Total costs of inpatient treatment for COVID-19 in a tertiary hospital in Serbia.

BACKGROUND: Our study aimed to identify the total costs of inpatient treatment for coronavirus disease 2019 (COVID-19) in a tertiary institution in Serbia, an upper-middle-income country in Southeast Europe. METHODS: An observational, retrospective, cost-of-illness study was performed from the perspective of the National Health Insurance Fund and included a cohort of 78 females and 118 males admitted to the COVID-19 ward units of a tertiary center during the first wave of the pandemic. RESULTS: The median of the total costs in the non-survivors subgroup (n =43) was 3,279.16 Euros [interquartile range (IQR): 4,023.34; range: 355.20-9,909.61) which is higher than in the survivors (n =153) subgroup 747.10 Euros (IQR: 1,088.21; 46.71-3,265.91). The cut-off value of 156.46 Euros regarding the total costs per day was estimated to have 95.3 % sensitivity and 91.5 % specificity for predicting patients' dismal prognosis, with the area under the curve (AUC) of 0.968 (95 % confidence interval: 0.940-0.996, p <0.001). CONCLUSIONS: Direct medical inpatient treatment costs for COVID-19 represent a significant economic burden. The link between increased costs and an ultimate unfavorable outcome should be further explored.HIPPOKRATIA 2022, 26 (2):62-69.

Lethal outcome in a healthy man infected with covid-19

COVID-19 is defined as a respiratory infection which is spread by droplets and immediate contact with an infected per-son. The first case of COVID-19 infection in Serbia was reported on March 6th, 2020. Herein, we present the case of confirmed COVID-19 infection in a previously healthy man, whose three other family members showed mild symptoms of coronavirus disease, without the need for hospitalization. The patient was treated at the tertiary medical center, four days after the onset of symptoms. During the hospi-talization, he developed serious complications and fatal outcome. In this case, hypoxia-induced cardiac arrest was secondary to severe COVID-19 pneumonia with the development of acute respiratory distress syndrome and sepsis. Laboratory and flow cytome-try results indicate the presence of the cytokine storm, while the mechanical ventilation might potentially increase the risk of lethal outcome. This case report is important because it should give clinicians the insight into the treatment of the previously healthy individuals with COVID-19, especially in terms of possible laboratory markers that could indicate the presence of the cytokine storm phenom-enon. © 2020, University of Kragujevac, Faculty of Science. All rights reserved.