Clinical Characteristics and Durations of Hospitalized Patients with COVID-19 in Beijing: A Retrospective Cohort Study

  1. Wen Zhao
  2. Xiangyi Zha
  3. Ning Wang
  4. Dongzeng Li
  5. Aixin Li
  6. Shikai Yu

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Abstract

Objective: To provide information on clinical characteristics and different durations of COVID-19 and to identify the potential risk factors for longer hospitalization of patients with COVID-19.

Methods: In this retrospective study, we enrolled 77 patients (age 52±20 years; 44.2% males) with laboratory-confirmed COVID-19 admitted to Beijing YouAn Hospital between January 21 and February 8, 2020. Epidemiological, clinical, and radiological data on admission were collected; complications and outcomes were followed up until February 26, 2020. The end point of the study was discharge alive within 2 weeks. Cox proportional-hazards regression was performed to identify risk factors for longer hospitalization.

Results: Of 77 patients, there were 34 males (44.2%), 24 (31.2%) with comorbidities, 22 (28.6%) with lymphopenia, 20 (26.0%) with severe COVID-19, and 28 (36.4%) with complications. By the end of follow-up, 64 patients (83.1%) were discharged home, eight remained in hospital, and five had died. Thirty-six patients (46.8%) were discharged within 14 days and thus reached the study end point, including 34 of the 57 patients with nonsevere COVID-19 (59.6%) and two of the 20 patients with severe COVID-19 (10%). The overall cumulative probability of the end point was 48.3%. Hospital length of stay and the duration from exposure to discharge for the 64 discharged patients were 13 (10–16.5) days and 23 (18–24.5) days, respectively. A multivariable stepwise Cox regression model showed that bilateral pneumonia on CT scan, shorter time from illness onset to admission, severity of disease, and lymphopenia were independently associated with longer hospitalization.

Conclusions: COVID-19 has a shorter duration of disease and hospital length of stay than severe acute respiratory syndrome. Bilateral pneumonia on CT scan, shorter period from illness onset to admission, lymphopenia, and severity of disease are the risk factors for longer hospitalization of patients with COVID-19.

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  1. Version published to 10.15212/cvia.2021.0019
  2. Version published to 10.1101/2020.03.13.20035436v3 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2020.03.13.20035436: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The local ethic review board of the hospital approved this study and waived informed consent for each patient, considering the retrospective nature of this study.
    Consent: The local ethic review board of the hospital approved this study and waived informed consent for each patient, considering the retrospective nature of this study.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All analyses were done with SAS software, version 9.4.
    SAS
    suggested: (SASqPCR, RRID:SCR_003056)

    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:
    This study has several limitations. First, a relatively small number of patients from a single center in Beijing were included. Obviously, length of hospital stay differs across hospitals, cities and countries. It would be more valuable to draw the corresponding durations and to identify the risk factors based on the dataset at city or nation scale. Second, we could not provide useful information on the average duration from the illness onset to death, because of limited data in our study. Third, treatment is a pivotal determinant of durations of disease, however, we currently have no detailed data of treatment for patients with COVID-19 and cannot determine the influence of treatment on durations of COVID-19. But we will continue this work in the future. In conclusion, the average hospital length of stay is 13 days for discharged patients with COVID-19; average time of clinical course is 23 days. Both are significantly shorter than SARS. Bilateral pneumonia on CT scan, shorter period of illness onset to admission, lymphopenia, severity of disease are the risk factors for longer hospitalization duration of COVID-19. There findings might be useful for the countries or territories facing the threat of COVID-19 to well prepare and rebalance their medical resource.

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.03.13.20035436v2 on medRxiv
  5. Version published to 10.1101/2020.03.13.20035436v1 on medRxiv