risk for an adverse event.
No direct funding.
出院后，人们对新冠病毒疾病 2019（COVID-19）的康复情况知之甚少。
描述 COVID-19 患者的家庭健康康复情况，并确定与再住院或死亡相关的危险因素。
回顾性观察队列。
纽约市。
2020 年 4 月 1 日至 6 月 15 日期间，1409 名 COVID-19 患者在住院后接受家庭健康护理（HHC）。
从强制性 OASIS（结果和评估信息集）中获取协变量和结果。使用 Cox 比例风险模型估计与再住院或死亡相关的危险因素的风险比（HR）。
在 HHC 平均 32 天后，94%的患者出院，大多数患者的症状和功能有显著改善。日常生活活动依赖程度从平均 6（95%CI，5.9 至 6.1）下降到 1.2（CI，1.1 至 1.3）。男性患者（HR，1.45[CI，1.04 至 2.03]）、白人患者（HR，1.74[CI，1.22 至 2.47]）、心力衰竭患者（HR，2.12[CI，1.41 至 3.19]）、合并并发症的糖尿病患者（HR，1.71[CI，1.17 至 2.52]）、过去 6 个月内 2 次或以上急诊就诊（HR，1.78[CI，1.21 至 2.62]）、每日或持续疼痛（HR，1.46[CI，1.05 至 2.05]）、认知障碍（HR，1.49[CI，1.04 至 2.13]）或功能依赖（HR，1.09[CI，1.00 至 1.20]）的患者再住院或死亡风险较高。11 名患者（1%）死亡，137 名患者（10%）再次住院，23 名患者（2%）仍在接受服务。
护理由 1 家家庭健康机构提供。HHC 出院后再住院和死亡的信息不可用。
在接受 HHC 治疗时，症状负担和功能依赖很常见，但大多数患者的情况有所改善。心力衰竭和糖尿病等合并症以及入院时的特征，确定了发生不良事件风险最高的患者。
无直接资助。
