COVID-19 length of hospital stay: a systematic review and data synthesis
Date
2020
Journal Title
Journal ISSN
Volume Title
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Abstract
Background: The COVID-19 pandemic has placed an unprecedented strain on
health systems, with rapidly increasing demand for healthcare in hospitals and
intensive care units (ICUs) worldwide. As the pandemic escalates, determining
the resulting needs for healthcare resources (beds, sta , equipment) has become
a key priority for many countries. Projecting future demand requires estimates of
how long patients with COVID-19 need di erent levels of hospital care.
Methods: We performed a systematic review to gather data on length of stay
(LoS) of patients with COVID-19 in hospital and in ICU. We subsequently
developed a method to generate LoS distributions which combines summary
statistics reported in multiple studies, accounting for di erences in sample sizes.
Applying this approach we provide distributions for general hospital and ICU LoS
from studies in China and elsewhere, for use by the community.
Results: We identi ed 52 studies, the majority from China (46/52). Median
hospital LoS ranged from 4 to 53 days within China, and 4 to 21 days outside of
China, across 45 studies. ICU LoS was reported by eight studies - four each within
and outside China - with median values ranging from 6 to 12 and 4 to 19 days,
respectively. Our summary distributions have a median hospital LoS of 14 (IQR:
10-19) days for China, compared with 5 (IQR: 3-9) days outside of China. For
ICU, the summary distributions are more similar (median (IQR) of 8 (5-13) days
for China and 7 (4-11) days outside of China). There was a visible di erence by
discharge status, with patients who were discharged alive having longer LoS than
those who died during their admission, but no trend associated with study date.
Conclusion: Patients with COVID-19 in China appeared to remain in hospital for
longer than elsewhere. This may be explained by di erences in criteria for
admission and discharge between countries, and di erent timing within the
pandemic. In the absence of local data, the combined summary LoS distributions
provided here can be used to model bed demands for contingency planning and
then updated, with the novel method presented here, as more studies with
aggregated statistics emerge outside China.
Description
CITATION: Rees, E. M. et al. 2020. COVID-19 length of hospital stay: a systematic review and data synthesis. MedRxiv, doi:10.1101/2020.04.30.20084780.
The original publication is available at https://www.medrxiv.org
The original publication is available at https://www.medrxiv.org
Keywords
COVID-19 (Disease) -- Treatment, Hospitals -- Space utilization, Intensive care units -- Length of stay, Hospital utilization -- Length of stay
Citation
Rees, E. M. et al. 2020. COVID-19 length of hospital stay: a systematic review and data synthesis. MedRxiv, doi:10.1101/2020.04.30.20084780.