Postdischarge Evaluation for Individuals Hospitalized With COVID-19

Gail Berkenblit, MD, PhD; Kaelin O'Connell, MD; Sara Mixter, MD, MPH; Caitlin Dowd-Green, PharmD; Rosalyn W. Stewart, MD, MS

Disclosures

South Med J. 2022;115(1):13-17. 

In This Article

Abstract and Introduction

Abstract

A 46-year-old financial analyst with a medical history of obesity, hypertension, and paroxysmal atrial fibrillation presents to her general practitioner for a postdischarge appointment following hospitalization for coronavirus disease 2019 (COVID-19). The patient initially presented to the hospital with a cough after exposure to a coronavirus-infected patient at her church. Her course was complicated by acute respiratory distress syndrome (ARDS), requiring intubation, as well as intermittent episodes of atrial fibrillation with rapid ventricular response. She was successfully extubated after 7 days and ultimately discharged home with plans for close follow-up. The patient lives with her husband and two teenage daughters.

Introduction

Primary care providers (PCPs) now face a novel clinical scenario: postdischarge care for patients with COVID-19. In a study of 138 patients hospitalized for COVID-19 in Wuhan, China, discharged patients had an average hospital stay of 10 days, with courses that were complicated by ARDS, venous thromboembolism (VTE), arrhythmias, and shock.[1] The World Health Organization estimates an overall recovery time from COVID-19 of 2 weeks for mild infections and 3 to 6 weeks for severe disease.[2] Thus, many discharged patients will need continuing management of pulmonary conditions, surveillance for secondary infections, monitoring for cardiac complications, and screening for depression or posttraumatic stress disorder (PTSD) in the outpatient setting. Clinicians also must address ending home isolation and safe timelines for returning to work. Here, we discuss special considerations in caring for patients with COVID-19 following hospital discharge.

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