ABSTRACT
Background: Since March 2020 hospitals were required to respond to the SARS-CoV-2 pandemic by creating specialized isolation wards;our Internal Medicine (IM) was also called to continue caring for non-COVID-19 patients. Aim of our study was to compare the outcomes of admissions to IM between 2018- 2019 and 2020-2021. Methods: All admissions to IM for from 2018 to 2021 were included in a prospective database. Demographic and clinical data, length of stay (LOS) and outcome (discharge, death, transfer to Intensive Care Unit [ICU]) were analysed and compared between pre- and post-pandemic biennia. Results: 2577 admissions were included in the analysis (males, 48.4%, median age 80 years, median LOS 9 days, range 0-91). There were no differences in mortality or rate of transfer to ICU between the two biennia. Patients in 2020-2021 were significantly younger (mean age 75.5±14.8 vs 77.1±14.6 years, p=0.008) and had longer LOS (12.5±11.0 vs 11.0±9.1 days, p<0.001) compared to 2018-2019. LOS in 2020-2021 remained significantly longer after excluding SARS CoV2 cases (n=161, 14.4%). SARS CoV2-positive patients were significantly younger, had significantly longer LOS, and higher rate of transfer to ICU than SARS CoV2- nagative patients. In-hospital mortality did not differ between SARS CoV2-positive and negative patients. Conclusions: Our IM ward treated COVID-19 as well as non-SARSCoV- 2 acute patients throughout the pandemic. The challenges have resulted in an increased strain on hospital resources and LOS increased significantly.
ABSTRACT
Background and Aim: Respiratory infections are a leading cause of admission to Internal Medicine (IM) wards, and the 2020 SARSCoV- 2 pandemic dramatically increased this burden. Aim of our study was to assess the changes in admissions to IM for respiratory infections over the past 5 years and the impact on patient outcomes. Methods: All admissions to IM for acute pneumonia (AP) during 2015-2020 were included in a prospective database. Demographic and clinical data, length of stay (LOS) and outcome were analysed. Testing for SARS-CoV-2 began for all febrile patients in March 2020. Results: 745 admissions for AP were included in the analysis (males, 50.8%, mean age 76.5±15.4 years, median LOS 9 days, range 0-57). Admissions to IM for AP rose from 14.7% in 2015 to 20.1% in 2019 (18% overall), vs 27.2% in 2020 (p<0.001). In 2015-2019, 32% of admissions occurred in the first quarter vs 24.1% in 2020 (p=0.001). During 2020, 56 AP were SARS-CoV- 2-positive (38.6%, 95% in the fourth quarter). SARS-CoV-2 patients were younger and had a higher rate of intensive care therapy. Mean LOS in 2020 was 12.7±10.0 vs 10.9±7.6 days in 2015- 2019 (p=0.01). In-hospital mortality was not significantly different, although negative outcomes in the fourth quarter were significantly higher in 2020 (28.1% vs 15.1%, p=0.02). Conclusions: Admissions to IM for AP have been increasing even before the onset of the SARS-CoV-2 pandemic. In 2020 urgent admissions for AP were significantly higher than in previous years, requiring greater LOS, although SARS-CoV-2 infections were concentrated in the fourth quarter.