Understanding factors influencing the length of hospital stay among non-severe COVID-19 patients: A retrospective cohort study in a Fangcang shelter hospital

• Published in: PloS one 2020-10, Vol.15 (10), p.e0240959-e0240959
• Main Authors: Wu, Shishi, Xue, Lanping, Legido-Quigley, Helena, Khan, Mishal, Wu, Hua, Peng, Xiaoxiang, Li, Xuewen, Li, Ping
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antiviral drugs; Asymptomatic; Betacoronavirus - genetics; Biology and Life Sciences; Blood; Body temperature; Cardiovascular Diseases - epidemiology; Care and treatment; Clinical decision making; Cohort analysis; Comorbidity; Computed tomography; Coronavirus Infections - diagnostic imaging; Coronavirus Infections - epidemiology; Coronavirus Infections - therapy; Coronavirus Infections - virology; Coronaviruses; COVID-19; Critical care; Decision making; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Disease transmission; Electronic health records; Epidemics; Evaluation; Female; Fever; Health care; Health services; Hospital stays; Hospitals; Humans; Length of Stay; Lymphocyte Count; Lymphocytes; Male; Medical imaging; Medical records; Medical treatment; Medicine; Medicine and Health Sciences; Middle Aged; Oxygen saturation; Pandemics; Patients; Pneumonia; Pneumonia, Viral - diagnostic imaging; Pneumonia, Viral - epidemiology; Pneumonia, Viral - therapy; Pneumonia, Viral - virology; Public health; Quarantine; Regression analysis; Research and Analysis Methods; Retrospective Studies; Risk analysis; Risk Factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Sex Factors; Shelters; Signs and symptoms; Tomography, X-Ray Computed; Viral diseases
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0240959

As a novel concept of responding to disease epidemics, Fangcang shelter hospitals were deployed to expand the health system's capacity and provide medical services for non-severe COVID-19 patients during the outbreak in Wuhan. To give insights on patient management within Fangcang hospitals, we conducted a retrospective analysis to: 1) describe the characteristics of the patients admitted to Fangcang hospitals and 2) explore risk factors for longer length of stay (LOS). We enrolled 136 confirmed COVID-19 patients, including asymptomatic patients and those with mild symptoms, who were hospitalized in the Wuti Fangcang Hospital. 58 patients completed the treatment and discharged before 1 March 2020. After describing patients' demographic and clinical characteristics, exposure history, treatment received and time course of the disease, we conducted linear regression analysis to identify factors influencing LOS. We found that patients having fever before admission were hospitalized 3.5 days (95%CI 1.39 to 5.63, p = 0.002) longer than those without fever and that patients having bilateral pneumonia were hospitalized 3.4 days (95%CI 0.49 to 6.25, p = 0.023) longer than those with normal CT scan results. We also found weak evidence suggesting that patients with diabetes were hospitalized 3.2 days longer than those without diabetes (95%CI -0.2 to 6.56, p = 0.065). However, we observed no significant differences in LOS between symptomatic and asymptomatic patients and between patients who received treatment and those without treatment. Longer duration of hospitalization among non-severe COVID-19 patients is associated with having fever, bilateral pneumonia on CT scan and diabetes. However, being asymptomatic and using supportive medications at the early stage of infection do not have significant influences on LOS. Our study is a single-centered study with relatively small sample size. The findings provide evidence for predicting hospital bed demand in a novel response scenario and may help decision-makers in preparing for ramping up the health system capacity.