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Factors Influencing the Length of Hospital Stay Among Pediatric COVID-19 Patients at Queen Rania Al Abdullah Hospital
Alia M Al-Khlaifat1, Asmaa M Al Quraan2, Aseel F Nimri1
1Pediatric Infectious Diseases, Jordanian Royal Medical Services, Amman, JOR.
Insights
In pediatric COVID-19 patients, comorbidities did not significantly prolong hospital stays. Steroid use decreased length of stay, while chest CT abnormalities increased it.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Epidemiology
Background:
- COVID-19 (Coronavirus Disease 2019) poses risks to children, including severe illness and hospitalization.
- Understanding factors influencing pediatric hospital length of stay (LOS) is crucial during the pandemic.
- Previous studies identified age, gender, and disease severity as LOS predictors.
Purpose of the Study:
- To determine if comorbidities prolong hospital LOS in pediatric COVID-19 patients.
- To identify key risk factors affecting hospital stay duration in children with COVID-19.
Main Methods:
- Retrospective analysis of 100 pediatric COVID-19 patients (up to 14 years) hospitalized over 24 months.
- Data collected included clinical symptoms, oxygen demand, imaging, lab results, and medication use (corticosteroids, antivirals).
- Compared LOS between patients with and without comorbidities, and analyzed the impact of specific treatments and findings.
Main Results:
- No statistically significant association was found between comorbidities and increased hospital LOS (p=0.07).
- Steroid administration was linked to a decreased LOS (p=0.04).
- Abnormal chest computed tomography (CT) findings significantly correlated with increased LOS (p=0.00).
Conclusions:
- Comorbidities did not directly extend hospital LOS in pediatric COVID-19 cases.
- Treatment with steroids and chest CT scan results are significant factors influencing pediatric COVID-19 hospital LOS.
- Further research with larger sample sizes is recommended to validate these findings.
Abstract:
Background COVID-19 caused by SARS-CoV-2 is a worldwide epidemic. Children are less commonly infected and have less severe symptoms than adults. However, they are at risk for COVID-19-associated severe sickness and hospitalization. The duration of stay is a major driver of effective health treatment during hospitalization; thus, it is only logical to attempt to comprehend the factors influencing the length of stay (LOS) for these patients, particularly in light of the ongoing pandemic caused by the new SARS-CoV-2 virus. As predictors of hospital LOS, several variables, including age, gender, disease severity, hospital mortality, insurance type, and hospital location, have been discovered. In our study, we focused on the severity of the patient's condition, the presence of comorbidities, and the necessary therapeutic regimen to predict the duration of stay. This study aimed to answer the following questions: If a patient has comorbidity and has COVID-19 requiring hospital treatment, will the patient's comorbidity elongate the duration of stay at the hospital for further management in the pediatric age group? What are the risk factors that play a significant role in the hospital stay duration in pediatrics? Methodology We gathered data from 100 hospitalized children aged up to 14 years who tested positive for COVID-19, which was not specific to variants of SARS-CoV-2, over 24 months (February 2020-February 2022) at Queen Rania Al Abdullah Hospital for Children, one of the Health Care Accreditation Council accredited facilities. Clinical symptoms, signs, oxygen demand, imaging study results, laboratory data, and usage of corticosteroid and antiviral medication were all taken from patients' medical records. There were no limitations in taking the sample of patients. All patients in the duration mentioned were included. Results Clinical data of 100 COVID-19-positive pediatric patients were analyzed; 52% of the patients had associated chronic illnesses, while 48% were medically free. The longest duration of LOS was 28 days, the shortest was one day, the median was eight days, and five days was the most frequent among patients owing to 21% of patients, using mean descriptive statistics. We compared LOS to having or not having comorbidities. The mean LOS of patients with the comorbid disease was 6.15 days, with a maximum of 28 days, while for patients without chronic illnesses, the mean was 4.81 days with a maximum of 14 days. The significance was 0.07. Our results also showed a significant correlation between using steroids and LOS, as it had an advantageous effect by decreasing it with a significance value of 0.04. Having abnormal findings on chest computed tomography (CT) scan was also associated with increased LOS with a significant value of 0.00. Conclusions According to our research, there was no direct association between comorbidity and hospital LOS, which is counterintuitive, as it was influenced by multiplayers of variables such as using steroids, which decreased the LOS, and abnormal findings on chest CT, which resulted in lengthening of the hospital stay. Our findings cannot be proven without further research and a larger patient sample.
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