Investigating Factors Impacting Hospitalization Duration in COVID-19 Patients: A Retrospective Case-Control Study in Jordan
DOI:
https://doi.org/10.35516/jjps.v18i1.1951Keywords:
COVID-19, Length of hospital stay, JordanAbstract
Objective: Coronavirus disease 2019 (COVID-19) is a severe acute respiratory illness of the upper respiratory tract. Evaluating the variables that influence the period of hospitalization and complications in COVID-19 patients can help effectively and safely decrease undesirable events. Therefore, the present study aimed to evaluate parameters influencing the length of hospital stay (LOS) in COVID-19 patients.
Patients and Methods: A retrospective case-control study involving hospitalized patients due to COVID-19. Demographic information, clinical treatment, and laboratory data were obtained from their medical records. Laboratory assessments included C-reactive protein (CRP), D-Dimer, lactate dehydrogenase (LDH), ferritin, urea, creatinine, estimated glomerular filtration rate (eGFR), uric acid, and complete blood count. Statistical analyses involved bivariate and multivariate logistic regressions to identify predictors of prolonged LOS.
Results: The median LOS for 83 patients was 7 days (IQR = 6–8). The median age of the patients was 58 years. Approximately half the patients were in the high-risk group (44.6%). The multivariate logistic regression analysis revealed that high neutrophil count (AOR = 1.144 95% CI 1.059–1.236, p = 0.001) increased the odds of prolonged LOS. In contrast, high creatinine levels decreased the odds of prolonged LOS (AOR 0.431, 95% CI 0.211–0.880, p = 0.021).
Conclusions: LOS was associated with increased neutrophil and decreased creatinine. Understanding these factors can assist in optimizing care and resource allocation in hospitals during health crises.
References
Jarab A. S., Al-Qerem W., Mukattash T. L., Al-Hajjeh D., Al-Azayzih A., and Abu Hammour K. Impact of Distance Learning on Pharmacy and Pharm.D Undergraduates during the COVID-19 Pandemic in Jordan. Jordan Journal of Pharmaceutical Sciences. 2022; 15(3):355–364. https://doi.org/10.35516/jjps.v15i3.409 DOI: https://doi.org/10.35516/jjps.v15i3.409
Al-Qerem W., Safar M., Safar I., and Al-Ibadah M. Identifying factors associated with increased rate of mortality of COVID-19 patients among Jordanian population: A multicenter case-controlled retrospective study. Jordan Journal of Pharmaceutical Sciences. 2023; 16(2):483. https://doi.org/10.35516/jjps.v16i2.1542 DOI: https://doi.org/10.35516/jjps.v16i2.1542
Jarab A. S., Al-Qerem W., Mukattash T. L., Alqudah S. G., Abu-Zaytoun L., Al-Azayzih A., and Khdour M. Public Perception of Pharmacist’s Role during COVID-19 Outbreak in Jordan. Jordan Journal of Pharmaceutical Sciences. 2022; 15(3):365–377.
https://doi.org/10.35516/jjps.v15i3.410 DOI: https://doi.org/10.35516/jjps.v15i3.410
Deng S. Q. and Peng H. J. Characteristics of and Public Health Responses to the Coronavirus Disease 2019 Outbreak in China. Journal of Clinical Medicine. 2020; 9(2). doi: 10.3390/jcm9020575. PubMed PMID: 32093211; PubMed Central PMCID: PMCPMC7074453. DOI: https://doi.org/10.3390/jcm9020575
Han Q., Lin Q., Jin S., and You L. Coronavirus 2019-nCoV: A brief perspective from the front line. The Journal of Infection. 2020; 80(4):373-377. doi: 10.1016/j.jinf.2020.02.010. PubMed PMID: 32109444; PubMed Central PMCID: PMCPMC7102581. DOI: https://doi.org/10.1016/j.jinf.2020.02.010
Razu S. R., Yasmin T., Arif T. B., Islam M. S., Islam S. M. S., Gesesew H. A., et al. Challenges Faced by Healthcare Professionals During the COVID-19 Pandemic: A Qualitative Inquiry From Bangladesh. Frontiers in Public Health. 2021; 9. doi: 10.3389/fpubh.2021.647315. DOI: https://doi.org/10.3389/fpubh.2021.647315
Sakka M., Connors J. M., Hékimian G., Martin-Toutain I., Crichi B., Colmegna I., et al. Association between D-Dimer levels and mortality in patients with coronavirus disease 2019 (COVID-19): a systematic review and pooled analysis. J Med Vasc. 2020; 45(5):268-274. doi: 10.1016/j.jdmv.2020.05.003. PubMed PMID: 32862984; PubMed Central PMCID: PMCPMC7250752. DOI: https://doi.org/10.1016/j.jdmv.2020.05.003
Nicola M., Alsafi Z., Sohrabi C., Kerwan A., Al-Jabir A., Iosifidis C., et al. The socio-economic implications of the coronavirus pandemic (COVID-19): A review. Int J Surg. 2020; 78:185-193. doi: 10.1016/j.ijsu.2020.04.018. PubMed PMID: 32305533. DOI: https://doi.org/10.1016/j.ijsu.2020.04.018
Maison D., Jaworska D., Adamczyk D., and Affeltowicz D. The challenges arising from the COVID-19 pandemic and the way people deal with them. A qualitative longitudinal study. PLOS ONE. 2021; 16(10):e0258133. doi: 10.1371/journal.pone.0258133. DOI: https://doi.org/10.1371/journal.pone.0258133
Fu Y., Zhong W., Liu T., Li J., Xiao K., Ma X., et al. Early Prediction Model for Critical Illness of Hospitalized COVID-19 Patients Based on Machine Learning Techniques. Frontiers in Public Health. 2022; 10. doi: 10.3389/fpubh.2022.880999. DOI: https://doi.org/10.3389/fpubh.2022.880999
Fumagalli C., Rozzini R., Vannini M., Coccia F., Cesaroni G., Mazzeo F., et al. Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study. BMJ Open. 2020; 10(9):e040729. doi: 10.1136/bmjopen-2020-040729. DOI: https://doi.org/10.1136/bmjopen-2020-040729
Al-Amer R. M., Malak M. Z., Aburumman G., Darwish M., Nassar M. S., Darwish M., and Randall S. Prevalence and predictors of depression, anxiety, and stress among Jordanian nurses during the coronavirus disease 2019 pandemic. International Journal of Mental Health. 2022; 51(2):152–163. https://doi.org/10.1080/00207411.2021.1916701. DOI: https://doi.org/10.1080/00207411.2021.1916701
Certain Medical Conditions and Risk for Severe COVID-19 Illness. CDC. Available online at: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html (accessed November 10, 2021).
Wu Z. and McGoogan J. M. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72,314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239-1242. doi: 10.1001/jama.2020.2648. PubMed PMID: 32091533. DOI: https://doi.org/10.1001/jama.2020.2648
Thai P. Q., Toan D. T. T., Son D. T., Van H. T. H., Minh L. N., Hung L. X., et al. Factors associated with the duration of hospitalisation among COVID-19 patients in Vietnam: A survival analysis. Epidemiology and Infection. 2020; 148:e114. doi: 10.1017/S0950268820001259. PubMed PMID: 32517822.
Lescure F.-X., Bouadma L., Nguyen D., Parisey M., Wicky P.-H., Behillil S., et al. Clinical and virological data of the first cases of COVID-19 in Europe: a case series. The Lancet Infectious Diseases. 2020; 20(6):697-706. doi: 10.1016/S1473-3099(20)30200-0. DOI: https://doi.org/10.1016/S1473-3099(20)30200-0
Wise J. A third of COVID-19 patients admitted to UK hospitals die. BMJ. 2020; 369:m1794. doi: 10.1136/bmj.m1794. DOI: https://doi.org/10.1136/bmj.m1794
Guo A., Lu J., Tan H., Kuang Z., Luo Y., Yang T., et al. Risk factors on admission associated with hospital length of stay in patients with COVID-19: a retrospective cohort study. Scientific Reports. 2021; 11(1):7310. doi: 10.1038/s41598-021-86853-4. DOI: https://doi.org/10.1038/s41598-021-86853-4
Liu X., Zhou H., Zhou Y., Wu X., Zhao Y., Lu Y., et al. Risk factors associated with disease severity and length of hospital stay in COVID-19 patients. Journal of Infection. 2020; 81(1):e95-e97. doi: 10.1016/j.jinf.2020.04.008. DOI: https://doi.org/10.1016/j.jinf.2020.04.008
Wu S., Xue L., Legido-Quigley H., Khan M., Wu H., Peng X., et al. Understanding factors influencing the length of hospital stay among non-severe COVID-19 patients: A retrospective cohort study in a Fangcang shelter hospital. PLOS ONE. 2020; 15(10):e0240959. doi: 10.1371/journal.pone.0240959. PubMed PMID: 33085709; PubMed Central PMCID: PMCPMC7577449 DOI: https://doi.org/10.1371/journal.pone.0240959
Thai P. Q., Toan D. T. T., Son D. T., Van H. T. H., Minh L. N., Hung L. X., et al. Factors associated with the duration of hospitalisation among COVID-19 patients in Vietnam: A survival analysis. Epidemiology and Infection. 2020; 148:e114. doi: 10.1017/s0950268820001259. PubMed PMID: 32517822; PubMed Central PMCID: PMCPMC7306545. DOI: https://doi.org/10.1017/S0950268820001259
Vahey G. M., McDonald E., Marshall K., Martin S. W., Chun H., Herlihy R., et al. Risk factors for hospitalization among persons with COVID-19—Colorado. PLOS ONE. 2021; 16(9):e0256917. doi: 10.1371/journal.pone.0256917. PubMed PMID: 34473791; PubMed Central PMCID: PMCPMC8412293.
Vahey G. M., McDonald E., Marshall K., Martin S. W., Chun H., Herlihy R., et al. Risk factors for hospitalization among persons with COVID-19—Colorado. PLOS ONE. 2021; 16(9):e0256917. doi: 10.1371/journal.pone.0256917. DOI: https://doi.org/10.1371/journal.pone.0256917
Chen F.-J., Li F.-R., Zheng J.-Z., Zhou R., Liu H.-M., Wu K.-Y., et al. Factors associated with duration of hospital stay and complications in patients with COVID-19. Frontiers in Public Health. 2021; 5. DOI: https://doi.org/10.21037/jphe-20-74
Guo A., Lu J., Tan H., Kuang Z., Lou Y., Yang T., Xu J., Yu J., Wen C., and Shen A. Risk factors on admission associated with hospital length of stay in patients with COVID-19: A retrospective cohort study. SSRN Electronic Journal. 2020.
https://doi.org/10.2139/ssrn.3582769 . DOI: https://doi.org/10.2139/ssrn.3582769