Total severity score and age predict long-term hospitalization in COVID-19 pneumonia

Abstract

Background: Severe COVID-19 pneumonia implies increased oxygen demands and length of hospitalization (LOS). We aimed to assess a possible correlation between LOS and COVID-19 patients' clinical laboratory data of admission, including the total severity score (TSS) from chest computed tomography (CT).

Methods: Data were assessed retrospectively at the General Hospital "Agios Pavlos" in Greece. Clinical laboratory data, TSS, and LOS were recorded.

Results: A total of 317 patients, 136 women and 181 men, with a mean age of 66.58 ± 16.02 years were studied. Significant comorbidities were hypertension (56.5%), dyslipidemia (33.8%), type 2 diabetes mellitus (22.7%), coronary heart disease (12.9%), underlying pulmonary disease (10.1%), and malignancy (4.4%). Inpatient time was related to age (p < 0.001), TSS (p < 0.001), time from symptom onset to hospitalization (p = 0.006), inhaled oxygen fraction (p < 0.001), fibrinogen (p = 0.024), d-dimers (p < 0.001), and C-reactive protein (p = 0.025), as well as a history of hypertension (p < 0.001) and type 2 diabetes mellitus (p < 0.008). The multivariate analysis showed a significant association of the LOS with age (p < 0.001) and TSS (p < 0.001) independent of the above-mentioned factors.

Conclusion: Early identification of disease severity using the TSS and patients' age could be useful for inpatient resource allocation and for maintaining vigilance for those requiring long-term hospitalizations.

Keywords: COVID-19; chest computed tomography; hospitalization length; pneumonia; total severity score.

Figure 1

Associated comorbidities of the study population. COPD, chronic obstructive pulmonary disease.