Evaluation of re-hospitalized COVID-19 patients in a hospital

SUMMARY PURPOSE: This study intends to investigate the reasons for re-hospitalization, complaints, and prognoses of COVID-19 patients after being discharged. METHODS: COVID-19 patients who were re-hospitalized at the Sakarya University Training and Research Hospital were examined. Reverse transcriptase-polymerase chain reaction (RT-PCR), tomography and laboratory results, demographic characteristics, and prognostic results were recorded retrospectively. RESULTS: A total of 60 patients, including 26 males (43.3%) and 34 females (56.7%), with repeated admissions to the hospital for COVID-19 symptoms, were included in the study with a mean age of 56.9 (± 22.5) (median value = 61, age range = 3-88). The number of days of the second hospitalization was statistically significantly higher (p < 0.05). Patient age and number of days of hospitalization were strongly positively correlated (p < 0.01). A total of 11 patients (18%) had negative results in their first RT-PCR and subsequently tested positive in their second hospitalization. In addition, 10 (17.5%) of the patients who underwent thoracic tomography had unilateral involvement, 34 (59.6%) had bilateral involvement, and 13 (22.8%) had no significant results. Note that 4 (6.6%) of the patients re-hospitalized died in the hospital, while 56 (93.4%) were discharged once more. All of the four patients that died were female with a mean age of 81.5 years. CONCLUSION: Particularly patients with advanced age and comorbidities should be examined more carefully when discharged; if their complaints are repeated, they should be advised to quickly contact the emergency service.

RESUMO OBJETIVO: Este estudo pretende investigar as causas para re-hospitalizações, as reclamações e os prognósticos de pacientes com COVID-19 após a alta hospitalar. MÉTODOS: Pacientes com COVID-19 internados que foram re-hospitalizados no Sakarya University Training and Research Hospital foram examinados. Os resultados da reação em cadeia de polimerase precedida de transcrição reversa (RT-PCR), tomografia e dos exames laboratoriais, as características demográficas e os resultados prognósticos foram registrados retrospectivamente. RESULTADOS: Um total de 60 pacientes, 26 do sexo masculino (43,3%) e 34 do sexo feminino (56,7%), com internações repetidas devido a sintomas de COVID-19 foram incluídos no estudo, com uma idade média de 56,9 (± 22,5) (mediana = 61, faixa etária = 3-88). O número de dias da segunda internação foi estatisticamente significativamente maior (p < 0,05). A idade do paciente e o número de dias de internação apresentaram uma forte correlação positiva (p < 0,01). Um total de 11 pacientes (18%) apresentaram resultados negativos no primeiro RT-PCR e posteriormente tiveram resultados positivos na segunda internação. Além disso, 10 (17,5%) dos pacientes submetidos a tomografia de tórax apresentaram envolvimento unilateral, 34 (59,6%) bilateral, e 13 (22,8%) não apresentaram resultados significativos. Nota-se que 4 (6,6%) dos pacientes re-hospitalizados morreram no hospital, enquanto 56 (93,4%) receberam alta mais uma vez. Todos os quatro pacientes que morreram eram do sexo feminino, com idade média de 81,5 anos. CONCLUSÃO: Principalmente pacientes com idade avançada e comorbidades devem ser examinados com mais cuidado no momento da alta hospitalar; caso suas queixas se repitam, eles devem ser aconselhados a contatar o serviço de emergência o quanto antes.

Religious affiliation as a predictor of involuntary psychiatric admission: a brazilian 1-year follow-up study.

OBJECTIVE: The aim of this study was to analyze factors associated with the legal status at psychiatric admission of individuals with psychosis or bipolar disorder in a Latin-American cultural setting. METHODS: Prospective observational study was conducted in São Paulo, Brazil. We analyzed 169 individuals with bipolar or psychotic disorder in need of hospitalization. Sociodemographic data, data on the psychiatric disorder, information about the hospital stay, and data at time of discharge were collected. Their families were also contacted by telephone and interviews were conducted at 1, 2, 6, and 12 months post-discharge as a follow-up. RESULTS: Eighty-eight patients (52%) had a voluntary admission and 81 (48%) had an involuntary admission (IA). The average length of admission was similar in both groups (17.4 vs. 17.3 days, p = 0.22). It was significantly more common for IA patients to be admitted because of other-directed aggressiveness (47.7 vs. 65.4%, p = 0.02). The percentage of individuals that needed physical restraint during hospital stay among IA patients was also significantly higher (11.4 vs. 25.9%, p = 0.01). Having any religious affiliations was significantly related to an IA status as well (OR = 4-6.48). CONCLUSION: Our results suggest that cultural factors related to religious affiliations might play an important role in determining psychiatric hospitalization legal status. Religion might possibly influence someone's judgment and insight about his/her psychiatric disorder. This study restates the importance of dealing with the subject of religion with patients.