Association of discharge policy with the length of hospital stay among patients with coronavirus disease 2019: a cross-sectional study

Aim To assess the association between discharge policy and hospital stay length, and to evaluate the factors related to duration of viral clearance among patients with coronavirus disease 2019 (COVID-19). Methods This cross-sectional study enrolled consecutive patients aged >= 18 years with SARS-CoV-2 infection confirmed by reverse transcription polymerase chain reaction test who were admitted to hospital. The participants were divided into the test-based (TB) policy group or symptombased (SB) group depending on the policy valid at their hospital discharge. Multivariable analyses were performed to assess the factors related to the duration of hospital stay and viral clearance. Results The study involved 305 patients (66.6% men). The mean age was 60.9 (15.2) years. TB and SB policy groups consisted of 145 (47.5%) and 160 patients (52.5%), respectively. The TB group had significantly longer duration of hospital stay (21.0 vs 16.0, P = 0.003). In multivariable analysis, SB policy was associated with significantly shorter hospital stay (beta-coefficient -5.87, 95% confidence interval [CI] -9.78 to -1.96, P = 0.003). Longer viral clearance was associated with older age (beta-coefficient 0.33, 95% CI 0.15 to 0.51, P < 0.001) and history of cough in the pre-hospital phase of the disease (5.96, 95% CI 0.64 to 11.29, P = 0.028). Conclusion SB discharge policy is preferable in the context of limited resources during the COVID-19 pandemic.