The Severity of Disease and Hospital Length of Stay for the First and Second Admission of COVID-19 Patients: An Observational Study from Southeastern Iran

Background: This study aimed to investigate the severity of disease and length of hospital stay for COVID-19 patients admitted to a hospital in southeastern Iran. Method: This cross-sectional study was conducted in Kerman, Iran. Data were collected from patients who visited Afzalipour Hospital in Kerman more than twice during the COVID-19 epidemic from the end of February 2020 to March 21, 2021. We conducted two key analyses: 1. Mixed effect logistic regression was used to check the relationship between the variables and COVID-19 severity. 2. Mixed effect linear regression was used to check the relationship between the variables and the length of stay in the hospital. Results: The findings indicated that the most important risk factors for the severity of COVID-19 were heart diseases (OR=1.67,95%CI:1.20-2.30), increasing age (OR=2.23 for age>54, 95%CI:1.70- 2.90), male gender (OR=1.47,95%CI:1.10-1.96), respiratory diseases other than asthma, and frequency of admission (OR=1.60,95%CI:1.20-2.15). All patients who underwent readmission experienced a shorter duration of hospitalization during their subsequent admission (OR=0.94,95%CI:0.91,0.96) and had a higher mortality rate (30% within 14 days, 26.6% between 14-90 days). Patients readmitted at intervals of 14-90 days and greater than 90 days exhibited lower disease severity compared to those readmitted within the 0-14 day period. Conclusion: Examining readmissions, the severity of COVID-19, and the length of hospital stay in affected patients are important factors for planning and allocating resources for COVID-19 management and treatment. These factors can help policymakers develop effective clinical guidelines for hospitalization or outpatient treatment of COVID-19 patients and contribute to reducing the burden of disease in the community.