Introducción. La Hospitalización a Domicilio (HAD) es una modalidad de ingreso alternativa que puede resultar de gran utilidad en momentos de estrés sanitario como la pandemia de COVID-19. En el presente trabajo se recoge el manejo de los pacientes ingresados con COVID-19 en HAD en dos hospitales comarcales españoles durante dos años.
Métodos. Se realizó un estudio descriptivo, observacional y retrospectivo de los pacientes ingresados en HAD con COVID-19. Posteriormente se realizó un análisis para caracterizar a los pacientes que fallecieron en HAD o a 30 días del alta y otro para comparar el manejo entre la primera fase del estudio (2020) y la segunda (2021 y parte de 2022).
Resultados. Se reclutaron 167 pacientes. Un 52,1% se trasladaron para vigilar que continuaban mejorando frente a un 40,7% en los que se hizo para vigilar que no empeoraran. Los pacientes que fallecieron en HAD resultaron más ancianos (87,5 años de media), más comórbidos y con mayor probabilidad de ser no reanimables en caso de paro cardiaco (No RCP) (85%). En la segunda fase del estudio se ingresaron pacientes más ancianos, más comórbidos y en mayor grado No RCP que los ingresados en 2020.
Conclusiones. La HAD es un recurso útil para aumentar la resiliencia de los sistemas sanitarios en casos de estrés como supuso la enfermedad por COVID-19. El desarrollo y crecimiento de las unidades ya existentes, así como la creación de otras nuevas allá donde no existan, puede ser una herramienta básica para la medicina del futuro.

Introduction. Home Hospitalization (HH) is an alternative hospitalization modality that can be very useful in times of health stress such as the COVID-19 pandemic. This paper includes the management of patients admitted with COVID-19 in HH in two county spanish hospitals for two years.
Methods. A descriptive, observational and retrospective study of all patients admitted at HH with a diagnosis of COVID-19 disease was carried out. Subsequently, further analysis was carried out to characterize the patients who died in HH or 30 days after discharge and another to compare the management between the first phase of the study (2020) and the second one (2021 and part of 2022).
Results. A total of 167 patients were recruited. A 52.1% moved to watch that the recovery continued compared to 40.7% in which it was done to watch that they did not worsen. The patients who died in HAD were older (mean 87.5 years), more comorbid and more likely to have do-not resucitate orders (DNR) in case of cardiac arrest (85%). In the second phase of the study, older patients, more comorbid patients and with a greater degree of DNR orders were admitted than those admitted throughout 2020.
Conclusions. HAD is a useful resource to increase the resilience of health systems in cases of stress such as the disease caused by COVID-19. The development and growth of existing units, as well as the creation of new ones where they do not exist, could be a basic tool for the medicine of the future.