Abstract
The global epidemic of novel coronavirus pneumonia (COVID-19) has resulted in substantial healthcare resource consumption. Since patients' hospital length of stay (LoS) is at stake in the process, an investigation of COVID-19 patients' LoS and its risk factors becomes urgent for a better understanding of regional capabilities to cope with COVID-19 outbreaks. First, we obtained retrospective data of confirmed COVID-19 patients in Sichuan province via National Notifiable Diseases Reporting System (NNDRS) and field surveys, including their demographic, epidemiological, clinical characteristics and LoS. Then we estimated the relationship between LoS and the possibly determinant factors, including demographic characteristics of confirmed patients, individual treatment behavior, local medical resources and hospital grade. The Kaplan-Meier method and the Cox Proportional Hazards Model were applied for single factor and multi-factor survival analysis. From January 16, 2020 to March 4, 2020, 538 human cases of COVID-19 infection were laboratory-confirmed, and were hospitalized for treatment, including 271 (50%) patients aged ≥ 45, 285 (53%) males, and 450 patients (84%) with mild symptoms. The median LoS was 19 (interquartile range (IQR): 14-23, range: 3-41) days. Univariate analysis showed that age and clinical grade were strongly related to LoS (P<0.01). Adjusted multivariate analysis showed that the longer LoS was associated with those aged ≥ 45 (Hazard ratio (HR): 0.74, 95% confidence interval (CI): 0.60-0.91), admission to provincial hospital (HR: 0.73, 95% CI: 0.54-0.99), and severe illness (HR: 0.66, 95% CI: 0.48-0.90). By contrast, the shorter LoS was linked with residential areas with more than 5.5 healthcare workers per 1,000 population (HR: 1.32, 95% CI: 1.05-1.65). Neither gender factor nor time interval from illness onset to diagnosis showed significant impact on LoS. Understanding COVID-19 patients' hospital LoS and its risk factors is critical for governments' efficient allocation of resources in respective regions. In areas with older and more vulnerable population and in want of primary medical resources, early reserving and strengthening of the construction of multi-level medical institutions are strongly suggested to cope with COVID-19 outbreaks.
Highlights
The first case of novel coronavirus disease-2019 (COVID-19) was admitted to hospital in Wuhan, Hubei province, on December 12, 2019 [1]
Univariate analysis showed that age and clinical grade were strongly related to length of stay (LoS) (P
In areas with older and more vulnerable population and in want of primary medical resources, early reserving and strengthening of the construction of multi-level medical institutions are strongly suggested to cope with COVID-19 outbreaks
Summary
The first case of novel coronavirus disease-2019 (COVID-19) was admitted to hospital in Wuhan, Hubei province, on December 12, 2019 [1]. Many studies have reported epidemiological, clinical features, molecular and biological mechanisms, as well as prevention and control management of COVID-19 [4,5,6]. These descriptive studies enabled researchers and policy makers to understand the incubation period and transmutability of SAR-CoV-2 [7, 8]. Advance attention and evaluation on resouce consumption was demanded, and insight into COVID-19 patients’ hospital length of stay (LoS) and its risk factors could contribute to the proper allocation of medical resources. Since patients’ hospital length of stay (LoS) is at stake in the process, an investigation of COVID-19 patients’ LoS and its risk factors becomes urgent for a better understanding of regional capabilities to cope with COVID-19 outbreaks
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