ABSTRACT
Background: The coronavirus disease (COVID-19) is a global health problem with ever-increasing attributed deaths. Patients with COVID-19 may deteriorate rapidly, and their continuous monitoring is necessary. Monitoring and providing care beyond the traditional face-to-face model is a new chapter in the history of medicine. It consists of remote monitoring and management using virtual platform as a critical component in the ever-changing environment of this deadly pandemic. We evaluated the impact of remote monitoring of the patients at their residences after being infected with SARS-COV-2 virtually. Methodology: This observational study was conducted among patients with symptoms of COVID-19 attending in the Fever Clinic between January and March 2021. The study was set to continue for the duration of the pandemic. Access to pulse oximeter and virtual platform was given to the enrolled patients. The participants were monitored in a remote monitoring platform at home and during the hospital stay. The primary outcome measures included number of recovery i.e. discharged from remote home monitoring and/or hospital and escalation of management such as hospitalization or transfer to the ICU facilities. Duration of hospital stay, patient experience and satisfaction, and barriers to use the virtual platform were included in the secondary outcome measures. Results: A total of twenty patients (median age 45 y, male to female ratio 65:35) were included. The median duration of monitoring was 10 days (IQR 8-12 days). Out of twenty patients, 3 (15%) patients needed hospitalization and were recognized in time by the team. The duration of hospital stay was 4 days median (IQR 3-6 days). All patients were discharged from this service safely;no death was reported. Ninety percent of the studied population were satisfied and felt reassured by this remote monitoring service. Conclusion: Early recognition of deterioration and prompt management through remote monitoring model increases the chances of survival of patients, and reduces the morbidity. Such remote monitoring model can be applied for future outbreaks of pandemics. [ FROM AUTHOR];Copyright of Anaesthesia, Pain & Intensive Care is the property of Department of Anaesthesia, Pain & Intensive Care and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
BACKGROUND: As evidence is mounting regarding irrational and often unnecessary use of antibiotics during the COVID-19 pandemic a cross-sectional Point Prevalence Survey (PPS) (in accordance with WHO guideline) was conducted across COVID-19 dedicated wards in Dhaka Medical College and Hospital (DMCH). METHODOLOGY: Antibiotic usage data were collected from 193 patients at different COVID-19 dedicated wards at DMCH on 11 June 2020. Comparisons in antibiotic usage were made between different groups using Pearson chi-square and Fisher's exact test. RESULT: Findings reveal all surveyed patients (100%) were receiving at least one antibiotic with 133 patients (68.91%) receiving multiple antibiotics. Overall, patients presenting with the severe disease received more antibiotics. Third-generation cephalosporins (i.e. ceftriaxone) (53.8%), meropenem (40.9%), moxifloxacin (29.5%), and doxycycline (25.4%) were the four most prescribed antibiotics among surveyed patients. Diabetes mellitus (DM) was independently associated with multiple antibiotic prescribing. Abnormal C-reactive protein (CRP) and serum d-dimer were linked with higher odds of multiple antibiotic prescribing among study patients. CONCLUSION: Prevalence of multiple antibiotic prescriptions was high among severely ill patients and those with abnormal CRP and d-dimer levels. Data regarding the quality of antibiotic prescribing were lacking.