COVID-19 Hospitalization and Death: A Retrospective Cohort Study of 238,000 Patients in Brazil

Background: The COVID-19 pandemic has overwhelmed the healthcare system in many countries, and bed availability has become a concern. In this context, the present study aims to analyze the hospitalization and ICU time in patients diagnosed with COVID-19.Methods: The study covers 55,563 ICU admissions and 238,075 hospitalizations in Brazilian Health System units, from February 22, 2020, to June 7, 2021. All patients had a positive diagnosis for COVID-19. For each patient, the presence of symptoms were analyzed: fever, dyspnea, low saturation (SpO2<95%), cough, respiratory distress, fatigue, sore throat, diarrhea, vomiting, loss of taste, loss of smell, and abdominal pain. We perform the Cox regression in two models (ICU time and hospital time). Hazard Ratio (HR) and survival was calculated by age group.Findings: The average stay was 14.4 days for hospitalization and 12.4 days for ICU. For hospitalizations, the highest Hazard mean values, with a positive correlation, were dyspnea 1.249 (95% CI, 1.225 to 1.273) and saturation 1.157 (95% CI, 1.137 to 1.178). In the ICU, the highest Hazards were respiratory discomfort 1.194 (95% CI, 1.161 to 1.227) and abdominal pain 1.100 (95% CI, 1.047 to 1.156). The survival decreases on average 2.27%/day (Hospitalization) and 3.27%/day (ICU). Survival by age group curves indicates that younger groups are more resistant to prolonged hospital stays than the older group.Interpretation: The hospitalization is lower in younger patients. There is higher mortality in males. Symptoms related to the respiratory tract are associated with a more extended hospital stay.Funding Information: None.Declaration of Interests: None.