ABSTRACT
Background: Hospital capacity management has been one of the main public health problems in many countries during the COVID-19 outbreak. Field hospitals were developed as a means of taking care of patients with limited resource utilization. Objective: To demonstrate clinical presentations and treatment outcomes of patients infected with COVID-19 treated at a field hospital. Additionally, cost and utilization were also evaluated. Materials and Methods: The present study was a retrospective study. Data from the medical records of the patients diagnosed with COVID-19 admitted and discharged from a field hospital between April 2021 and June 2021 were reviewed. Clinical presentation, treatment outcomes, cost, and utilization were analyzed, classified by disease severity. Results: Seventy-two patients with a mean age (SD) of 30.2 (8.4) years were enrolled in the present study. Thirty-six patients (50.0%) were asymptomatic. Nasal congestion was the most common symptom of COVID-19 (30.6%). Patients with mild pneumonia had higher body mass index (BMI) and older age than asymptomatic cases, and symptomatic COVID-19 cases without pneumonia (p=0.014, 0.028, respectively). The two common final diagnoses were acute pharyngitis (27.8%) and pneumonia (26.4%). Asymptomatic pneumonia was found in 5.6%. The mortality rate was 0% in the field hospital. The average length of stay was 12 days, and the mean total cost of treatment was 48,396 THB per patient. The patients with mild pneumonia had significant higher total cost of treatment than asymptomatic cases and symptomatic COVID-19 cases without pneumonia. Conclusion: Field hospitals could be the most efficient option for taking care of COVID-19 patients when healthcare resources in hospital are limited. COVID-19 patients’ triage was important to determine the outcomes. Asymptomatic cases, symptomatic cases without pneumonia, and cases with mild pneumonia could be treated in a field hospital with cost-effective outcomes. © 2022 JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND.
ABSTRACT
Co-infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and tuberculosis (TB) is infrequent. Here, we report two patients diagnosed with coronavirus disease 2019 (COVID-19) pneumonia together with pulmonary TB. Patient 1 is a 70-year-old male with COVID-19 pneumonia with acute respiratory distress syndrome (ARDS) complication and pulmonary TB who received darunavir plus ritonavir, chloroquine and favipiravir for COVID-19 ARDS, and standard anti-TB agents were adjusted to non-rifampicin (levofloxacin) regimen to avoid drug-drug interaction between protease inhibitors and rifampicin. Patient 2 is a 56-year-old male with COVID-19 pneumonia and miliary TB who received hydroxychloroquine, azithromycin and favipiravir for COVID-19 pneumonia, and a standard short course of rifampicin-based regimen for miliary TB. Given the prevalence of TB in Thailand, determination of TB co-infection among COVID-19 patients should lead to favorable clinical outcomes.