Disease burden from COVID-19 symptoms among inpatients at the temporary military hospitals in Wuhan: a retrospective multicentre cross-sectional study

Maihong He; Xiaoxiao Li; Qing Tan; Yong Chen; Yue Kong; Jianping You; Xian Lin; Ying Lin; Qing Zheng

doi:10.1136/bmjopen-2021-048822

Disease burden from COVID-19 symptoms among inpatients at the temporary military hospitals in Wuhan: a retrospective multicentre cross-sectional study

BMJ Open. 2021 May 18;11(5):e048822. doi: 10.1136/bmjopen-2021-048822.

Authors

Maihong He^{1

2

3}, Xiaoxiao Li^{4

2

3}, Qing Tan⁵, Yong Chen⁶, Yue Kong⁷, Jianping You⁸, Xian Lin², Ying Lin², Qing Zheng⁹

Affiliations

¹ Department of National Defense Education and Research, Fuzhou University, Fuzhou, China.
² Department of Disease Control and Prevention, The No. 900 Hospital of Joint Logistics Support Troop of PLA, Fuzhou, China.
³ Clinical College in Fuzhou General Hospital of Fujian Medical University, Fuzhou, China.
⁴ Department of National Defense Education and Research, Fuzhou University, Fuzhou, China shawnleemm@gmail.com shawnlee@fzu.edu.cn.
⁵ Department of Disease Control and Prevention, The No. 923 Hospital of PLA, Nanning, China.
⁶ Chinese PLA Center for Disease Control and Prevention, Beijing, China.
⁷ Department of Education, The No. 900 Hospital of Joint Logistics Support Troop of PLA, Fuzhou, China.
⁸ Department of Infectious Diseases, The First Affiliated Hospital of Army Medical University of PLA, Chongqing, China.
⁹ Meifeng Branch, The No. 900 Hospital of Joint Logistics Support Troop of PLA, Fuzhou, China.

Abstract

Objectives: We aimed to establish a set of disability weights (DWs) for COVID-19 symptoms, evaluate the disease burden of inpatients and analyse the characteristics and influencing factors of the disease.

Design: This was a multicentre retrospective cross-sectional descriptive study.

Setting: The medical records generated in three temporary military hospitals in Wuhan.

Participants: Medical records of 2702 inpatients generated from 5 February to 5 April 2020 were randomly selected for this study.

Primary and secondary outcome measures: DWs of COVID-19 symptoms were determined by the person trade-off approach. The inpatients' medical records were analysed and used to calculate the disability-adjusted life years (DALYs). The mean DALY was evaluated across sex and age groups. The relationship between DALY and age, sex, body mass index, length of hospital stay, symptom duration before admission and native place was determined by multiple linear regression.

Results: For the DALY of each inpatient, severe expiratory dyspnoea, mild cough and sore throat had the highest (0.399) and lowest (0.004) weights, respectively. The average synthetic DALY and daily DALY were 2.29±1.33 and 0.18±0.15 days, respectively. Fever and fatigue contributed the most DALY at 31.36%, whereas nausea and vomiting and anxiety and depression contributed the least at 7.05%. There were significant differences between sex and age groups in both synthetic and daily DALY. Age, body mass index, length of hospital stay and symptom duration before admission were strongly related to both synthetic and daily DALY.

Conclusions: Although the disease burden was higher among women than men, their daily disease burdens were similar. The disease burden in the younger population was higher than that in the older population. Treatment at the hospitals relieved the disease burden efficiently, while a delay in hospitalisation worsened it.

Keywords: health economics; health services administration & management; public health.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Cost of Illness*
Cross-Sectional Studies
Female
Hospitals, Military
Humans
Inpatients
Male
Quality-Adjusted Life Years
Retrospective Studies
SARS-CoV-2
United States