Research ArticleOriginal Research

Home Oxygen After Hospitalization for COVID-19: Results From the Multi-Center OXFORD Study

Michael B Freedman, Yoo Jin Kim, Ramandeep Kaur, Bijal V Jain, Ayodeji O Adegunsoye, Yu-Che Chung, Julie A DeLisa, Jessica M Gardner, Howard S Gordon, Jared A Greenberg, Malvika Kaul, Nader Khouzam, Stephanie L Labedz, Babak Mokhlesi, Jacob Rintz, Israel Rubinstein, Analisa Taylor, David L Vines, Lubna Ziauddin, Lynn B Gerald and Jerry A Krishnan
Respiratory Care March 2024, 69 (3) 281-289; DOI: https://doi.org/10.4187/respcare.11436

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

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 guidelines, 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 4 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.

Footnotes

  • Correspondence: Michael B Freedman MD MPH, Breathe Chicago Center, Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, University of Illinois Chicago, 1220 South Wood Street, 3rd Floor (MC 619), Chicago, IL 60608. E-mail: mfreed2{at}uic.edu

  • Dr Adegunsoye discloses relationships with the National Institute of Health, Genentech, Inogen, and Boehringer Ingelheim. Dr Gerald discloses relationships with the National Institute of Health, American Lung Association, UpToDate, American Lung Association of Arizona, and the Arizona Asthma Coalition. Dr Krishnan discloses relationships with the National Institutes of Health, COPD Foundation, Regeneron, Sergey Brin Family Foundation, Patient-Centered Outcomes Research Institute, American Lung Association, GSK, AstraZeneca, CereVu Medical, Propeller Health and ResMed, BData, University of Chicago, American Academy of Asthma, Allergy, and Immunology, Global Initiative for Asthma, American Thoracic Society, Central Society of Clinical and Translational Research, and the Respiratory Health Association. Dr Vines discloses relationships with the Rice Foundation, Teleflex Medical, Elsevier, Dräger, Mayo Clinic Didier Memorial Lecture, and the National Board for Respiratory Care. The remaining authors have disclosed no conflicts of interest.

  • Portions of this work were presented at the American Thoracic Society 2022 International Conference, held May 13–18, 2022, in San Francisco, California; and at the American Thoracic Society 2023 International Conference, held May 19–24, 2023, in Washington, District of Columbia.

  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • This work was funded by the National Heart, Lung, and Blood Institute grant number T32HL144909 (Dr Freedman) and the Clinical and Translational Science Award Program grant number UL1TR002003 (University of Illinois Chicago Center for Clinical and Translational Science). The funders of this work had no role in study design, data collection and analysis, preparation of the manuscript, or decision to publish.

  • See the Related Editorial on Page 379

View Full Text

Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$30.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Back to top

In this issue

 

Print
Download PDF
Article Alerts
Email Article
Citation Tools

Jump to section

Related Articles

Cited By...

Keywords