P-1903. Beyond the Hospital Walls: Unveiling the Post-COVID-19 Path to Institutionalization

Abstract Background Functional decline (decrement in physical/cognitive functioning that causes inability to engage in daily activities) is common following acute hospitalization in elderly patients and is associated with hospital readmission, institutionalization, and mortality. We sought to determine rate of institutionalization after COVID-19 hospitalization and to characterize functional decline of patients institutionalized after COVID-19. Characteristics of COVID-19 and pre-COVID-19 hospitalized patients Methods We conducted a retrospective cohort study using health administrative database from Lombardy Welfare Directorate. We included patients 44 years-old and older who were discharged from a Lombardy hospital with a diagnosis of COVID-19 between Feb 1st, 2020 and Jun, 30th, 2022 (COVID cohort) compared with patients discharged from the same sites with any diagnosis from Jan, 1st 2018 until Dec 31st, 2018 (pre-COVID cohort). Our primary outcome was institutionalization during the 6-month period following hospital discharge. We also compared functional decline parameters at institutionalization in the two cohorts. Trend of institutionalization during the COVID-19 pandemic waves Results Our study included 141651 patients hospitalized for COVID-19 and 251459 individuals acutely hospitalized before COVID-19 pandemic (pre-COVID-cohort) for any diagnosis (Table 1). Among them, 3835 (2.7%) and 7976 (3.2%) were institutionalized during the following 6-months, respectively. Rates of institutionalization in the COVID-cohort increased over time during the observation period (Table 2). At institutionalization, patients hospitalized for COVID-19 were younger (median 83.6 years vs 84.9 years, p >0.0001), and more frequently female (37.8% vs 32.3%, p< 0.0001). Moreover, they had more frequently pressure sores (20.5% vs 16.3%, p< 0.0001) and urinary catheter (27% vs 19.8%, p< 0.0001) and fewer assistive devices (p< 0.0001) as compared to the pre-COVID cohort (Table 3). Characteristics of institutionalized patients following acute COVID-19-realated hospitalizations vs non-COVID-19 acute hospitalization Conclusion Hospitalization for COVID-19 was followed by institutionalization at the same rate as acute hospitalization for all-cause in the pre-COVID period. However, functional decline, pressure sores, urinary catheter, incontinence, and use of assistive devices following COVID-19 hospitalization in the elderly population should be closely monitored. Disclosures All Authors: No reported disclosures