ABSTRACT
Key Clinical Message: Patients with COVID-19 who have undergone B-cell depletion therapy could have prolonged SARS-CoV-2 infection; therefore, even in the hospital-at-home setting, primary care physicians should carefully consider the treatment regimen and the timing of ending isolations in such cases, and should not hesitate to consult with infectious disease specialists if necessary. Abstract: We presented the first reported case of hospital-at-home care for a patient with persistent COVID-19 who had undergone B-cell depletion therapy. He received hospital-at-home care, including two courses of remdesivir; however, he ultimately failed to recover and was transferred to the hospital.
ABSTRACT
Hospital-at-home (HaH) care is useful for patients with COVID-19 and an alternative strategy when hospital capacity is under pressure due to patient surges. However, the efficacy and safety of HaH in elderly patients with COVID-19 remain unknown. In Kyoto city, we conducted a retrospective medical record review of HaH care focused on elderly COVID-19 patients from 4 February to 25 June 2021. Eligible patients were (1) COVID-19 patients aged ≥70 years and those who lived with them or (2) COVID-19 patients aged <70 years with special circumstances and those who lived with them. During the study period, 100 patients received HaH care. Their median age was 76 years (interquartile range 56-83), and 65% were over 70 years. Among 100 patients, 36 (36%) had hypoxia (oxygen saturation ≤ 92%), 21 (21%) received steroid medication, and 34 (34%) received intravenous fluids. Although 22 patients were admitted to the hospital and 3 patients died there, no patients died during HaH care. HaH care may be safe and effective in elderly patients with COVID-19. Our study shows that HaH provides an alternative strategy for treating COVID-19 patients and can reduce the healthcare burden at hospitals.