Risk factors of COVID-19 hospital stay prolongation: a retrospective analysis
Keywords:Coronavirus, COVID-19, Length of hospitalization
Introduction: COVID-19 is a global concern and since the number of infected cases and affected countries had a sudden raise, hospitals got faced a huge number of patients. Long hospitalization lengths might contribute to high rates of bed occupancy. So, we focused on the risk factors of prolonged hospitalization length in this study.
Methods: This was a retrospective review of COVID-19 patients with a positive SARS-CoV-2 nasopharyngeal swab test, who were admitted to Vasei Sabzevar Hospital from March 1, 2020 to August 31, 2021. The primary outcome was hospitalization length and the secondary outcome was in-hospital death. A comprehensive list of demographic and clinical variables was collected. Hospitalization length was compared through the variables. Bed occupancy was calculated in an epidemic state of respiratory disease to predict hospital capacity in future epidemics.
Results: Out of 772 patients (mean age of 58.52 ± 17.62 years; 50.4% male) who were studied, the average length of hospitalization was 6.39 ± 4.22 days. The majority of patients (85.5%) were discharged and 112 of them (14.5%) were deceased. Statistics did not show a significant difference between deceased and recovered patients in the duration of hospitalization (P=0.860). The correlation test showed a positive and significant correlation between the length of hospital stay and lymphocyte count (r=-0.130, P=0.001); while not so powerful. This test also showed a negative and significant correlation between the patient's oxygen saturation percentage and the duration of hospitalization (r=-0.134, P<0.001). patients who had a history of high blood pressure had a significantly longer hospitalization period (6.76±4.524 days) than people without hypertension (5.79±3.596 days), P=0.039. there was a significant difference between the groups of subjects with different hypoxia severities and patients with severe hypoxia stayed longer at the hospital compared to others, p=0.003. During this epidemic peak, the hospital's occupancy rate was around 54% which was optimal compared to the standard maximum of 80%; while is better to be calculated monthly.
Conclusion: Patients with underlying diseases, especially high blood pressure and patients with a low percentage of oxygen might need a longer duration of hospitalization. Our study data on hospitalization length should be interpreted with caution to not consider short hospitalization length as good an outcome as this stands for death time for deceased ones.
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