Investigating the Patterns of Readmission of Patients with COVID-19 and Its Associated Factors

Abstract

Background: Hospital readmission is a key measure of care quality in COVID-19 management, yet the factors driving readmission remain unclear and vary across healthcare settings. Objectives: To determine independent predictors of 60-day readmission among COVID-19 patients and propose a framework for risk-based post-discharge care. Methods: A matched case–control study was conducted at Taleghani Teaching Hospital (March 2020 - March 2023). From 7,182 admissions, 121 readmitted patients were matched 1:1 with controls by age, sex, comorbidities, and disease severity using propensity scores. Demographic, clinical, and laboratory data were analyzed using multivariate logistic regression to identify predictors of readmission. Results: The 60-day readmission rate was 1.68%, lower than international reports. Six independent predictors were identified: Older age, male sex, lower SPO₂, elevated potassium, higher blood urea nitrogen (BUN), and increased total bilirubin. Respiratory complications were the most frequent cause of readmission, followed by hepatic and renal dysfunction. Conclusions: COVID-19 readmission was uncommon in this study but was strongly associated with demographic, respiratory, renal, and hepatic factors. Risk-stratified discharge planning and targeted post-discharge monitoring, particularly for older male patients with abnormal biochemical markers, could further reduce preventable readmissions.