Demand for hospitalization services for COVID-19 patients in Brazil

Castro, Márcia C.; Carvalho, Lucas Resende de; Chin, Taylor; Kahn, Rebecca; França, Giovanny Vinícius Araújo de; Macário, Eduardo Marques; Oliveira, Wanderson Kleber de

doi:10.1101/2020.03.30.20047662

Cited by 66 publications

(69 citation statements)

References 28 publications

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“…There have been numerous previous studies which have aimed to forecast the number of hospital beds required for COVID-19 patients [16][17][18][19][20][21][22]54]. Many of these studies published so far have used point estimates, only originating from one study which often does not reflect the context of interest.…”

Section: Summarising Length Of Staymentioning

confidence: 99%

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

Rees

Nightingale

Jafari

et al. 2020

Preprint

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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, staff, equipment) has become a key priority for many countries. Projecting future demand requires estimates of how long patients with COVID-19 need different 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 differences 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 identified 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 difference 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 differences in criteria for admission and discharge between countries, and different 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.

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Section: Summarising Length Of Staymentioning

confidence: 99%

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

Rees

Nightingale

Jafari

et al. 2020

Preprint

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“…As of July 15, 2020, 264,561 Iranians have been infected with COVID-19, of whom 13,410 are deceased. Due to the rapidly growing number of con rmed cases of COVID-19, there is a worldwide concern that overwhelmed health systems may face shortages of hospital beds, ICU beds, and ventilators [4], as well as burnout and fatigue [24] of healthcare professionals. Lack of resources in the health sector can lead to discrimination in the optimal distribution of medical services during pandemic diseases.…”

Section: Introductionmentioning

confidence: 99%

“…Previous experience with other outbreaks such as MERS and pandemic in uenza has shown that identifying high-risk patients for hospitalization can help healthcare providers and emergency staffs in nding patients who would bene t the most from early, available treatments. In addition, policymakers can use this information to forecast healthcare needs [4].…”

Section: Introductionmentioning

confidence: 99%

Value of laboratory tests in COVID-19 hospitalized patients for clinical decision-makers: a predictive model, using data mining approach

Mousavi

Rezaei

Salamzadeh

et al. 2020

Preprint

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Purpose: Because of the rapid increase in confirmed cases of COVID-19, in particular those with severe or critical status, overwhelming of health systems is a worldwide concern. Therefore, identifying high-risk COVID-19 patients, can help service providers for priority setting and hospital resource allocation. Methods: 4542 adult patients with confirmed COVID-19 admitted in 15 hospitals in Tehran, Iran, from Feb 20 to April 18, 2020 were included in this retrospective cohort study with final outcomes of survived and died patients. Demographic features including age and sex, and laboratory data measured at admission were extracted and compared between recovered and died patients. Data analysis was performed applying SPSS modeler software using a logistic regression method.Results: Of 4542 hospitalized adult patients, 822 patients (18.09%) died during hospitalization, and 3720 (81.90%) recovered and discharged. Based on logistic regression model, older age, 40-49 (RR= 1.80, CI: 1.13-2.87), 50-59 (RR=2.63, CI: 1.71-4.02), 60-69 (RR= 4.40, CI: 2.92-6.63), 70-79 (RR=7.49, CI: 5.01-11.19), Above 80 (RR=13.85, CI: 9.23-2.77), ALT ≥ 55 IU/ (RR=2.20, CI: 1.69-2.86), AST ≥ 100 IU/L (RR=5.93, CI: 4.75-7.39), ALP ≥ 200 IU/L (RR=2.46, CI: 1.80-3.37), sodium < 135 mEq/l (RR=1.69, CI: 1.35-2.11) or more than 145 mEq/l (RR=7.24, CI: 5.07-10.33), potassium > 5.50 mEq/l (RR=7.53, CI: 4.15-13.64), and calcium < 8.50 mEq/l (RR=3.39, CI: 2.81-4.09), CPK between 307-600 IU/L (RR=2.73, CI: 2.12-3.53) and above 600 IU/L (RR=4.41, CI: 3.40-5.71) in men, and 192-400 IU/L (RR=2.73, CI: 2.12-3.53), and above 400 (RR=4.41, CI: 3.40-5.71) in women, CRP > 3 mg/l (RR=3.22, CI: 1.99-5.20), and creatinine > 1.5 mg/l (RR=6.37, CI: 5.30-7.66) were significantly associated with COVID-19 mortality. Conclusion: Our findings suggested less than one in five hospitalized patients with COVID-19 die mostly due to electrolyte disbalance, liver, and renal dysfunctions. Better supportive care is needed to improve outcomes for patients with COVID-19.

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“…Its high transmissibility, including through asymptomatic cases, and its tendency to lead to severe complications, hospitalizations and deaths, together with the absence of prior immunity (as it is a virus unknown to the human species), inexistence of vaccine or treatment known to be efficacious and the vulnerability of the Brazilian population (living and health conditions), mean it can assumed that infection incidence will be high and that the number of severe cases, needing hospitalization and/ or intensive care, may exceed health service capacity. 26 In this context it is recommendable to adopt measures that contribute to flattening the COVID-19 epidemic curve, preventing an abrupt increase in the number of cases and reducing the peak in demand for health services. The aim is to avoid the health system from becoming overloaded and collapsing, which could lead to increased mortality owing to lack of hospital beds and intensive care.…”

mentioning

confidence: 99%

Como o Brasil pode deter a COVID-19

Oliveira¹,

Duarte²,

França³

et al. 2020

Epidemiologia e Serviços de Saúde

245

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This article presents the strategies and actions adopted by the Brazilian Ministry of Health to hold back COVID-19. The response to the disease was immediate and occurred prior to the first case being detected in Brazil. Provision of information and communication to the population and the press was adopted as a fundamental strategy for addressing the epidemic. Guidance provided to the population has been clear, stressing the importance of coronavirus transmission prevention measures. Efforts have been directed towards strengthening health surveillance and health care, as well as boosting research, development and innovation. Actions have targeted human resource training and expanding coverage afforded by the Brazilian National Health System (SUS). Protecting health workers is a priority. All SUS health workers, managers and directors are dedicated to preserving the health and life of each and every Brazilian citizen.

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Demand for hospitalization services for COVID-19 patients in Brazil

Cited by 66 publications

References 28 publications

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

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

Value of laboratory tests in COVID-19 hospitalized patients for clinical decision-makers: a predictive model, using data mining approach

Como o Brasil pode deter a COVID-19

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