Management Strategies of Corona Virus Disease 2019 in Neurology Ward of Large General Hospital

Abstract: During the corona virus disease 2019 prevention and control period, based on the conscientiously studying the relevant documents issued by the National Health Protection Committee and the hospital infection department, and combining the characteristics of the neurological diseases and the actual work situation, the neurology ward reasonably set up three districts and two channels, ensure the adequacy and accessibility of the protective products, establish a comprehensive and detailed identification management, Strengthen the standardized training of staff, improve the relevant system, standardize the work process;strengthen the management of patients during admission and hospitalization, pay attention to the symptomatic nursing of patients, and strengthen the predictive nursing of various complications. From three levels of overall management (environment, staffs, patients), the spread of new coronavirus in the department of neurology was curbed effectively.

Family-centered care management strategies for term and near-term neonates with brief hospitalization in a level III NICU in Shenzhen, China during the time of COVID-19 pandemic.

BACKGROUND: Adopting the family-centered care (FCC) approach in the neonatal care has been shown to improve breastfeeding rate and parental satisfaction. To minimize the transmission of COVID-19, family visit in neonatal intensive care unit (NICU) was suspended in China. In order to maintain the benefits of FCC, the Hong Kong University-Shenzhen Hospital NICU modified FCC strategies. We evaluated the effects of new strategies and aimed to share our results and experience with other NICUs during the COVID-19 pandemic. METHODS: Using prospectively collected hospital databases, we retrospectively compared the demographic and clinical data of neonates, rates of breastfeeding at discharge, nosocomial infection and parental satisfaction one month before (open group) and after (closed group) the implementation of alternative FCC management strategies when family visit was suspended during COVID-19 pandemic. RESULTS: During the COVID-19 pandemic, we organized a multidisciplinary task force and adopted strategies of triage and screening, management of suspected infants, and breastfeeding promotion with effective communication. The nosocomial infection rate and parental satisfaction for open and closed groups (144 and 108 term and near-term neonates with brief hospitalization, respectively) were not different (1% vs. 0%, p = 1.00; 98.6 vs. 98.8, p = .80; respectively). Breastfeeding rate at discharge decreased but the difference was not significant (74% vs. 80%, p = .29). CONCLUSIONS: In our experience, in term and near-term neonates with brief hospitalization, the alternative FCC strategies maintained high parental satisfaction without increased nosocomial infection rate, but strong support for breastfeeding was needed. Through multidisciplinary collaboration, the continuation of "modified" FCC in a level III NICU is feasible in the context of COVID-19 pandemic with reduced family visitation and participation in the care.

Clinical features and outcomes of pregnant women with COVID-19: a systematic review and meta-analysis (preprint)

Background: COVID-19 outbreak in Wuhan, China recently. It quickly spread throughout worldwide. In this study, we systematically reviewed the clinical features and outcomes of pregnant women with COVID-19.Methods: PubMed、Web of Science、EMBASE、MEDLINE were searched from January 1, 2020 to April 16, 2020. Case review of pregnant women infected with COVID-19 were included. Two reviewers screened 366 literatures and 14 studies included, four reviewers independently extracted the features of the literatures. We used random-effects model to analyze incidence (P) and 95% confidence interval (95%CI). Heterogeneity was assessed using the I2 statistic.Results: The meta- analysis included 236 pregnant women with COVID-19. The results were as follows: positive CT findings (71%; 95%CI, 0.49~0.93), cesarean section (65%; 95%CI, 0.42~0.87), fever (51%; 95%CI, 0.35~0.67), lymphopenia (49%; 95%CI, 0.29~0.70), coexisting disorders (33%; 95%CI, 0.21~0.44), cough (31%; 95%CI, 0.23~0.39), fetal distress (29%; 95%CI, 0.08~0.49), preterm labor (23%; 95%CI, 0.14~0.32), severe case or death (12%; 95%CI, 0.03~0.20). The subgroup analysis showed compared with nonpregnant patients, pregnant women with COVID-19 had significantly lower incidences of fever (pregnant women group, 51%; nonpregnant patients group, 91%; P＜0.00001) and cough (pregnant women group, 31%; nonpregnant patients group, 67%; P＜0.0001). Conclusions: The incidence of fever, cough and positive CT findings in pregnant women with COVID-19 is less than that in the general population, preterm labor is the opposite. There is no evidence that COVID-19 can propagate vertically for the time being.