COVID-19 Hospitalisation in Portugal, the first year: Results from hospital discharge data

  1. João F. Pereira
  2. Constantino Caetano
  3. Liliana Antunes
  4. Paula Patrício
  5. Maria Luísa Morgado
  6. Baltazar Nunes

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Abstract

Using Portuguese diagnosis-related groups (DRGs) data we analysed the dynamics of the COVID-19 hospitalisation in Portugal, with the ultimate goal of estimating parameters to be used in COVID-19 mathematical modelling.

After processing the data, corresponding to the period between March 2020 and the end of March 2021, an exploratory analysis was conducted, in which the length of stay (LoS) in hospital care, the time until death (TuD), the number of admissions and mortality count were estimated and described with respect to the age and gender of the patients, but also by region of admission and evolution over time.

The median and mean of LoS was estimated to be 8 and 12.5 days (IQR:4-15) for non-ICU patients and for ICU patients as 18 and 24.3 days (IQR:11-30). The percentage of patients that, during their hospitalisation, required ICU care was determined to be 10.9%. In-hospital mortality of non-ICU patients (22.6%) and of ICU patients (32.8%) were also calculated. In a visual exploratory analysis we observed that they changed with time, age group, gender and region.

Various univariable probability distributions were fitted to the LoS and TuD data, using maximum likelihood estimation (MLE) but also maximum goodness-of-fit estimation (MGE) to obtain the distribution parameters.

AMS Subject Classification

62-07,62E07,62F10,62P10

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  1. ScreenIT

    SciScore for 10.1101/2022.03.03.22271349: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    One of the limitations of the data used is the lack of distinction between length of stay in ICU care and the overall time in hospital care for a patient that received ICU treatment, as the LoS refers to the total time in hospital. Unfortunately, there are not very many studies presenting LoS, as Rees [15] also report, LoS is normally not the primary measure of interest in studies which report it, and most of them consider LoS in ICU as time in ICU hospitalisation, what makes comparing them with our data difficult. Another limitation comes from the fact that the database BI-MH does not include hospitalizations in private hospitals or other non-public healthcare providers. Other factor to take in consideration, as it overestimates entries in hospital care, is that hospital transfers count as new entries and therefore a patient can have multiple consecutive entries. Our objective with this study was to elucidate the COVID-19 hospitalization dynamics in Portugal. We took advantage of the DRG data to explore time in hospital care and other important parameters providing the necessary tools and knowledge for the construction of better COVID-19 models that consider hospitalization. The parameters here presented were already used in the COVID-19 in-CTRL model [2].

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2022.03.03.22271349 on medRxiv