Behavior of COVID-19 virus in an intensive care unit

Introduction: The COVID-19 pandemic affected public health. Objective: To describe the behavior of COVID-19 virus in patients with a confirmed diagnosis in the ICU of the San Juan de Dios University Hospital in Armenia between April and June 2020. Materials and methods: Descriptive cross-sectional study. Variables are described in mean, standard deviation and confidence intervals. A comparative analysis is made by sex and outcome, analysis of variance and Chi square were performed and statistical difference was considered when the p value was less than 0.05. Results: Sixty patients were included, 38% female and 62% male, with a significant difference by gender (p value = .003). The average age was 57 ± 1 years. Symptoms were dyspnea in 98.3%, dyspnea and cough in 38%, dyspnea and fever in 32%, and dyspnea, cough and fever in 12%. The comorbidities were arterial hypertension 33%, diabetes mellitus 21% and obesity 25%. Dimer D (763 ng/ml), ferritin (1253 ng/ml) and LDH (426 U/l) were elevated. The oxygenation index was decreased (114 mm/Hg). Chest X-rays showed pneumonia in 78% and infiltrates in all four quadrants in 7%, and chest CT showed a ground glass image in 47% and multifocal pneumonia in 20%. The average stay in the ICU was 13.55 days, with a range between 0 and 41 days. Conclusions: The patients presented a moderate to severe oxygenation disorder, which is why they required mechanical ventilation and prone position and 45% died. © 2023

Behavior of COVID-19 virus in an intensive care unit

Introduction: The COVID-19 pandemic affected public health. Objective: To describe the behavior of COVID-19 virus in patients with a confirmed diagnosis in the ICU of the San Juan de Dios University Hospital in Armenia between April and June 2020. Materials and methods: Descriptive cross-sectional study. Variables are described in mean, standard deviation and confidence intervals. A comparative analysis is made by sex and outcome, analysis of variance and Chi square were performed and statistical difference was considered when the p value was less than 0.05. Results: Sixty patients were included, 38% female and 62% male, with a significant difference by gender (p value = .003). The average age was 57 ± 1 years. Symptoms were dyspnea in 98.3%, dyspnea and cough in 38%, dyspnea and fever in 32%, and dyspnea, cough and fever in 12%. The comorbidities were arterial hypertension 33%, diabetes mellitus 21% and obesity 25%. Dimer D (763 ng/ml), ferritin (1253 ng/ml) and LDH (426 U/l) were elevated. The oxygenation index was decreased (114 mm/Hg). Chest X-rays showed pneumonia in 78% and infiltrates in all four quadrants in 7%, and chest CT showed a ground glass image in 47% and multifocal pneumonia in 20%. The average stay in the ICU was 13.55 days, with a range between 0 and 41 days. Conclusions: The patients presented a moderate to severe oxygenation disorder, which is why they required mechanical ventilation and prone position and 45% died. © 2023

Comportamiento del virus Covid-19 en una Unidad de Cuidados Intensivos

Resumen Introducción: La pandemia Covid-19 afectó la salud pública. Objetivo: Describir el comportamiento del virus Covid-19 en los pacientes con diagnóstico confirmado en la UCI del Hospital Universitario San Juan de Dios de Armenia entre abril y junio de 2020. Materiales y métodos: Estudio descriptivo de corte transversal. Se describen variables en promedio, desviación estándar e intervalos de confianza, se hace un análisis comparativo por sexo y desenlace, se realizaron análisis de varianza y Chi cuadrado y se consideró diferencia estadística cuando el valor de p fue menor a 0,05. Resultados: Se incluyen 60 pacientes, 38% de sexo femenino y 62% de sexo masculino, con diferencia significativa por sexo (valor de p=0,003). El promedio de edad fue de 57±11 años. Los síntomas fueron disnea 98,3%, disnea y tos 38%, disnea y fiebre 32% y disnea, tos y fiebre en 12%. Las comorbilidades fueron hipertensión arterial 33%, diabetes mellitus 21% y obesidad 25%. Se encontraron elevados el Dímero D (763 ng/ml), la Ferritina (1253 ng/ml) y la LDH (426 U/L). El índice de oxigenación, estaba disminuido (114 mm/Hg). Los RX de tórax mostraron neumonía 78% e infiltrados en los 4 cuadrantes en 7% y el TAC de tórax mostró imagen de vidrio esmerilado en 47% y neumonía multifocal en 20%. La estancia promedio en la UCI fue de 13,55 días, con un rango entre 0 y 41 días. Conclusiones: Los pacientes presentaron un trastorno moderado a grave de la oxigenación, razón por la cual requirieron ventilación mecánica y posición decúbito prono y 45% fallecieron. Introduction: The Covid-19 pandemic affected public health. Objective: To describe the behavior of Covid-19 virus in patients with a confirmed diagnosis in the ICU of the San Juan de Dios University Hospital in Armenia between April and June 2020. Materials and methods: Descriptive cross-sectional study. Variables are described in mean, standard deviation and confidence intervals. A comparative analysis is made by sex and outcome, analysis of variance and Chi square were performed and statistical difference was considered when the p value was less than 0.05. Results: 60 patients were included, 38% female and 62% male, with a significant difference by gender (p value=0.003). The average age was 57±11 years. Symptoms were dyspnea in 98.3%, dyspnea and cough in 38%, dyspnea and fever in 32%, and dyspnea, cough and fever in 12%. The comorbidities were arterial hypertension 33%, diabetes mellitus 21% and obesity 25%. Dimer D (763 ng/ml), Ferritin (1253 ng/ml) and LDH (426 U/L) were elevated. The oxygenation index was decreased (114 mm/Hg). Chest X-rays showed pneumonia in 78% and infiltrates in all 4 quadrants in 7%, and chest CT showed a ground glass image in 47% and multifocal pneumonia in 20%. The average stay in the ICU was 13.55 days, with a range between 0 and 41 days. Conclusions: The patients presented a moderate to severe oxygenation disorder, which is why they required mechanical ventilation and prone position and 45% died.

Learning from the COVID-19 pandemic in Italy to advance multi-hazard disaster risk management.

COVID-19 challenged all national emergency management systems worldwide overlapping with other natural hazards. We framed a 'parallel phases' Disaster Risk Management (DRM) model to overcome the limitations of the existing models when dealing with complex multi-hazard risk conditions. We supported the limitations analysing Italian Red Cross data on past and ongoing emergencies including COVID-19 and we outlined three guidelines for advancing multi-hazard DRM: (i) exploiting the low emergency intensity of slow-onset hazards for preparedness actions; (ii) increasing the internal resources and making them available for international support; (iii) implementing multi-hazard seasonal impact-based forecasts to foster the planning of anticipatory actions.

Nosocomial infections among COVID-19 patients: an analysis of intensive care unit surveillance data.

Surveillance of nosocomial infections, like catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection, possible ventilator-associated pneumonia and secondary bloodstream infections were observed to study the impact of COVID-19 outbreak in ICUs from Tan Tock Seng Hospital and National Centre for Infectious Diseases, Singapore between February and June 2020. Higher nosocomial infection rates were observed in COVID-19 patients, although it was not statistically significant. Moreover, COVID-19 patients seem to be more predisposed to CAUTI despite a higher proportion of non-COVID-19 patients having urinary catheters. Thus, continued vigilance to ensure adherence to IPC measures is needed.