survival analysis of hospital length of stay of novel coronavirus covid 19 pneumonia CORD-Papers-2021-10-25 (Version 1)

Title: Survival analysis of hospital length of stay of novel coronavirus (COVID-19) pneumonia patients in Sichuan, China
Abstract: Objective Allocation of medical resource is essential to a strong public health system in response to COVID-19. Analysis of confirmed COVID-19 patients' hospital length of stay in Sichuan can be informative to decision-making in other regions of the world. Design A retrospective cross-sectional study. Data and Method Data from confirmed COVID-19 cases in Sichuan Province were obtained from the National Notifiable Diseases Reporting System (NNDRS) and field survey. We collected information on demographic, epidemiological, clinical characteristics, and the length of hospital stay for confirmed patients. We conducted an exploratory analysis using adjusted multivariate cox-proportional models. Participants A total of 538 confirmed patients of COVID-19 infection in Sichuan Province from January to March 2020. Outcome measure The length of hospital stay after admissions for confirmed patients. Results From January 16, 2020 to March 4, 2020, 538 human cases of COVID-19 infection were laboratory-confirmed, and were hospitalized for treatment. Among these, 271 (50%) were 45 years of age or above, 285 (53%) were male, 450 (84%) were considered as having mild symptoms. The median hospital length of stay was 19 days (interquartile range (IQR): 14-23, Range: 3-41). Adjusted multivariate analysis showed that longer hospital length of stay was associated with factors aged 45 and over (HR: 0.74, 95% CI: 0.60-0.91), those admitted to provincial hospital (HR: 0.73, 95% CI: 0.54-0.99), and those with serious illness (HR: 0.66, 95% CI: 0.48-0.90); living in areas with more than 5.5 healthcare workers per 1000 population (HR: 1.32, 95% CI: 1.05-1.65) was associated with shorter hospital length of stay. There was no gender difference. Conclusions Preparation control measures of COVID-19 should involve the allocation of sufficient medical resources, especially in areas with older vulnerable populations and in areas that lack basic medical resources.
Published: 4/10/2020
DOI: 10.1101/2020.04.07.20057299
DOI_URL: http://doi.org/10.1101/2020.04.07.20057299
Author Name: wang, z
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wang_z
Author Name: Ji, J S
Author link: https://covid19-data.nist.gov/pid/rest/local/author/ji_j_s
Author Name: Liu, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_y
Author Name: Liu, R
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_r
Author Name: Zha, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zha_y
Author Name: Chang, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/chang_x
Author Name: Zhang, L
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhang_l
Author Name: Zhang, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhang_y
Author Name: Zeng, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zeng_j
Author Name: Dong, T
Author link: https://covid19-data.nist.gov/pid/rest/local/author/dong_t
Author Name: Xu, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/xu_x
Author Name: Zhou, L
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhou_l
Author Name: He, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/he_j
Author Name: Deng, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/deng_y
Author Name: Zhong, B
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhong_b
Author Name: Wu, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wu_x
sha: 490e713cc05ed77d20ce139f2349c471c4164fe3
license: medrxiv
source_x: MedRxiv; WHO
source_x_url: https://www.who.int/
url: http://medrxiv.org/cgi/content/short/2020.04.07.20057299v1?rss=1 https://doi.org/10.1101/2020.04.07.20057299
has_full_text: TRUE
Keywords Extracted from Text Content: Province COVID-19 patients patients human COVID-19 Patients people men h(t COVID-19 human patient Hubei Province body Hubei Figure 1B pulmonary β 1 People's Republic people residents Wuhan 1-3 Figure 1A serum b. the 3-41 Figure 1C patients β 2 coronavirus SAR-CoV-2 7 8 medRxiv Coronavirus persons Province female P<0.01 women inpatients oxygen medRxiv preprint
Extracted Text Content in Record: First 5000 Characters:Objective Allocation of medical resource is essential to a strong public health system in response to . Analysis of confirmed COVID-19 patients' hospital length of stay in Sichuan can be informative to decision-making in other regions of the world. Design A retrospective cross-sectional study. Data and Method Data from confirmed COVID-19 cases in Sichuan Province were obtained from the National Notifiable Diseases Reporting System (NNDRS) and field survey. We collected information on demographic, epidemiological, clinical characteristics, and the length of hospital stay for confirmed patients. We conducted an exploratory analysis using adjusted multivariate cox-proportional models. Participants A total of 538 confirmed patients of COVID-19 infection in Sichuan Province , 538 human cases of COVID-19 infection were laboratory-confirmed, and were hospitalized for treatment. Among these, 271 (50%) were 45 years of age or above, 285 (53%) were male, 450 (84%) were considered as having mild symptoms. The median hospital length of stay was 19 days (interquartile range (IQR): 14-23, Range: 3-41). Adjusted multivariate analysis showed that longer hospital length of stay was associated with factors aged 45 and over (HR: 0.74, 95% CI: 0.60-0.91), those admitted to provincial hospital (HR: 0.73, 95% CI: 0.54-0.99), and those with serious illness (HR: 0.66, 95% CI: 0.48-0.90); living in areas with more than 5.5 healthcare workers per 1000 population (HR: 1.32, 95% CI: 1.05-1.65) was associated with shorter hospital length of stay. There was no gender difference. Conclusions Preparation control measures of COVID-19 should involve the allocation of sufficient medical resources, especially in areas with older vulnerable populations and in areas that lack basic medical resources. Patients at least 45 years, those with serious illness, those living in areas with fewer healthcare workers per 1,000 people, and those admitted to higher levels of hospitalization had longer lengths of hospitalization, while gender, time interval from # Contributed equally. onset to visit the hospital had no effect on the length of the hospital stay. Preparation of timely evidence-based prevention and control measures for COVID-19 involve allocation of sufficient medical resources, especially in areas with older vulnerable populations and in areas that lack basic medical resources. Based on findings, it is of great significance to strengthen the construction of multi-level medical institutions in response to public health emergencies and occupation of medical resources. The characteristics of inpatients can be further subdivided to obtain more detailed inpatient characteristics. . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.07.20057299 doi: medRxiv preprint Sichuan Province has a population of more than 80 million people. Despite of being located adjacent to Hubei Province, where the COVID-19 transmission originated, 1-3 the number of confirmed cases of COVID-19 was fewer than 600 as of March, 2020. This is partially due to preventive measures taken by government authorities and residents quarantine measures. Thus far, many studies have reported COVID-19 epidemiological and clinical features, molecular and biological mechanisms, prevention and control management. [4] [5] [6] These descriptive studies have allowed researchers and policy makers to understand the incubation period and transmutability of SAR-CoV-2 7 8 . As of now, knowledge on factors affecting the hospital length of stay is evolving. As the global pandemic of COVID-19 progress in other regions of the world, insight into hospital length of stay is informative for planning of allocation of medical resources to those most in need. In this study, the relationship between demographic characteristics of confirmed patients, individual treatment behavior, local medical resources, hospital grade and length of stay in hospital were assessed in relation to hospital length of stay in Sichuan. We used data on laboratory-confirmed cases of COVID-19, which were reported to the Sichuan Center for Disease Control and Prevention (CDC) through the National Notifiable Diseases Reporting System (NNDRS). 9 In addition to the network of data reported by hospitals at all levels, part of the data come from a field survey of confirmed cases conducted by the staff of local or provincial CDC and Health Resources Report of Health Commission of Sichuan Province. 10 Demographic, epidemiological, and basic clinical data were obtained by combining these data sources. Combined the information of 538 confirmed patients in Sichuan Province from January to March 2020 was used for analysis, which included age, sex, place of residence, dates of illness onset, dates of diagnosis, hospital admission, discha
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