Factors Associated with Prolonged Hospital Stay among Adult Patients with Chickenpox in Pakistan: A Prospective Cohort Study

Abstract

Background: Chickenpox is a highly contagious viral disease characterized by a polymorphic rash and systemic manifestations. Although traditionally considered a childhood illness, its prevalence among adults is notably higher in tropical regions such as Pakistan, where it is often associated with poorer outcomes. However, factors contributing to adverse prognosis in adults remain insufficiently explored. This study aimed to identify factors affecting outcomes among hospitalized adult patients with chickenpox.

Methodology: A prospective cohort study was conducted at Pak Emirates Military Hospital and Combined Military Hospital, Rawalpindi, from July 1 to December 31, 2024. After obtaining informed consent, patients were admitted to the dermatology ward, and baseline investigations were performed. All patients received acyclovir upon admission and were followed throughout their hospital stay. Data were analyzed using SPSS version 23.0.

Results: A total of 53 patients were included, with a mean age of 30.63 years (range: 17–41 years). The mean duration of hospital stay was 5.53 days, while the mean total duration of illness was 7.79 days. Dysphagia (p = 0.014) and high-grade fever (p = 0.012) were significantly associated with prolonged hospital stay. In contrast, transaminitis (p = 0.586), thrombocytopenia (p = 0.492), leukopenia (p = 0.651), and initiation of acyclovir within 72 hours of symptom onset (p = 0.126) were not significantly associated with prolonged hospitalization.

Conclusion: Chickenpox represents a significant health burden among adults in Pakistan. Dysphagia and severity of fever are important predictors of prolonged hospital stay. Early identification and management of high-risk patients may help reduce disease severity and alleviate pressure on healthcare systems.