A Bicentric Study to Investigate the Impact of COVID-19 on Urological Patients

In December 2019, SARS-CoV-2 broke out, which raised great attention worldwide. In fact, it was essential to reorganize the management of economic, infrastructural and medical resources to deal with the inadequate preparation of medical practitioners for this emergency. It was evident that the global health, medical and scientific communities were not adequately prepared for this emergency, so during the pandemic. In this paper, data extracted from hospital discharge records of the Department of Urology of the A.O.R.N "Cardarelli” in Naples, Italy, were used. This work is an extension of a previous work, whose goal concerned how admission procedure in the Urology department of the "San Giovanni di Dio and Ruggi d'Aragona” hospital has been affected by COVID-19 pandemic. In this work we compare the results obtained for the patients of the University Hospital "San Giovanni di Dio and Ruggi d'Aragona” of Salerno and the patients of the A.O.R.N. "Antonio Cardarelli” of Naples (Italy). Data have been extracted from both hospitals discharge records of the Departments of Urology. Experimental analysis performed comparing pre-pandemic data with those collected during the epidemic showed an in-crease in the number of emergency hospitalizations and a decrease in planned pre-admission hospitalizations. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The Impact of the COVID-19 Pandemic on Acute Appendicitis Presentation in Two Urban Multiethnic Community Hospitals

Background Acute appendicitis (AA) is the most common abdominal surgical emergency in pediatrics. There was a precipitous drop in pediatric visits to hospitals, including the emergency department, since the United States declared COVID-19 a national emergency. Managing AA during the pandemic remains a challenge as fear of COVID exposure can lead to delays in presentation and surgery, as well as a shift to conservative management. Alvarado score (AS) is a ten-point clinical scoring system to identify AA and the American Association for the Surgery of Trauma (AAST) grading system (I-V) is a validated tool for AA diagnosis and severity. There are no studies on prevalence and severity of AA during the COVID-19 pandemic in an urban multiethnic community. Method This is a retrospective chart review of patients admitted to Flushing Hospital Medical Center and Jamaica Hospital Medical Center with the diagnosis of AA from March 2018 to March 2021. Charts were reviewed for demographics, clinical, imaging and surgical data to determine AS and AAST. AS grouped from 1-6 (less likely to require surgery) and 7-10 (more likely to require surgery). AAST scoring was based on most severe criteria if grading discrepancies were found between pathology, surgical and computed tomography findings. Leukocytosis was defined as white blood cell count >10. G1 identified AA cases March 2018 - February 2020 and G2 March 2020 – March 2021. Data was analyzed using SPSS software, p<0.05 was considered significant. Results Of 239 patients with AA over 3 years, G1 totaled 184 (77%) in 2 years pre-pandemic and G2 had 55 (23%) during first year pandemic. Mean age, gender and ethnicity were similar for G1 and G2. AS and AAST were compared for G1 and G2, Table 1. G2 had significantly greater overall AS of >7 (p=0.038) and higher AAST (p=0.016). Only three patients tested positive for SARS-CoV-2 and 9 (16%) of G2 were transferred to a tertiary care center. Conclusion Although there was a decline in number of AA evaluated in our emergency department, the severity of AA was heightened during the pandemic. Healthcare providers need to have a high index of suspicion of increased severity with AA complications.

COVID-19 Prevalence and Outcomes in Postpartum Women and Newborns in a Community Hospital System...Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) Convention, 25-29 June, 2022, Aurora, Colorado

The article offers information about the Covid-19 prevalence and outcomes in postpartum women and newborns in a community hospital system. It mentions that pregnant women are at a significantly increased risk for severe illness, pregnancy complications, and preterm delivery if they are infected with Covid-19.

Changes in pediatric hospital care during the COVID-19 pandemic: a national qualitative study.

BACKGROUND: The COVID-19 pandemic has necessitated rapid changes in healthcare delivery in the United States, including changes in the care of hospitalized children. The objectives of this study were to identify major changes in healthcare delivery for hospitalized children during the COVID-19 pandemic, identify lessons learned from these changes, and compare and contrast the experiences of children's and community hospitals. METHODS: We purposefully sampled participants from both community and children's hospitals serving pediatric patients in the six U.S. states with the highest COVID-19 hospitalization rates at the onset of the pandemic. We recruited 2-3 participants from each hospital (mix of administrators, front-line physicians, nurses, and parents/caregivers) for semi-structured interviews. We analyzed interview data using constant comparative methods to identify major themes. RESULTS: We interviewed 30 participants from 12 hospitals. Participants described how leaders rapidly developed new hospital policies (e.g., directing use of personal protective equipment) and how this was facilitated by reviewing internal and external data frequently and engaging all relevant stakeholders. Hospital leaders optimized communication through regular, transparent, multi-modal, and bi-directional communication. Clinicians increased use of videoconference and telehealth to facilitate physical distancing, but these technologies may have disadvantaged non-English speakers. Due to declining volumes of hospitalized children and surges of adult patients, clinicians newly provided care for hospitalized adults. This was facilitated by developing care teams supported by adult hospitalists, multidisciplinary support via videoconference, and educational resources. Participants described how the pandemic negatively impacted clinicians' mental health, and they stressed the importance of mental health resources and wellness activities/spaces. CONCLUSIONS: We identified several major changes in inpatient pediatric care delivery during the COVID-19 pandemic, including the adoption of new hospital policies, video communication, staffing models, education strategies, and staff mental health supports. We outline important lessons learned, including strategies for successfully developing new policies, effectively communicating with staff, and supporting clinicians' expanding scope of practice. Potentially important focus areas in pandemic recovery include assessing and supporting clinicians' mental health and well-being, re-evaluating trainees' skills/competencies, and adapting educational strategies as needed. These findings can help guide hospital leaders in supporting pandemic recovery and addressing future crises.

Transition of a Large Tertiary Heart Failure Program in Response to the COVID-19 Pandemic: Changes That Will Endure.

The coronavirus disease 2019 (COVID-19) pandemic imposed severe restrictions on traditional methods of patient care. During the pandemic, the heart failure program at New York-Presbyterian Hospital in New York, NY rapidly and comprehensively transitioned its care delivery model and administrative organization to conform to a new healthcare environment while still providing high-quality care to a large cohort of patients with heart failure, heart transplantation, and left ventricular assist device. In addition to the widespread adoption of telehealth, our program restructured outpatient care, initiating a shared clinic model and introducing a comprehensive remote monitoring program to manage patients with heart failure and heart transplant. All conferences, including administrative meetings, support groups, and educational seminars were converted to teleconferencing platforms. Following the peak of COVID-19, many of the new changes have been maintained, and the program structure will be permanently altered as a lasting effect of this pandemic. In this article, we review the details of our program's transition in the face of COVID-19 and highlight the programmatic changes that will endure.