COVID-19 patients staying longer at hospitals this time: Experts

The second wave of Covid-19 in India has seen an increase in the length of hospital stays, doctors said. A key reason is patients are spending 20-25 days in intensive care this time around and remaining oxygen dependent even after they turn Covid negative.

The length of hospital stay — an indicator of the severity of a disease — has increased manifold in the second wave for reasons such as this, said experts. Hospitals have reported that a Covid-19 patient reporting moderate symptoms is spending 10-14 days and a severe patient could spend up to a month due to dependence on medical oxygen.

“In the second wave, severe cases are being admitted in the hospital and this is why their length of hospital stay is longer,” said Praveen Gupta, director, neurology, Fortis Memorial Research Institute. “Even after they are Covid negative, patients remain oxygen dependent because of lung damage and some are in ICU for over two weeks.”

This is in sharp contrast with standard procedures followed in the first wave. At the start of the pandemic in February 2020, every Covid patient was admitted to a healthcare facility not only for treatment, but also for isolation.

‘Discharge Hinges on Other Factors
The patient was discharged after turning negative, typically in about 7-10 days. However, this procedure changed as the caseload increased and mild patients were advised to stay in home isolation.

The lingering dependence on oxygen support in the second wave, despite testing negative for Covid, requires patients to stay in the hospital system.

“The discharge of a patient is not dependent on Covid status — patients are discharged when they are physically alright,” Gupta said. “A patient who has moderate or severe lung damage is still on 6 litres of oxygen and needs to be in hospital. The percentage of such people is much higher in the second wave and that is why duration of stay is longer.”

The average length of stay is usually used as an indicator to assess the hospital’s efficiency and, in the case of infectious diseases, the severity. The shorter the length of stay (LOS) the better, as more patients can be treated.

One of the distressing aspects of the second wave has been the shortage of hospital beds, particularly those with oxygen, supplies of which have been inadequate, leading to deaths across the country.

“In the second wave, length of stay, even in a multi-speciality hospital has increased manifold,” said Shuchin Bajaj, founder and director, Ujala Cygnus Group of hospitals. “For a moderate patient, it is extending up to 10-12 days.”

Medical experts, however, said the severity of the disease can be better gauged once cases start falling.

“If we see hospital settings, the severity of disease is more in the second wave. This is because the sheer numbers are large. If we were treating 900 patients in one facility, we are taking 5,000 in the same,” Gupta said. Apart from severity, even mortality is higher in the current wave as patients get admitted only when they cannot manage at home with oxygen cylinders and concentrators.