COVID-19 length of hospital stay: a systematic review and data synthesis

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dc.contributor.authorRees, Eleanor M.en_ZA
dc.contributor.authorNightingale, Emily S.en_ZA
dc.contributor.authorJafari, Yaldaen_ZA
dc.contributor.authorWaterlow, Naomi R.en_ZA
dc.contributor.authorClifford, Samuelen_ZA
dc.contributor.authorPearson, Carl A. B.en_ZA
dc.contributor.authorCMMID Working Groupen_ZA
dc.contributor.authorJombart, Thibauten_ZA
dc.contributor.authorProcter, Simon R.en_ZA
dc.contributor.authorKnight, Gwenan M.en_ZA
dc.date.accessioned2020-05-22T06:20:17Z
dc.date.available2020-05-22T06:20:17Z
dc.date.issued2020
dc.descriptionCITATION: 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.
dc.descriptionThe original publication is available at https://www.medrxiv.org
dc.description.abstractBackground: 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.en_ZA
dc.description.urihttps://www.medrxiv.org/content/10.1101/2020.04.30.20084780v3
dc.description.versionPre-print
dc.format.extent33 pages
dc.identifier.citationRees, 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.
dc.identifier.otherdoi:10.1101/2020.04.30.20084780
dc.identifier.urihttp://hdl.handle.net/10019.1/108587
dc.language.isoen_ZAen_ZA
dc.rights.holderAuthors retain copyright
dc.subjectCOVID-19 (Disease) -- Treatmenten_ZA
dc.subjectHospitals -- Space utilizationen_ZA
dc.subjectIntensive care units -- Length of stayen_ZA
dc.subjectHospital utilization -- Length of stayen_ZA
dc.titleCOVID-19 length of hospital stay: a systematic review and data synthesisen_ZA
dc.typeArticleen_ZA
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