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This retrospective cohort study of 60\u2010day readmission included 105\u2009543 COVID\u201019 patients at 21 US healthcare systems who were discharged alive between February 2020 and November 2021. Generalized linear mixed regression analyses tested predictors of 60\u2010day readmission and severity. The all\u2010cause readmission rate was 15% (95% confidence interval [CI]\u2009=\u200910%\u201321%), with 22% (95% CI\u2009=\u200918%\u201326%) of readmitted patients needing intensive care, and 6% (95% CI\u2009=\u200905%\u201307%) dying. Factors associated with readmission included male sex, government insurance, positive smoking history, co\u2010morbidity burden, longer index admissions, and diagnoses at index admission (e.g., cancer, chronic kidney disease, and liver disease). Death and intensive care rates at readmission declined postvaccine availability. 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