Predictors of prolonged hospitalization in COVID-19 patients

Od početka pandemije COVID-19, zdravstveni sustavi diljem svijeta suočavaju se s brojnim izazovima koje ona donosi. Klinička slika ove bolesti varira od blage do kritične, a zabilježen je i znatan broj asimptomatskih infekcija. Najčešći simptomi su povišena tjelesna temperatura, bolovi u mišićima, gubitak/promjena osjeta okusa ili mirisa te simptomi respiratornog sustava poput kašlja. Kronični komorbiditeti prepoznati su kao prediktori lošeg kliničkog ishoda, a istraživanja su pokazala da je čak 10-15% oboljelih u razdoblju prije dostupnosti cijepljenja zahtijevalo hospitalizaciju. Ovo istraživanje provedeno je s ciljem analiziranja potencijalne povezanosti kliničkih i laboratorijskih parametara s potrebom prolongirane hospitalizacije (>21 dan) osoba sa SARS-CoV-2 infekcijom. Cilj nam je također bio analizirati povezanost prolongirane hospitalizacije s komorbiditetima oboljelih, kao i dugoročne ishode nakon otpusta pacijenata iz bolnice. Retrospektivno smo analizirali podatke Registra hospitalno liječenih COVID-19 bolesnika u Respiracijskom centru KB Dubrava. Od ukupno 5959 analiziranih pacijenata, 799 (13.4%) ih je bilo liječeno dulje od 21 dan. Analizom smo utvrdili da je s potrebom prolongirane hospitalizacije povezan niz faktora uključujući težinu prezentacije samog COVID-19 prilikom prijema u bolnicu, pojedine kronične komorbiditete bolesnika, upućivanje iz vanjske bolničke ustanove te komplikacije tijekom boravka u bolnici. Dobiveni podaci također ukazuju na to da je prolongirana hospitalizacija loš prognostički pokazatelj po otpustu bolesnika i povezana s povećanim mortalitetom nakon otpusta iz bolnice.Since the beginning of the COVID-19 pandemic, healthcare systems worldwide have been facing numerous challenges it brought them. Clinical presentation of this illness varies from mild to critical, but a significant amount of asymptomatic cases has been noted as well. The most common symptoms include fever, myalgia, loss of/change in taste or smell and respiratory symptoms like cough. Chronic comorbidities have been recognized as predictors of adverse clinical outcome of COVID-19, with researches showing that prior to availability of vaccination up to 10-15% of all cases required hospitalization. This study aimed to analyze a potential connection between the clinical and laboratory parameters and the need of prolonged hospitalization (>21 days) of patients with SARS-CoV-2 infection. Another one of our goals was analyzing the connection of prolonged hospitalization to patients' comorbidities, as well as the long-term outcomes after discharging hospitalized patients. We have retrospectively analyzed data from the Registry of hospitalized COVID-19 patients in the Respiratory center KB Dubrava. Out of 5959 patients that were analyzed, 799 (13.4%) of them were treated for more than 21 days. We have determined that there is a series of factors connected to prolonged hospitalization, including the severity of COVID-19 symptoms at the time of patient admission, certain chronic comorbidities those patients had, referral from other hospitals and complications that have arised during their stay at the hospital. The data we have obtained also imply that prolonged hospitalization is a negative indicator of patient outcome following their dishcarge from the hospital

Predictors of prolonged hospitalization in COVID-19 patients

Od početka pandemije COVID-19, zdravstveni sustavi diljem svijeta suočavaju se s brojnim izazovima koje ona donosi. Klinička slika ove bolesti varira od blage do kritične, a zabilježen je i znatan broj asimptomatskih infekcija. Najčešći simptomi su povišena tjelesna temperatura, bolovi u mišićima, gubitak/promjena osjeta okusa ili mirisa te simptomi respiratornog sustava poput kašlja. Kronični komorbiditeti prepoznati su kao prediktori lošeg kliničkog ishoda, a istraživanja su pokazala da je čak 10-15% oboljelih u razdoblju prije dostupnosti cijepljenja zahtijevalo hospitalizaciju. Ovo istraživanje provedeno je s ciljem analiziranja potencijalne povezanosti kliničkih i laboratorijskih parametara s potrebom prolongirane hospitalizacije (>21 dan) osoba sa SARS-CoV-2 infekcijom. Cilj nam je također bio analizirati povezanost prolongirane hospitalizacije s komorbiditetima oboljelih, kao i dugoročne ishode nakon otpusta pacijenata iz bolnice. Retrospektivno smo analizirali podatke Registra hospitalno liječenih COVID-19 bolesnika u Respiracijskom centru KB Dubrava. Od ukupno 5959 analiziranih pacijenata, 799 (13.4%) ih je bilo liječeno dulje od 21 dan. Analizom smo utvrdili da je s potrebom prolongirane hospitalizacije povezan niz faktora uključujući težinu prezentacije samog COVID-19 prilikom prijema u bolnicu, pojedine kronične komorbiditete bolesnika, upućivanje iz vanjske bolničke ustanove te komplikacije tijekom boravka u bolnici. Dobiveni podaci također ukazuju na to da je prolongirana hospitalizacija loš prognostički pokazatelj po otpustu bolesnika i povezana s povećanim mortalitetom nakon otpusta iz bolnice.Since the beginning of the COVID-19 pandemic, healthcare systems worldwide have been facing numerous challenges it brought them. Clinical presentation of this illness varies from mild to critical, but a significant amount of asymptomatic cases has been noted as well. The most common symptoms include fever, myalgia, loss of/change in taste or smell and respiratory symptoms like cough. Chronic comorbidities have been recognized as predictors of adverse clinical outcome of COVID-19, with researches showing that prior to availability of vaccination up to 10-15% of all cases required hospitalization. This study aimed to analyze a potential connection between the clinical and laboratory parameters and the need of prolonged hospitalization (>21 days) of patients with SARS-CoV-2 infection. Another one of our goals was analyzing the connection of prolonged hospitalization to patients' comorbidities, as well as the long-term outcomes after discharging hospitalized patients. We have retrospectively analyzed data from the Registry of hospitalized COVID-19 patients in the Respiratory center KB Dubrava. Out of 5959 patients that were analyzed, 799 (13.4%) of them were treated for more than 21 days. We have determined that there is a series of factors connected to prolonged hospitalization, including the severity of COVID-19 symptoms at the time of patient admission, certain chronic comorbidities those patients had, referral from other hospitals and complications that have arised during their stay at the hospital. The data we have obtained also imply that prolonged hospitalization is a negative indicator of patient outcome following their dishcarge from the hospital

Predictors of prolonged hospitalization of COVID-19 patients

Purpose Despite the importance of hospital bed network during the pandemic, there are scarce data available regarding factors predictive of prolonged length of hospitalization of COVID-19 patients. Methods We retrospectively analyzed a total of 5959 consecutive hospitalized COVID-19 patients in period 3/2020–6/2021 from a single tertiary-level institution. Prolonged hospitalization was defned as hospital stay>21 days to account for mandatory isolation period in immunocompromised patients. Results Median length of hospital stay was 10 days. A total of 799 (13.4%) patients required prolonged hospitalization. Factors that remained independently associated with prolonged hospitalization in multivariate analysis were severe or critical COVID-19 and worse functional status at the time of hospital admission, referral from other institutions, acute neurological, acute surgical and social indications for admission vs admission indication of COVID-19 pneumonia, obesity, chronic liver disease, hematological malignancy, transplanted organ, occurrence of venous thromboembolism, occurrence of bacterial sepsis and occurrence of Clostridioides difcile infection during hospitalization. Patients requiring prolonged hospitalization experienced higher post-hospital discharge mortality (HR=2.87, P<0.001). Conclusions Not only severity of COVID-19 clinical presentation but also worse functional status, referral from other hospitals, certain indications for admission, certain chronic comorbidities, and complications that arise during hospital stay independently refect on the need of prolonged hospitalization. Development of specifc measures aimed at improvement of functional status and prevention of complications might reduce the length of hospitalizatio