Influence of Comorbidities on the Length of Stay of Covid-19 Patients in Kenyatta National Hospital – Infectious Disease Unit (KNH–IDU), Nairobi County, Kenya

Dr. Vivian Manyeki, Sr. Dr. Margaret Nyongesa, Dorcas Maina
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Abstract

Purpose: To determine the influence of comorbidities on the LOS of COVID-19 patients in KNH-IDU between 1st June 2020 and 30th November 2020 Materials and Methods: This retrospective cohort study comprised of 558 COVID-19 patients of which 69% survived and 31% died. The overall median LOS was 7.5 days (IQR: 0-183) – 8 days (IQR: 1-171) for the survivors, and 6 days (IQR: 0-183) for the non survivors. Data was extracted from hospital records using a questionnaire and analyzed with STATA version 15. Chi-square tests determined associations, while regression analysis examined LOS determinants based on model coefficients and significance. Findings: Significant differences were seen in age (p<0.01), with more survivors aged 20-40 years and non-survivors aged over 40 years. Non-survivors had higher referral rates (p<.001), ICU admissions (p<.001), and intubation needs (p<.001). Diabetes and hypertension were more common in non-survivors (p<.001). Non-survivors also had higher WBC counts (p<.001), higher neutrophil counts (p<.01), lower lymphocyte counts (p<.001), and lower platelet counts (p<.001). Implications to Theory, Practices and Policy: Practically, the findings underscore the need for targeted clinical management strategies, particularly for younger patients and those with severe disease, to optimize LOS and improve survival rates.
合并症对肯尼亚内罗毕县肯雅塔国立医院传染病科(KNH-IDU)Covid-19 患者住院时间的影响
目的:确定 2020 年 6 月 1 日至 2020 年 11 月 30 日期间合并症对 KNH-IDU COVID-19 患者 LOS 的影响:这项回顾性队列研究包括 558 名 COVID-19 患者,其中 69% 存活,31% 死亡。存活患者的总住院时间中位数为 7.5 天(IQR:0-183)--8 天(IQR:1-171),非存活患者的总住院时间中位数为 6 天(IQR:0-183)。数据通过调查问卷从医院记录中提取,并使用 STATA 15 版进行分析。卡方检验确定了相关性,而回归分析则根据模型系数和显著性检验了 LOS 的决定因素。研究结果年龄差异显著(p<0.01),幸存者多为 20-40 岁,非幸存者多为 40 岁以上。非幸存者的转诊率(p<.001)、重症监护室入院率(p<.001)和插管需求(p<.001)均较高。糖尿病和高血压在非幸存者中更为常见(p<.001)。非幸存者的白细胞计数更高(p<.001),中性粒细胞计数更高(p<.01),淋巴细胞计数更低(p<.001),血小板计数更低(p<.001)。对理论、实践和政策的影响:在实践中,研究结果强调了有针对性的临床管理策略的必要性,尤其是针对年轻患者和病情严重的患者,以优化患者的生命周期并提高存活率。
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