Table 2

Factors associated with COVID-19 readmission to eight metropolitan Atlanta hospitals (March–December 2020)—multivariable regression; age 1:1 match

Total population,
N=926, n (%)
Non-readmitted,
N=463, n (%)
Readmitted,
N=463, n (%)
Crude modelAdjusted model*
OR (95% CI)P valueOR (95% CI)P value
Age group, years
 <45172 (18.6)86 (18.6)86 (18.6)Ref (1.0)Ref (1.0)
 45–64348 (37.6)174 (37.6)174 (37.6)1.0 (0.7 to 1.4)0.990.8 (0.5 to 1.2)0.35
 65–79270 (29.2)135 (29.2)135 (29.2)1.0 (0.7 to 1.5)0.980.7 (0.5 to 1.2)0.31
 ≥80136 (14.7)68 (14.7)68 (14.7)1.0 (0.6 to 1.6)0.990.7 (0.4 to 1.1)0.14
Sex
 Women432 (46.7)220 (47.5)212 (45.8)Ref (1.0)Ref (1.0)
 Men494 (53.3)243 (52.5)251 (54.2)1.0 (0.8 to 1.3)0.941.0 (0.8 to 1.3)0.99
Insurance status
 Private Insurance (including Kaiser Permanente)406 (43.8)219 (47.3)187 (40.4)Ref (1.0)Ref (1.0)
 Medicare340 (36.7)163 (35.2)177 (38.2)1.3 (1.0 to 1.7)0.101.1 (0.8 to 1.5)0.66
 Medicaid94 (10.2)37 (8.0)57 (12.3)1.8 (1.1 to 2.9)0.011.6 (1.0 to 2.6)0.07
 VA55 (5.9)28 (6.0)27 (5.8)1.1 (0.6 to 2.0)0.671.4 (0.6 to 2.9)0.42
 Uninsured31 (3.3)16 (3.5)15 (3.2)1.1 (0.5 to 2.3)0.801.1 (0.8 to 1.5)0.65
Race/ethnicity
 White (non-Hispanic)183 (19.8)87 (18.8)96 (20.7)Ref (1.0)Ref (1.0)
 Black (non-Hispanic)570 (61.6)281 (60.7)289 (62.4)1.0 (0.7 to 1.4)0.930.9 (0.6 to 1.3)0.51
 Hispanic58 (6.3)29 (6.3)29 (6.3)0.9 (0.5 to 1.5)0.611.0 (0.6 to 1.9)0.96
 Asian23 (2.5)10 (2.2)13 (2.8)0.9 (0.4 to 2.0)0.760.9 (0.4 to 2.1)0.85
 Other/unknown92 (9.9)56 (12.1)36 (7.8)0.7 (0.4 to 1.2)0.200.5 (0.2 to 1.1)0.08
Comorbidities
 Obesity408 (45.3)216 (47.8)192 (42.8)0.8 (0.6 to 1.1)0.080.7 (0.5 to 0.9)<0.01
 Hypertension668 (72.1)324 (70.0)344 (74.3)1.6 (1.2 to 2.2)<0.0011.4 (1.1 to 2.0)0.04
 Diabetes394 (42.5)189 (40.8)205 (44.3)1.2 (0.9 to 1.5)0.181.1 (0.8 to 1.5)0.62
 Hyperlipidemia358 (38.7)173 (37.4)185 (40.0)1.1 (0.9 to 1.5)0.420.8 (0.6 to 1.1)0.28
 Chronic lung disease127 (13.7)59 (12.7)68 (14.7)1.4 (1.0 to 2.1)0.081.3 (0.8 to 2.0)0.24
Chronic kidney disease
 Stages 3 and 4168 (18.1)60 (13.0)108 (23.3)2.4 (1.7 to 3.4)<0.0012.1 (1.4 to 3.2)<0.001
 Stage 5 and ESRD93 (10.7)28 (6.4)65 (14.9)2.1 (1.4 to 3.3)<0.0011.8 (1.1 to 2.9)0.01
 Chronic congestive heart failure250 (27.0)106 (22.9)144 (31.1)1.7 (1.3 to 2.4)<0.0011.3 (0.9 to 1.8)0.21
 Other cardiovascular disease353 (40.5)167 (38.4)186 (42.7)1.2 (0.9 to 1.6)0.181.0 (0.7 to 1.3)0.99
 Mental health condition†209 (22.6)105 (22.7)104 (22.5)1.0 (0.8 to 1.4)0.891.1 (0.8 to 1.6)0.56
 Cancer80 (8.6)29 (6.3)51 (11.0)3.2 (1.8 to 5.7)<0.0014.9 (2.5 to 9.7)<0.001
 HIV13 (1.4)5 (1.1)8 (1.7)1.6 (0.5 to 5.0)0.412.3 (0.6 to 7.9)0.20
Charlson Comorbidity Index‡
 0 (low risk)163 (22.5)98 (27.8)65 (17.5)Ref (1.0)Ref (1.0)
 1–3 (medium risk)447 (61.8)208 (59.1)239 (64.4)2.0 (1.4 to 2.8)<0.0012.6 (1.6 to 4.2)<0.001
 ≥4 (high risk)113 (15.6)46 (13.1)67 (18.1)3.2 (1.9 to 5.3)<0.0014.8 (2.1 to 11.0)<0.001
Index admission treatment
 Remdesivir233 (27.7)130 (34.3)103 (22.2)0.5 (0.4 to 0.7)<0.0010.5 (0.4 to 0.8)<0.001
 Dexamethasone419 (49.8)186 (49.1)233 (50.3)0.9 (0.7 to 1.2)0.430.8 (0.6 to 1.1)0.21
 Remdesivir and dexamethasone216 (25.7)122 (32.2)94 (20.3)0.6 (0.4 to 0.8)<0.0010.6 (0.4 to 0.7)0.002
 Required intensive care unit204 (22.0)113 (24.4)91 (19.7)0.6 (0.5 to 0.9)0.0030.5 (0.4 to 0.7)<0.001
 Required mechanical ventilation100 (11.9)65 (17.2)35 (7.6)0.4 (0.2 to 0.6)<0.0010.3 (0.2 to 0.5)<0.001
Index admission length of stay
 ≤7 days574 (65.9)294 (67.6)280 (64.2)Ref (1.0)Ref (1.0)
 8–14 days149 (17.1)64 (14.7)85 (19.5)1.4 (0.9 to 2.0)0.071.3 (0.9 to 1.8)0.23
 >14 days148 (17.0)77 (17.7)71 (16.3)1.0 (0.7 to 1.4)0.860.8 (0.5 to 1.2)0.26
Index admission disposition
 Home (self-care)512 (58.8)258 (59.3)254 (58.3)Ref (1.0)Ref (1.0)
 Home (with home health services)133 (15.3)44 (10.1)89 (20.4)2.1 (1.4 to 3.1)<0.0011.8 (1.2 to 2.8)0.007
 Long-term acute care hospital7 (0.8)3 (0.7)4 (0.9)1.4 (0.3 to 6.1)0.690.7 (0.1 to 3.9)0.71
 Skilled nursing facility102 (11.7)40 (9.2)62 (14.2)1.6 (1.0 to 2.4)0.041.3 (0.8 to 2.1)0.26
 Hospice (home or inpatient)25 (2.9)19 (4.4)6 (1.4)0.3 (0.1 to 0.8)0.020.3 (0.1 to 0.7)0.008
 Transferred to another hospital27 (3.1)18 (4.1)9 (2.1)0.5 (0.2 to 1.2)0.110.5 (0.2 to 1.2)0.14
 Other§24 (2.8)12 (2.8)12 (2.8)1.0 (0.4 to 2.3)0.971.0 (0.4 to 2.4)0.98
  • Length of stay (of index admission) was not available for VA Medical Center data.

  • *Adjusted for: gender, obesity, race/ethnicity, hypertension, diabetes, hyperlipidemia, chronic lung disease, chronic kidney disease, congestive heart failure, and mental disease.

  • †Mental health condition include depression, anxiety, bipolar disorder, and schizophrenia.

  • ‡Charlson Comorbidity Index was not available for the academic safety-net hospital.

  • §Other was the combination of other rehab, left against medical advice or discontinued care, and other discharge dispositions not included above.

  • ¶Data from all eight hospitals, including six academic health system hospitals, one academic safety-net hospital, and one VA Hospital.

  • ESRD, end-stage renal disease; VA, Veterans Affairs.