PLoS ONE (Jan 2022)

What are the risk factors of hospital length of stay in the novel coronavirus pneumonia (COVID-19) patients? A survival analysis in southwest China.

  • Zhuo Wang,
  • Yuanyuan Liu,
  • Luyi Wei,
  • John S Ji,
  • Yang Liu,
  • Runyou Liu,
  • Yuxin Zha,
  • Xiaoyu Chang,
  • Lun Zhang,
  • Qian Liu,
  • Yu Zhang,
  • Jing Zeng,
  • Ting Dong,
  • Xinyin Xu,
  • Lijun Zhou,
  • Jun He,
  • Ying Deng,
  • Bo Zhong,
  • Xianping Wu

DOI
https://doi.org/10.1371/journal.pone.0261216
Journal volume & issue
Vol. 17, no. 1
p. e0261216

Abstract

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BackgroundThe 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.MethodsFirst, 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.ResultsFrom 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 (PConclusionsUnderstanding 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.