Risk Factors on Admission Associated with Hospital Length of Stay in Patients with COVID-19: A Retrospective Cohort Study

Abstract

Background: Epidemiological and clinical characteristics of patients with COVID-19 have been reported. Treating patients with COVID-19 is high cost, so investigating the risk factors for prolonged hospital length of stay (LOS) is useful. Knowing these risk factors could help identify COVID-19 patients with a poor prognosis early and thus improve outcomes for these patients. Methods: This retrospective study involved patients with COVID-19 laboratory-confirmed from the infectious Diseases Department of the First Affiliated Hospital of the University of Scienc and Technology of China, Hefei (discharged from January 20 to March 16, 2020). Demographic, clinical treatment, and laboratory data were extracted from medical records. Prolonged LOS was defined as equal to or greater than the median inhospitable stay time. We used univariable and multivariable logistic regression to explore risk factors associated with prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. Results: The median age of the 75 patients was 47 (interquartile range 31-54) years (range 5 to 91), and 57% were male. About 75% of the patients had mild or general disease. Odds of prolonged LOS was associated with female sex (aOR 0.19, 95%CI 0.05-0.63, p =0.01), fever (aOR 8.27, 95%CI 1.47-72.16, p = 0.028), and chronic kidney or liver disease on admission (aOR 13.73, 95%CI 1.95-145.4, p =0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9-0.98, p =0.007). Conclusions: Female sex, fever, chronic kidney or liver disease before admission and increasing creatinine level were associated with prolonged LOS in patients with COVID-19. Future research should evaluate and support interventions and treatments to improve outcomes for these high-risk groups. Funding Statement: This study received the following funding: Natural Science Foundation of China (11801540), Natural Science Foundation of Guangdong (2017A030310572) and Fundamental Research Funds for the Central Universities (WK2040170015, WK2040000016), the Science and Technology Planning Project of Guangdong Province (2017A010101030), the third Medical technology projects of Shantou City in 2018. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was approved by the Research Ethics Commission of the First Affiliated Hospital of the University of Science and Technology of China (2020-P-018) and the requirement for informed consent was waived by the ethics commission.