TY - JOUR
T1 - Home Oxygen After Hospitalization for COVID-19
T2 - Results From the Multi-Center OXFORD Study
AU - Freedman, Michael B.
AU - Kim, Yoo Jin
AU - Kaur, Ramandeep
AU - Jain, Bijal V.
AU - Adegunsoye, Ayodeji O.
AU - Chung, Yu Che
AU - Delisa, Julie A.
AU - Gardner, Jessica M.
AU - Gordon, Howard S.
AU - Greenberg, Jared A.
AU - Kaul, Malvika
AU - Khouzam, Nader
AU - Labedz, Stephanie L.
AU - Mokhlesi, Babak
AU - Rintz, Jacob
AU - Rubinstein, Israel
AU - Taylor, Analisa
AU - Vines, David L.
AU - Ziauddin, Lubna
AU - Gerald, Lynn B.
AU - Krishnan, Jerry A.
N1 - Publisher Copyright:
© 2024, American Association for Respiratory Care. All rights reserved.
PY - 2024/3/1
Y1 - 2024/3/1
N2 - BACKGROUND: In the first months of the pandemic, prior to the introduction of proven-effective treatments, 15–37% of patients hospitalized with COVID-19 were discharged on home oxygen. After proven-effective treatments for acute COVID-19 were established by evidence-based guide-lines, little remains known about home oxygen requirements following hospitalization for COVID-19. METHODS: This was a retrospective, multi-center cohort study of subjects hospitalized for COVID-19 between October 2020–September 2021 at 3 academic health centers. Information was abstracted from electronic health records at the index hospitalization and for 60 d after discharge. The World Health Organization COVID-19 Clinical Progression Scale score was used to identify patients with severe COVID-19. RESULTS: Of 517 subjects (mean age 58 y, 47% female, 42% Black, 36% Hispanic, 22% with severe COVID-19), 81% were treated with systemic corticosteroids, 61% with remdesivir, and 2.5% with tocilizumab. About one quarter of subjects were discharged on home oxygen (26% [95% CI 22–29]). Older age (adjusted odds ratio [aOR] 1.02 per 5 y [95% CI 1.02–1.02]), higher body mass index (aOR 1.02 per kg/m2 [1.00–1.04]), diabetes (yes vs no, aOR 1.73 [1.46–2.02]), severe COVID-19 (vs moderate, aOR 3.19 [2.19–4.64]), and treatment with systemic corticosteroids (yes vs no, aOR 30.63 [4.51–208.17]) were associated with an increased odds of discharge on home oxygen. Comorbid hypertension (yes vs no, aOR 0.71 [0.66–0.77) was associated with a decreased odds of home oxygen. Within 60 d of hospital discharge, 50% had documentation of pulse oximetry; in this group, home oxygen was discontinued in 46%. CONCLUSIONS: About one in 41 subjects were prescribed home oxygen after hospitalization for COVID-19, even after guidelines established proven-effective treatments for acute illness. Evidence-based strategies to reduce the requirement for home oxygen in patients hospitalized for COVID-19 are needed.
AB - BACKGROUND: In the first months of the pandemic, prior to the introduction of proven-effective treatments, 15–37% of patients hospitalized with COVID-19 were discharged on home oxygen. After proven-effective treatments for acute COVID-19 were established by evidence-based guide-lines, little remains known about home oxygen requirements following hospitalization for COVID-19. METHODS: This was a retrospective, multi-center cohort study of subjects hospitalized for COVID-19 between October 2020–September 2021 at 3 academic health centers. Information was abstracted from electronic health records at the index hospitalization and for 60 d after discharge. The World Health Organization COVID-19 Clinical Progression Scale score was used to identify patients with severe COVID-19. RESULTS: Of 517 subjects (mean age 58 y, 47% female, 42% Black, 36% Hispanic, 22% with severe COVID-19), 81% were treated with systemic corticosteroids, 61% with remdesivir, and 2.5% with tocilizumab. About one quarter of subjects were discharged on home oxygen (26% [95% CI 22–29]). Older age (adjusted odds ratio [aOR] 1.02 per 5 y [95% CI 1.02–1.02]), higher body mass index (aOR 1.02 per kg/m2 [1.00–1.04]), diabetes (yes vs no, aOR 1.73 [1.46–2.02]), severe COVID-19 (vs moderate, aOR 3.19 [2.19–4.64]), and treatment with systemic corticosteroids (yes vs no, aOR 30.63 [4.51–208.17]) were associated with an increased odds of discharge on home oxygen. Comorbid hypertension (yes vs no, aOR 0.71 [0.66–0.77) was associated with a decreased odds of home oxygen. Within 60 d of hospital discharge, 50% had documentation of pulse oximetry; in this group, home oxygen was discontinued in 46%. CONCLUSIONS: About one in 41 subjects were prescribed home oxygen after hospitalization for COVID-19, even after guidelines established proven-effective treatments for acute illness. Evidence-based strategies to reduce the requirement for home oxygen in patients hospitalized for COVID-19 are needed.
KW - Long COVID
KW - SARS-CoV-2l
KW - durable medical equipment
KW - hypoxemia
KW - post-acute sequelae of SARS-CoV-2
UR - https://www.scopus.com/pages/publications/85186195832
UR - https://www.scopus.com/pages/publications/85186195832#tab=citedBy
U2 - 10.4187/respcare.11436
DO - 10.4187/respcare.11436
M3 - Editorial
C2 - 38176902
AN - SCOPUS:85186195832
SN - 0020-1324
VL - 69
SP - 281
EP - 289
JO - Respiratory care
JF - Respiratory care
IS - 3
ER -