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

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.

Burden of disease due to symptoms of hospitalized patients with COVID-19

OBJECTIVE: To establish a set of disability weights(DWs) for symptoms of COVID-19 infection so as to evaluate the burden due to symptoms of hospitalized patients and analyze the related factors for the burden. METHODS: The items of symptoms were identified by literature review and questionnaire survey for medical staff. Set the DWs of WHO global burden of disease projects as benchmark, DWs of the symptom items were determined by analytical hierarchy process. The medical records of the patients with COVID-19 of Taikang Tongji(Wuhan) Hospital were reviewed, the related data were extracted by using text mining software. Then, the disability adjusted life years(DALYs) of the patients were calculated. The means of DALY between gender groups and the means of DALY between age groups were tested by variance analysis. Multivariate linear regression model analysis was performed for the correlation between DALY and age, body mass index, length of hospital stay and duration of symptoms before the admission. RESULTS The DWs of symptoms of COVID-19 were obtained, while DALY of each patient was calculated. The synthetic DALY was(3.49+/-2.09) days, and the average of daily DALY was(0.27+/-0.21) days. There were significant differences in the synthetic DALY and average of daily DALY between the gender groups and between the age groups(P<0.05). The synthetic DALY and average of daily DALY were associated with the age, BMI, length of hospital stay and duration of duration of symptoms before the admission(P<0.05). CONCLUSION: The symptoms of COVID-19 can lead to heavy burden. Generally, the burden of female patients is heavier than that of the male patients, but there is no significant difference in the average of daily burden. Taken the life value changing with age into account, the overall burden of the young patients is heavier than that of the aged patients. The hospitalization can effectively reduce the burden, but the delay of hospitalization may increase the burden.