ABSTRACT
Background and Aim: Many obstacles have risen during the lockdown period due to the COVID-19 pandemic, including the provision of urgent dental care. The Rothschild hospital had to establish a balance between providing a core service and limiting patient admission through a fair sorting system. This study aims to assess the efficacy of the dental emergency protocol implemented during the first lockdown. Methods: The protocol was applied for patients who arrived at the hospital between March 18 and May 11, 2020. First, they underwent a sorting diagnosis (A) based on self-reported symptoms. If deemed as urgent, they were oriented towards dental professionals, who performed an intraoral examination leading to a clinical diagnosis (B). Diagnoses (A and B) were categorized into four groups: infectious, prosthetic, traumatic, and other emergencies. The agreement between diagnoses A and B was tested (Cohen's Kappa score). Positive predictive value, negative predictive value, sensitivity and specificity among diagnostic categories were assessed to evaluate the performance and efficacy of the sorting diagnosis. Results: Out of 1651 dental visits, 1064 were included for this analysis. The most frequent reported symptom at the sorting diagnosis was pain (40%), whereas the most frequent clinical diagnosis was endodontic emergency (30%). Periodontal emergency concerned 6% of patients. Tooth extraction was required in 32% of cases;systemic antibiotics were prescribed for 49.2% of patients. Infectious emergency diagnosis had the higher sensitivity (94.2%), whereas prosthetic emergency diagnosis had the higher specificity (99.1%). The level of agreement was substantial (kappa > 0.6) for the majority of diagnoses. No Covid-19 contamination occurred. Conclusions: This study demonstrates that the implemented protocol during the first COVID-19 lockdown to manage dental emergencies was effective, establishing an appropriate patient orientation prior to clinical examination to minimize the risk of COVID-19 exposure whilst safeguarding professionals and patients.
ABSTRACT
The French-language Respiratory Medicine Society (SPLF) proposes a guide for the follow-up of patients who have presented with SARS-CoV-2 pneumonia. The proposals are based on known data from previous epidemics, on acute lesions observed in SARS-CoV-2 patients and on expert opinion. This guide proposes a follow-up based on three categories of patients: (1) patients managed outside hospital for possible or proven SARS-CoV-2 infection, referred by their physician for persistent dyspnoea; (2) patients hospitalized for SARS-CoV-2 pneumonia in a medical unit; (3) patients hospitalized for SARS-CoV-2 pneumonia in an intensive care unit. The subsequent follow-up will have to be adapted to the initial assessment. This guide emphasises the possibility of others causes of dyspnoea (cardiac, thromboembolic, hyperventilation syndrome…). These proposals may evolve over time as more knowledge becomes available.
ABSTRACT
Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2020
ABSTRACT
Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2020
Subject(s)
Cardiovascular Diseases/diagnostic imaging , Cardiovascular Diseases/epidemiology , Coronavirus Infections/epidemiology , Echocardiography/methods , Pneumonia, Viral/epidemiology , Troponin T/blood , Aged , Biomarkers/blood , COVID-19 , Cardiovascular Diseases/blood , Comorbidity , Coronavirus Infections/diagnosis , Databases, Factual , Female , Heart Function Tests , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Prognosis , Retrospective Studies , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
The French-language Respiratory Medicine Society proposes a guide for the follow-up of patients who have presented with SARS-CoV-2 pneumonia. The proposals are based on known data from previous epidemics, on acute lesions observed in SARS-CoV-2 patients and on expert opinion. This guide proposes a follow-up based on three categories of patients: 1) patients managed outside hospital for possible or proven SARS-CoV-2 infection, referred by their physician for persistent dyspnoea;2) patients hospitalized for SARS-CoV-2 pneumonia in a medical unit;3) patients hospitalized for SARS-CoV-2 pneumonia in an intensive care unit. The subsequent follow-up will have to be adapted to the initial assessment. This guide emphasises the possibility of others causes of dyspnoea (cardiac, thromboembolic, hyperventilation syndrome..). These proposals may evolve over time as more knowledge becomes available.
ABSTRACT
Résumé La Société de Pneumologie de Langue Française propose un guide pour le suivi respiratoire des patients ayant présenté une pneumonie à SARS-CoV-2 à partir des données connues des précédentes épidémies, des lésions aiguës constatées chez ces patients et d’opinions d’experts. Ce guide propose une conduite à tenir selon le type de patients : 1) patient pris en charge en ville pour une infection à SARS-CoV-2 possible ou prouvée adressé par son médecin traitant pour dyspnée persistante, 2) patient hospitalisé pour pneumonie à SARS-CoV-2 en unité conventionnelle, 3) patient hospitalisé pour pneumonie à SARS-CoV-2 ayant fait un séjour en réanimation. Le suivi ultérieur sera à adapter au bilan initial. Ce guide insiste sur le fait qu’il ne faut pas méconnaitre les autres causes de dyspnée (cardiaques, thromboemboliques, syndrome d’hyperventilation, …). Ces propositions pourront évoluer dans le temps au fil des connaissances sur le sujet. The French-language Respiratory Medicine Society proposes a guide for the follow-up of patients who have presented with SARS-CoV-2 pneumonia. The proposals are based on known data from previous epidemics, on acute lesions observed in SARS-CoV-2 patients and on expert opinion. This guide proposes a follow-up based on three categories of patients: 1) patients managed outside hospital for possible or proven SARS-CoV-2 infection, referred by their physician for persistent dyspnoea;2) patients hospitalized for SARS-CoV-2 pneumonia in a medical unit;3) patients hospitalized for SARS-CoV-2 pneumonia in an intensive care unit. The subsequent follow-up will have to be adapted to the initial assessment. This guide emphasises the possibility of others causes of dyspnoea (cardiac, thromboembolic, hyperventilation syndrome..). These proposals may evolve over time as more knowledge becomes available.