ABSTRACT
Over the past fourteen months, services in various countries across the globe have been hit hard by the COVID-19 pandemic. The outbreak of corona virus has been overwhelming on healthcare systems in particular;and this is likely to have a lasting impact on health ventures and delivery models over the coming few years. On 31st December 2019, the World Health Organization reported the first case of COVID-19, and since then 179,553,288 cases have been reported across the sphere. In Oman, the total number of cases reported reached 250,572 as of 21st June 2021. This is against a hospital ward bed capacity of 6,034 beds across all government and private hospitals in the country. Due to the healthcare system becoming overwhelmed by the load of cases detected, a field hospital was established to act as a main hub of care for COVID-19 cases in the country. The aim of this article is to highlight the process involved in establishing and operating the field hospital. The main aspects that will be covered are the objectives of establishing the hospital, operation, components, in addition to the management and provision of cadres in its departments. The objective is to enlighten healthcare providers and the public about this service and share the experience of establishing a field hospital during this period. © 2021, Kuwait Medical Association. All rights reserved.
ABSTRACT
OBJECTIVE: The aim of this study was to evaluate the efficacy of anakinra in patients who were admitted to hospital for severe COVID-19 pneumonia requiring oxygen therapy. METHODS: A prospective, open-label, interventional study in adults hospitalized with severe COVID-19 pneumonia was conducted. Patients in the interventional arm received subcutaneous anakinra (100 mg twice daily for 3 days, followed by 100 mg daily for 7 days) in addition to standard treatment. Main outcomes were the need for mechanical ventilation and in-hospital death. Secondary outcomes included successful weaning from supplemental oxygen and change in inflammatory biomarkers. Outcomes were compared with those of historical controls who had received standard treatment and supportive care. RESULTS: A total of 69 patients were included: 45 treated with anakinra and 24 historical controls. A need for mechanical ventilation occurred in 14 (31%) of the anakinra-treated group and 18 (75%) of the historical cohort (p < 0.001). In-hospital death occurred in 13 (29%) of the anakinra-treated group and 11 (46%) of the historical cohort (p = 0.082). Successful weaning from supplemental oxygen to ambient air was attained in 25 (63%) of the anakinra-treated group compared with 6 (27%) of the historical cohort (p = 0.008). Patients who received anakinra showed a significant reduction in inflammatory biomarkers. CONCLUSION: In patients with severe COVID-19 pneumonia and high oxygen requirement, anakinra could represent an effective treatment option and may confer clinical benefit. TRIAL REGISTRATION NUMBER: ISRCTN74727214.