Impact of comorbidities on the average length of stay and mortality of COVID-19 patients in a hospital: In India

ObjectiveTo estimate the length of stay and proportional mortality in COVID patients in a COVID-dedicated hospital.MethodsA retrospective record review was done using medical records of COVID-19 in-patients, capturing the demographic, clinical, and laboratory details of admitted COVID patients, including serial samples for RTPCR/CBNAAT for Coronavirus. These details from electronic medical records were compared and collated for patients of different comorbidities to arrive at the average length of stay and case fatality rate and time duration for patients to turn COVID-negative.ResultsPatients with Diabetes Mellitus (DM) had the highest Average Length of Stay (ALS) of 12.09 days in the hospital followed by patients with Hypertension (11.5 days). Patients without any comorbidities had ALS of 8.8 days. A combination of HTN, DM, coronary artery disease (CAD), and chronic kidney disease (CKD) had the highest ALS of 14.5 days. The average duration for patients to test negative is 16 days for patients without any comorbidities. The average duration between the first symptom and the negative test is the longest for DM (21 days) followed by HTN (19.5 days), cancer (19 days), and obesity (16 days). Among the 731 people who died in the observed time, the proportional mortality rate was highest with HTN (10.80%) followed by carcinoma (7.66%) and DM (6.56%), 32.55% had a combination of two or more comorbidities. 33.70% deceased didn't have any comorbidities.ConclusionThe COVID-19 pandemic has highlighted the importance of preparing for future outbreaks and sudden increases in cases. Based on our findings, we recommend Hospital administrators have a comprehensive approach to planning for the future, considering all relevant factors, including the epidemiology of the disease, the average length of stay, and mortality rates, to ensure that their hospitals are equipped to provide high-quality care to all patients.

CHARACTERISTICS OF STATIONARY TOURIST VISITS IN URBAN MUNICIPALITIES IN SLOVENIA AFTER 2000

After 2010, a sharp increase in tourist visits was recorded in urban municipalities, and they became the most important group of tourist municipalities (with about 29% of all tourist arrivals and 36% of all foreign tourist arrivals in Slovenia in 2019). A large part of the growth in tourist visits was in the municipality of Ljubljana, which recorded 18% of all tourist arrivals and 23% of all foreign tourist arrivals in Slovenia in 2019. The Covid-19 pandemic hit urban municipalities the hardest. At the end of the article, it is pointed out that, on the one hand, Ljubljana has become one of the fastest growing and most important tourist destinations in Central Europe and, on the other hand, the increased tourist visits to Slovenia have not been reflected in the visits of other urban municipalities such as Celje, Murska Sobota, Velenje, Slovenj Gradec and Krško, which are far behind in both the number of tourists and the share of foreign tourists. This clearly shows that their tourist potential is relatively low and that the development of the tourist offer and infrastructure is still pending. © 2022, University of Ljubljana Press. All rights reserved.

[The hospital substitution form of home medical care of population of Tte Russian Federation: the analysis of functioning].

The important direction of the National Project "Health Care" are improvement of primary health care system, including introduction of hospital-replacing technologies.The purpose of the study is to evaluate functioning of hospital-substituting form of home medical care (home hospitals) to population of the Russian Federation in 2006-2020.The normative legal documents regulating activities of stationary-substituting form of home medical care (home hospitals) for adults and children, reporting forms of sectoral statistical observation № 14ds for 2006-2018 were analyzed. In 2019-2020, unified data on functioning of day hospitals and home hospitals and composition of patients treated there of medical organizations providing medical care on out-patient basis was filled in form № 14ds. The in-depth analysis permitted to extract information about activities of home hospitals for adults and children and to study their functioning in dynamics for 15 years. The content analysis, statistical and analytical methods were applied.The examination of data for 2006-2020 established increasing of number of treated adult patients in home hospitals up to 27.9% and children up to 15.0%.The distribution of the number of treated adults and children in hospitals at home per 1000 of the corresponding population by subjects indicates their significant fluctuation.For 15 years, it has been established that in the structure of treated adult patients, the proportion of people with diseases of the circulatory system has decreased from 62.2 to 31.5%, the musculoskeletal system and connective tissue - from 11.7 to 7.4%; in children - with respiratory diseases from 81.9 to 63.4%, some infectious and parasitic diseases - from 7.7 to 3.0%, diseases of the digestive system - from 3.6 to 3.2%.In the country for 2019-2020 in hospitals at home, the number of treated adults significantly increased by 1.8 times, children - by 2.3 times, the composition of those treated has changed, which is associated with the treatment of patients with a new coronavirus infection COVID-19 in them under conditions re-profiling of the majority of medical organizations into infectious diseases hospitals.

Prior Diagnosis of COVID Has No Increased Complications in Total Joint Arthroplasty.

Introduction Although a substantial portion of the United States population has been infected with and recovered from Coronavirus Disease-19 (COVID-19), many patients may have persistent symptoms and complications from disease-driven respiratory disease, arrhythmias, and venous thromboembolism (VTE). With institutions resuming elective total joint arthroplasties (TJA), it is unclear whether a prior resolved diagnosis of COVID has any implications on postoperative outcomes. Methods All elective TJA performed in 2021 at our institution were retrospectively reviewed and a history of prior COVID+ result recorded. Baseline demographics, days from prior COVID+ result to surgery date, preoperative methicillin-resistant Staphylococcus aureus (MRSA) nares colonization, and laboratory markers were obtained to determine baseline characteristics. Postoperative estimated blood loss (EBL), length of stay (LOS), rate of revision surgery, and discharge destination were compared between groups. Perioperative and postoperative rates of VTE, urinary tract infection (UTI), pneumonia, postoperative oxygen supplementation, cardiac arrhythmia, renal disease, sepsis, and periprosthetic joint infections within six months of surgery were recorded. Results Of the 155 elective TJA performed in 2021, 24 patients had a prior COVID+ diagnosis with a mean of 253 days from positive result to surgery date. There were no significant differences in baseline demographics, comorbidities, and preoperative lab markers between groups. Surgeries on patients with a prior COVID+ had a significantly higher EBL (260 vs 175cc), but postoperative outcomes of VTE, UTI, pneumonia, oxygen supplementation requirement, nares MRSA+, cardiac disease, and infection rates between groups were similar. Bivariate logistic regression revealed increased days from COVID+ diagnosis (>6 months) to surgery date were associated with a shorter LOS. Conclusion Although a prior COVID+ diagnosis had increased intraoperative blood loss, there were no significant differences in respiratory, infectious, cardiac, and thromboembolic complications up to six months after elective TJA. This study suggests that asymptomatic C+ patients receiving elective TJA do not require more aggressive prophylactic anticoagulation or antibiotic regimens to prevent VTE or perioperative infections. As institutions around the nation resume pre-COVID rates of arthroplasty surgeries, a prior diagnosis of COVID appears to have no effects on postoperative complications.