ABSTRACT
Background/Purpose: Our craniofacial center, just as many health care systems, adjusted its delivery of care in response to the current pandemic in order to reduce the risk of transmitting SARS-CoV-2, the virus the causes COVID to providers and patients. Considering the craniofacial (CFC) population, patient's treatment plan often requires at least annual follow-up visits with multiple interdisciplinary providers. Many of our patients undergo long commutes;moreover, 70% of the patients are from the underserved and diverse population and receive state-funded medical insurance. Thus, the maintenance of continuity of care is important for the CFC population as appointments are used to prepare and schedule upcoming treatments and surgeries. In response, our center has offered telehealth appointments for all our patients and families. The purpose of this study is to evaluate patient and caregiver experience of using telehealth services to determine its benefits and barriers as the center considers providing virtual care during and beyond the COVID-19 pandemic. Methods/Description: A bilingual, English and Spanish, survey was created using Qualtrics and emailed to the caregivers of patients who recently attended a virtual appointment with any of our providers from our craniofacial team. Families without emails were interviewed via phone call. A total of 60 families were invited to complete the survey. The survey assessed the following: The feasibility of attending telehealth services, benefits and barriers to attending the appointment, patient and caregiver satisfaction with each provider, preference of in-person versus telehealth meeting, and preference of future telehealth appointments (ie, seeing all providers in one day vs separate days). Results: Preliminary data suggest that caregivers are overall satisfied with telehealth appointments. Many participants reported liking the convenience of telehealth visits, specifically the flexibility, the shorter wait time and duration, and not needing to travel. They were overall satisfied with the time spent with the providers and indicated that they received the necessary information during the appointment. In addition, many caregivers indicated that they would rather attend virtual provider appointments on different days instead of the traditional full day of appointments at our center. No barriers or negative experiences were reported. Conclusions: The current findings indicate that with telehealth, caregivers are experiencing a reduction of burden of care without compromising the quality of care. This is extremely valuable considering the diverse and underserved patients our center aims to serve. Although preliminary, the data suggest that telehealth visits could be beneficial even beyond the pandemic as means to increase treatment engagement and decrease barriers to appointments.
ABSTRACT
AIM: To compare the incidence of pulmonary embolism (PE) in COVID-19 pneumonia and non-COVID-19-related community-acquired pneumonia (CAP) in hospitalised patients. MATERIALS AND METHODS: A retrospective case-control study was conducted. This included patients hospitalised with pneumonia and investigated for suspected PE with computed tomography pulmonary angiogram (CTPA). Cases were defined as patients with COVID-19 pneumonia from 1 March 2020 to 17 May 2020; controls were patients with CAP from 5 July 2019 to 31 January 2020. The primary outcome was to determine the risk of developing PE in both groups. Multivariable logistic regression was used to calculate the adjusted odds ratio for PE. RESULTS: One hundred and forty-four patients were included; 72 cases (47% male; mean age 59 (±15) years), and 72 controls (56% male; mean age 58 (±20) years). PE was diagnosed in 23.6% of the cases versus 6.9% of the controls. The adjusted odds ratio for PE in hospitalised patients with COVID-19 pneumonia compared with those with CAP was 3.23 (95% confidence interval [CI] 1.04-10.04, p=0.04). CONCLUSION: The odds of developing PE in hospitalised patients with COVID-19 pneumonia are three-times higher than in those with CAP. The results provide a quantitative assessment of the risk of PE in COVID-19 pneumonia, a condition new to healthcare, compared to other forms of pneumonia with a well-established scientific basis.