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Almost third of UK Covid hospital patients readmitted within four months

theguardian.com

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Re: Almost third of UK Covid hospital patients readmitted within four months

#31

Post by iso1210 »

makomk wrote: post #15
azakai wrote: post #11

Earlier quoted context omitted.

Yes, but that seems like a very relevant type of control group. If a person got COVID and ended up in the hospital, and that person wants to know what possible long-term harm that could cause them (that is, compared to had they not gotten COVID and not been hospitalized), then the article focused on exactly that.

Not really. The UK has been testing pretty much everyone who's admitted to hospital for COVID since the start of the outbreak regardless of why they were admitted, which means there's going to be quite a few people in the COVID and in hospital group who were actually admitted due to other, unrelated conditions. Particularly if they were being admitted to hospital regularly...

And throughout their stay. My father was vaccinated in January, went into hospital after a siezure (not unknown) a in mid febuary, he was tested on arrival, and was negative. Continued to be tested, and by early march (2 weeks after admittance) he tested positive.

Re: Almost third of UK Covid hospital patients readmitted within four months

#32

Post by surfpel »

peytn wrote: post #20
surfpel wrote: post #17

Earlier quoted context omitted.

The most useful result here is to isolate the impact of covid hospital admission status on the probability of mortality, not the difference between covid and other hospitalizations.

Anyone who’s even dipped a toe in this policy area can tell you that when old people and hospitals meet, gaudy statistics follow. It’s common knowledge in the field. To not include that context or any points of comparison seems irresponsible to me given the publicity.

> The increase in risk was not confined to the elderly and was not uniform across ethnicities

> Rate ratios comparing patients with covid-19 and matched controls were greater in individuals aged less than 70 than those aged 70 or more for all outcomes

> An alternative approach might have involved comparing outcomes after covid-19 and other hospital admissions; such research has recently been conducted with similar data sources to those in our own study (although with a smaller covid-19 cohort), and comparable rates of organ dysfunction were found between patients with covid-19 and patients with pneumonia who were discharged from hospital in 2019.36 We believe that our study design, where comparisons were made with the expected risk in the general population, was more relevant to public health policy, and complementary to the study that used non-covid hospital admissions as the comparison group. Also, the use of non-covid hospital admissions as the comparison group does not allow estimation of excess morbidity because non-covid admission does not necessarily represent an appropriate counterfactual situation to admission to hospital for covid-19, and the size and direction of the inferences will depend on the choice of control admissions.

Re: Almost third of UK Covid hospital patients readmitted within four months

#33

Post by mlyle »

peytn wrote: post #25
azakai wrote: post #14

Earlier quoted context omitted.

(I disagree, see discussion above: https://news.ycombinator.com/item?id=26672461 )

Essentially any contact with a hospital in that population produces eye-popping statistics. Having worked in this area, I’m of the opinion that the presentation of this work is misleading.

But the opposite would be misleading, too, in that the hospital contact was induced by COVID.

It's all confounded. If you compare to other hospital admits, you're finding an even-less-healthy population (because they had a reason to show up to the hospital -without- COVID). If you compare to the general populace, you risk inadequately controlling the comparison.

But if you want to know the increased risk people have subsequent to COVID hospitalization, perhaps the latter makes the most sense to measure.

Re: Almost third of UK Covid hospital patients readmitted within four months

#34

Post by nonameiguess »

gxqoz wrote: post #21
Tarsul wrote: post #5

what I find to be even more astonishing: "and about one in eight had died", so 1/8 of those who were in hospital for covid AND discharged afterwards, died within 4 months. We also had another article in the guardian that said that 1 million of people in the UK suffer from long covid ("Symptoms vary but include fatigue, muscle pain and difficulty concentrating."): https://www.theguardian.com/society/2021/apr/01/long-c…

I've seen some pushback that a lot of hard-to-diagnose chronic syndromes are now being deemed "long covid." My assumption is that at least some of this is happening as it's the trendiest disease of the moment. Not to say there aren't a lot of people with clear-cut long covid syndromes.

Just to add to the post-viral syndrome chorus, this happened to me when I was 20. I caught what seemed like a pretty normal flu, but it eventually morphed into bronchitis and then pneumonia because I was an idiot who thought he was immortal and continued going out clubbing and staying out late with friends and it was four months before I finally saw a doctor and took the advice to rest and get blasted with high dose antibiotics.

I was down for about two additional months after that, in which I caught another flu twice, and could barely get out of bed for a while. And then I proceeded to have complications from colds and flus that evolved to bronchitis or pneumonia every single flu season for the next 8 years.

It took nearly a decade to really recover from that. I see no reason to think any sufficiently bad respiratory infection with high enough viral load wouldn't do the same thing, especially to people much less healthy than 20 year-old me, a two-time state champion cross country runner in high school.

Re: Almost third of UK Covid hospital patients readmitted within four months

#35

Post by base698 »

Tarsul wrote: post #5

what I find to be even more astonishing: "and about one in eight had died", so 1/8 of those who were in hospital for covid AND discharged afterwards, died within 4 months. We also had another article in the guardian that said that 1 million of people in the UK suffer from long covid ("Symptoms vary but include fatigue, muscle pain and difficulty concentrating."): https://www.theguardian.com/society/2021/apr/01/long-c…

With the median death being > 80 is this surprising?

Re: Almost third of UK Covid hospital patients readmitted within four months

#36

Post by splithalf »

gxqoz wrote: post #21
Tarsul wrote: post #5

what I find to be even more astonishing: "and about one in eight had died", so 1/8 of those who were in hospital for covid AND discharged afterwards, died within 4 months. We also had another article in the guardian that said that 1 million of people in the UK suffer from long covid ("Symptoms vary but include fatigue, muscle pain and difficulty concentrating."): https://www.theguardian.com/society/2021/apr/01/long-c…

I've seen some pushback that a lot of hard-to-diagnose chronic syndromes are now being deemed "long covid." My assumption is that at least some of this is happening as it's the trendiest disease of the moment. Not to say there aren't a lot of people with clear-cut long covid syndromes.

One unexpected long covid symptom: writing buggy code. https://arstechnica.com/gadgets/2021/03/buffer-overruns-lice...

Re: Almost third of UK Covid hospital patients readmitted within four months

#37

Post by galangalalgol »

howinteresting wrote: post #24
gxqoz wrote: post #21

Earlier quoted context omitted.

I've seen some pushback that a lot of hard-to-diagnose chronic syndromes are now being deemed "long covid." My assumption is that at least some of this is happening as it's the trendiest disease of the moment. Not to say there aren't a lot of people with clear-cut long covid syndromes.

Or maybe, people have been dealing with post-viral syndromes for a long time, our society is completely unequipped to understand and deal with them, and they see post-COVID syndrome as finally a chance to address this. But taking that perspective requires correcting for the systematic underweighting of the testimonial evidence of patients of chronic illnesses. Less trendiness, more empathy, please.

A lot of post viral stuff seems to be autoimmune, and we don't treat autoimmune well. Chronic fatigue and fibromyalgia weren't even recognized as real things not that long ago. Others like RA or Hashi's we suppress the immune system and/or rely entirely on simple tests to determine medication levels instead of relying on patient testamony and testing instead for over medication symptoms. These feedback loops are amazingly complex and looking at a few numbers doesn't cut it. In addition we know diet and environmental triggers are a thing from many studies, but doctors don't say "eat more greens" anymore, they say lets do a test now take this pill.

Re: Almost third of UK Covid hospital patients readmitted within four months

#39

Post by tim333 »

Tarsul wrote: post #5

what I find to be even more astonishing: "and about one in eight had died", so 1/8 of those who were in hospital for covid AND discharged afterwards, died within 4 months. We also had another article in the guardian that said that 1 million of people in the UK suffer from long covid ("Symptoms vary but include fatigue, muscle pain and difficulty concentrating."): https://www.theguardian.com/society/2021/apr/01/long-c…

One in 8 died is pretty bad for average age 65.

Re: Almost third of UK Covid hospital patients readmitted within four months

#40

Post by incrudible »

morsch wrote: post #4
roenxi wrote: post #2

The article doesn't give us quite enough information - what percentage of hospitalised Covid patients are over 70? 70 year olds are getting to the point where they spend a lot of time in hospital. The "hospitalised for Covid" part of the sample group is introducing a lot of bias. Fit, young and healthy people are much less likely to end up in hospital. So it makes sense from the first that the group is suffering more…

Four times more often than the control group. Over a mean follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14 060 of 47 780) and more than 1 in 10 (5875) died after discharge, with these events occurring at rates four and eight times greater, respectively, than in the matched control group. Rates of respiratory disease (P

"Rates of respiratory disease (P

I could imagine COVID being causally implicated in respiratory disease or cardiovascular disease, but diabetes? That sounds to me like the control group wasn't representative.

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