Date of Conferral

4-11-2025

Date of Award

April 2025

Degree

Ph.D.

School

Public Health

Advisor

Dr. James Rohrer

Abstract

COVID-19 has put immense pressure on healthcare facilities, especially in managing patients with comorbidity. This study addressed the association between two important coinfections, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), and their effect on hospital length of stay (LOS) among COVID-19 patients. The study also explored the predictive role of the inflammatory biomarker C-reactive protein (CRP) in prolonged hospitalization, also considering the influence of age and race. This study applied the Biopsychosocial Model and Chronic Care Model (CCM) to examine health outcomes and resource use. A retrospective cohort research design was used to examine medical records of COVID-19 patients with proven CHF or COPD to see how these conditions’ influence increased LOS. CRP levels were assessed for significance of disease and possible complications, which were further incorporated into the LOS. Logistic regression models were used to analyze the joint effect of CHF, COPD, and CRP on hospital LOS. The findings revealed that elevated CRP levels were significant predictors of prolonged LOS among COVID-19 patients, with an odds ratio of 1.874. CHF was found to predict a weak increase in the propensity to prolonged LOS. Black patients with CHF are 30% more likely to experience a prolonged LOS, with an odds ratio of 1.303. COPD does not significantly impact the odds of a prolonged LOS, with an odd ratio of 0.902. Age < 60, age ≥ 70, and White race were significant predictors of LOS. The study's findings indicate the presence of systemic inflammation through elevated CRP as a significant predictor of LOS and support strategies for improving patient clinical outcomes.

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