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Delayed discharge is associated with higher complement C3 levels and a longer nucleic acid-negative conversion time
Peihuang Lin1, Wenhuang Chen2, Hongbo Huang3
1Department of Basic Medicine, Quanzhou Medical College, Quanzhou, China.
Insights
Delayed hospital discharge for COVID-19 patients is linked to longer time for SARS-CoV-2 RNA negativity and elevated complement C3 levels. Monitoring these factors can help predict discharge delays in coronavirus disease patients.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Epidemiology
Background:
- Hospitalized patients with coronavirus disease (COVID-19) may experience delayed discharge.
- Identifying factors associated with prolonged hospital stays is crucial for resource management and patient care.
Purpose of the Study:
- To determine factors associated with delayed discharge in hospitalized COVID-19 patients.
- To identify predictors for prolonged length of hospital stay in coronavirus disease patients.
Main Methods:
- Retrospective cohort study of 47 COVID-19 patients in Quanzhou City, China.
- Univariate and multivariate logistic regression analyses were used to identify risk factors for delayed discharge.
- Delayed discharge was defined as a length of hospital stay ≥ 21 days.
Main Results:
- The median length of hospital stay was 22 days.
- Factors associated with delayed discharge included diarrhea, anorexia, low white blood cell counts, elevated complement C3 and C-reactive protein, air bronchograms, and thymalfasin treatment.
- Multivariate analysis identified time to severe acute respiratory syndrome coronavirus (SARS-CoV-2) RNA-negative conversion (OR: 1.48) and complement C3 levels (OR: 1.14) as independent risk factors for delayed discharge.
Conclusions:
- Time to SARS-CoV-2 RNA-negative conversion and complement C3 levels are significant predictors of delayed hospital discharge in COVID-19 patients.
- Dynamic monitoring of complement C3 and SARS-CoV-2 RNA levels can aid in predicting delayed discharge, optimizing patient management.
Abstract:
To determine factors associated with delayed discharge of hospitalized patients with coronavirus disease (COVID-19). This retrospective cohort study included 47 patients with COVID-19 admitted to three hospitals in Quanzhou City, Fujian Province, China, between January 21, 2020 and March 6, 2020. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with delayed discharge. The median length of hospital stay was 22 days. Patients in the delayed discharge group (length of hospital stay ≥ 21 days, n = 27) were more likely to have diarrhea, anorexia, decreased white blood cell counts, increased complement C3 and C-reactive protein levels, air bronchograms, undergo thymalfasin treatment, and take significantly longer to convert to a severe acute respiratory syndrome coronavirus (SARS-CoV-2) RNA-negative status than those in the control group (length of hospital stay, < 21 days; n = 20). In multivariate logistic regression analysis, the time to SARS-CoV-2 RNA-negative conversion (odds ratio [OR]: 1.48, 95% confidence interval [CI] 1.09-2.04, P = 0.01) and complement C3 levels (OR 1.14 95% CI 1.02-1.27, P = 0.03) were the only risk factors independently associated with delayed discharge from the hospital. Dynamic monitoring of complement C3 and SARS-CoV-2 RNA levels is useful for predicting delayed discharge of patients.
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