Abstract
The coronavirus disease (COVID-19) pandemic has overwhelmed health care systems in many countries and bed availability has become a concern. In this context, the present study aimed to analyze the hospitalization and intensive care unit (ICU) times in patients diagnosed with COVID-19. The study covered 55,563 ICU admissions and 238,075 hospitalizations in Brazilian Health System units from February 22, 2020, to June 7, 2021. All the patients had a positive COVID-19 diagnosis. The symptoms analyzed included: fever, dyspnea, low oxygen saturation (SpO2 < 95%), cough, respiratory distress, fatigue, sore throat, diarrhea, vomiting, loss of taste, loss of smell, and abdominal pain. We performed Cox regression in two models (ICU and hospitalization times). Hazard ratios (HRs) and survival curves were calculated by age group. The average stay was 14.4 days for hospitalized patients and 12.4 days for ICU patients. For hospitalized cases, the highest hazard mean values, with a positive correlation, were for symptoms of dyspnea (HR = 1.249; 95% confidence interval [CI], 1.225–1.273) and low oxygen saturation (HR = 1.157; 95% CI 1.137–1.178). In the ICU, the highest hazard mean values were for respiratory discomfort (HR = 1.194; 95% CI 1.161–1.227) and abdominal pain (HR = 1.100; 95% CI 1.047–1.156). Survival decreased by an average of 2.27% per day for hospitalization and 3.27% per day for ICU stay. Survival by age group curves indicated that younger patients were more resistant to prolonged hospital stay than older patients. Hospitalization was also lower in younger patients. The mortality rate was higher in males than females. Symptoms related to the respiratory tract were associated with longer hospital stay. This is the first study carried out with a sample of 238,000 COVID-19 positive participants, covering the main symptoms and evaluating the hospitalization and ICU times.
Highlights
The coronavirus disease (COVID-19) pandemic has overwhelmed health care systems in many countries and bed availability has become a concern
This retrospective analytical cohort study identified factors and mortality risks that interfere with the length of hospital and intensive care unit (ICU) stay in individuals with COVID-19
The results showed that symptoms associated with the respiratory system, namely dyspnea and SpO2 < 95%, were positively associated with a more extended total hospital stay
Summary
The coronavirus disease (COVID-19) pandemic has overwhelmed health care systems in many countries and bed availability has become a concern. Symptoms related to the respiratory tract were associated with longer hospital stay This is the first study carried out with a sample of 238,000 COVID19 positive participants, covering the main symptoms and evaluating the hospitalization and ICU times. A very recent investigation ordered by the US administration in May 2021, which could bring us closer to a definitive conclusion on the origins of the virus that has killed more than 4 million people globally and wrecked national economies, has reported inconclusive results on whether the virus jumped from animals to humans as part of a natural process or might have accidentally escaped from a Wuhan laboratory in central C hina[5,6] Despite these doubts about the origin of the novel coronavirus, the most accepted explanation of transmissibility is that this virus spreads. Cytokine storms and viral evasion of cellular immune responses are thought to play important roles in disease s everity[11]
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