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1.
J Prim Care Community Health ; 13: 21501319211066667, 2022.
Article in English | MEDLINE | ID: covidwho-1606935

ABSTRACT

OBJECTIVE: This study aims to evaluate the safety, utilization, ability to reduce length of hospitalization and overall outcomes of a COVID-19 virtual ward providing ongoing treatment at home. METHOD: A retrospective single-center study of patients discharged to the COVID-19 virtual "step down" ward between January 27th 2021 and March 2nd 2021. The referral process, length of hospitalization, length of stay on the virtual ward, readmissions, and ongoing treatment requirements including supplemental oxygen, antibiotics, and/or steroids were all noted. RESULTS: A total of 50 patients were referred to the virtual ward. 43 referrals were accepted, 39 of which were from the respiratory ward. Four patients were readmitted, all due to hypoxia. All readmissions occurred within 5 days of discharge. 72% (n = 31) were discharged home with an ongoing oxygen requirement. 14.3% of patients were discharged with antibiotics only, 9.5% with steroids only and 23.8% with both antibiotics and steroids. The mean length of hospital stay for patients discharged to the virtual ward was 10.3 ± 9.7 days and 11.9 ± 11.6 days for all covid positive patients during this time. On average, patients spent 13.7 ± 7.3 days on the virtual ward. The average number of days spent on oxygen on the virtual ward was 11.6 ± 6.0 days. CONCLUSION: The virtual ward model exemplifies the potential benefits of collaborative working between primary and secondary care services, relieving pressure on hospitals whilst providing ongoing treatments at home such as supplemental oxygen. It also facilitates an early supported discharge of clinically stable patients with an improving clinical trajectory by managing them in the community.


Subject(s)
COVID-19 , Hospitals, General , Humans , Length of Stay , Patient Discharge , Retrospective Studies , SARS-CoV-2 , United Kingdom
2.
Epidemiol Health ; 43: e2021083, 2021.
Article in English | MEDLINE | ID: covidwho-1572772

ABSTRACT

OBJECTIVES: Coronavirus disease 2019 (COVID-19) outbreaks in general hospitals are particularly risky because they not only overburden the regional healthcare delivery system, but also increase the possibility of community transmission. This study shares an experience of a COVID-19 outbreak response in a general hospital in Gyeonggi Province, Korea. METHODS: Since the first COVID-19 confirmed case was recognized in Hospital A on March 29, 2020, the Immediate Response Team of Gyeonggi Province and Korea Disease Control and Prevention Agency devised a plan to conduct an epidemiological investigation and minimize the paralysis of hospital functions. Apart from the epidemiological investigation, a risk assessment of the hospital and management of contacts, including patients and workers, were also undertaken. RESULTS: In total, 72 confirmed cases were identified, including 26 hospitalized patients, 16 healthcare personnel, 7 visitors, and 22 cases identified externally. The majority of the confirmed cases were exposed in Ward B or were contacts of people exposed in Ward A (58.3% of 72 cases). Among healthcare personnel, caregivers were found to be the most vulnerable to COVID-19 in this outbreak. CONCLUSIONS: Preparation for all possible situations in medical facilities is important because it is difficult to find alternative resources. The findings of this study provide information on controlling the further transmission of COVID-19 and furnish evidence of the importance of ordinary management skills to be prepared for COVID-19.


Subject(s)
COVID-19 , Disease Outbreaks , Hospitals, General , Humans , Republic of Korea/epidemiology , SARS-CoV-2
3.
BMC Public Health ; 21(1): 2022, 2021 11 06.
Article in English | MEDLINE | ID: covidwho-1507120

ABSTRACT

BACKGROUND: Prevention and control (P&C) of Corona Virus Disease 2019 (COVID-19) is still a critical task in most countries and regions. However, there are many single evaluation indexes to assess the quality of COVID-19 P&C. It is necessary to synthesize the single evaluation indexes reasonably to obtain the overall evaluation results. METHODS: This study was divided into three steps. Step 1: In February 2020, the improved Delphi method was used to establish the quality evaluation indexes system for COVID-19 P&C. Step 2: in March 2020, the CRITIC method was used to adjust the Order Relation Analysis (G1) method to obtain the subjective and objective (S&O) combination weights. The comprehensive evaluation value was obtained using the weighted Efficacy Coefficient (EC) method, weighted TOPSIS method, weighted rank-sum ratio (RSR) method, and weighted Grey Relationship Analysis (GRA) method. Finally, the linear normalization method was used to synthesize the evaluation values of different evaluation methods. Step 3: From April 2020 to May 2021, this evaluation method was used to monitor and assess COVID-19 P&C quality in critical departments prospectively. The results were reported to the departments monthly. RESULT: A quality evaluation indexes system for COVID-19 P&C was established. Kendall's consistency test shows that the four evaluation method had good consistency (χ2 = 43.429, P<0.001, Kendall's consistency coefficient = 0.835). The Spearman correlation test showed that the correlation between the combined evaluation results and the original method was statistically significant(P < 0.001). According to the Mann-Kendall test, from March 2020 to May 2021, the mean value of COVID-19 P&C quality in all critical departments showed an upward trend (P < 0.01). CONCLUSIONS: The combined comprehensive evaluation method based on the S&O combined weight was more scientific and comprehensive than the single weighting and evaluation methods. In addition, monitoring and feedback of COVID-19 P&C quality were helpful for the improvement of P&C quality.


Subject(s)
COVID-19 , Hospitals, General , Health Services , Humans , Prospective Studies , SARS-CoV-2
4.
Community Dent Oral Epidemiol ; 49(6): 557-564, 2021 12.
Article in English | MEDLINE | ID: covidwho-1494632

ABSTRACT

OBJECTIVE: The impact of the worldwide COVID-19 pandemic on the dental community is evident. Dental education programmes and academic activities have suffered from the ramifications of the pandemic. This study aimed to depict the impacts of the COVID-19 epidemic on the clinical services and academic activities in the department of stomatology of a tertiary hospital in Wuhan, China. METHODS: We obtained historical data of the Department of Stomatology from the Health Information System of the General Hospital of Central Theater Command, Wuhan, China between January 2018 and June 2020. Mean, standard deviation and median with interquartile range were used to summarize the variables. Line plots were used to illustrate the temporal trend. The Kruskal-Wallis equality-of-populations rank test was used to compare the difference between groups. RESULTS: A significant decrease was noted in the monthly average number of patients seeking outpatient services for the year 2020, which were decreased by two-thirds from 2018 to 2020. The number of emergency cases also decreased significantly by 57.6% in 2020. The monthly number of teaching hours decreased from 3.8 ± 1.5 in 2018 and 4.7 ± 1.4 in 2019 to 1.7 ± 1.9 in 2020. The number of interns also decreased by more than 77.0% in 2020. CONCLUSIONS: The impacts of COVID-19 in the stomatology clinic were significant with notable decreases in clinical services and education offered to the stomatology students. There is a need to find solutions to keep as many dental professionals as needed remaining on the frontline of oral health care.


Subject(s)
COVID-19 , Oral Medicine , China/epidemiology , Hospitals, General , Humans , Pandemics , SARS-CoV-2 , Tertiary Care Centers
5.
Surg Endosc ; 35(11): 6268-6277, 2021 11.
Article in English | MEDLINE | ID: covidwho-1491141

ABSTRACT

BACKGROUND: The management of choledocholithiasis evolves with diagnostic imaging and therapeutic technology, facilitating a laparoscopic approach. We review our first 200 cases of laparoscopic exploration of the common bile duct, highlighting challenges and lessons learnt. METHODS: We retrospectively studied the first 200 cases of laparoscopic cholecystectomy with common bile duct exploration between 2006 and 2019. The database contains demographics, clinicopathological characteristics, diagnostic modalities, operative techniques, duration and outcomes. RESULTS: We compared two approaches: transcystic vs. transcholedochal in our 200 cases. Choledocholithiasis was suspected preoperatively in 163 patients. 21 cases found no stones. Of the remainder, 111/179 cases were completed via the transcystic route and the remaining were completed transcholedochally (68/179); 25% of the transcholedochal cases were converted from a transcystic approach. CBD diameter for transcystic route was 8.2 vs. 11.0 mm for transcholedochal. Total clearance rate was 84%. Retained or recurrent stones were noted in 7 patients. Length of stay was 5.8 days, 3.5 days in the transcystic route vs. 9.4 days after transcholedochal clearance. Eight patients required re-operation for bleeding or bile leak. No mortalities were recorded in this cohort, but 2 cases (1%) developed a subsequent CBD stricture. CONCLUSION: Concomitant laparoscopic common bile duct clearance with cholecystectomy is feasible, safe and effective in a district general hospital, despite constraints of time and resources. The transcystic route has a lower complication rate and shorter hospital stay, and hence our preference of this route for all cases. Advancements in stone management technology will allow wider adoption of this technique, benefitting more patients.


Subject(s)
Cholecystectomy, Laparoscopic , Choledocholithiasis , Laparoscopy , Choledocholithiasis/diagnostic imaging , Choledocholithiasis/surgery , Common Bile Duct/diagnostic imaging , Common Bile Duct/surgery , Hospitals, General , Humans , Retrospective Studies
6.
Int J Environ Res Public Health ; 18(21)2021 Oct 23.
Article in English | MEDLINE | ID: covidwho-1480767

ABSTRACT

Evaluating the use and impact of telemedicine in nursing homes is necessary to promote improvements in the quality of this practice. Even though challenges and opportunities of telemedicine are increasingly becoming well documented for geriatrics (such as improving access to healthcare, patient management, and education while reducing costs), there is still limited knowledge on how to better implement it in an inter-organizational context, especially when considering nursing homes. In this regard, this study aimed first to describe the telemedicine activity of nursing homes when cooperating with a general hospital; and then understand the behavioral differences amongst nursing homes while identifying critical factors when implementing a telemedicine project. We conducted a sequential, explanatory mixed-method study using quantitative then qualitative methods to better understand the results. Three years of teleconsultation data of twenty-six nursing homes (15 rural and 11 urban) conducting teleconsultations with a general hospital (Troyes Hospital, France) were included for the quantitative analysis, and eleven telemedicine project managers for the qualitative analysis. Between April 2018 and April 2021, 590 teleconsultations were conducted: 45% (n = 265) were conducted for general practice, 29% (n = 172) for wound care, 11% (n = 62) for diabetes management, 8% (n = 47) with gerontologist and 6% (n = 38) for dermatology. Rural nursing homes conducted more teleconsultations overall than urban ones (RR: 2.484; 95% CI: 1.083 to 5.518; p = 0.03) and included more teleconsultations for general practice (RR: 16.305; 95% CI: 3.505 to 73.523; p = 0.001). Our qualitative study showed that three critical factors are required for the implementation of a telemedicine project in nursing homes: (1) the motivation to perform teleconsultations (in other words, improving access to care and cooperation between professionals); (2) building a relevant telemedicine medical offer based on patients' and treating physicians' needs; and (3) it's specific organization in terms of time and space. Our study showed different uses of teleconsultations according to the rural or urban localization of nursing homes and that telemedicine projects should be designed to consider this aspect. Triggered by the COVID-19 pandemic, telemedicine projects in nursing homes are increasing, and observing the three critical factors presented above could be necessary to limit the failure of such projects.


Subject(s)
COVID-19 , Telemedicine , Hospitals, General , Humans , Nursing Homes , Pandemics , SARS-CoV-2
7.
Pan Afr Med J ; 39: 245, 2021.
Article in English | MEDLINE | ID: covidwho-1449272

ABSTRACT

Introduction: the year 2020 was marked by the COVID-19 pandemic that killed more than one million people. Several vaccines have been developed and vaccination campaigns started in December 2020. The objective of our study was to assess the acceptability of the COVID-19 vaccine by hospital staff. Methods: cross-sectional study conducted on a representative sample drawn at random from the staff of the Military General Hospital of Tunis. Data was collected between August and September 2020 by a clinical psychologist. We studied the associations between the different characteristics of our population and the decision to accept or refuse vaccination against COVID-19. Results: a total of 398 hospital staff agreed to answer our questionnaire. Our sample was composed of 9% (n=36) physicians, 0.9% (n=3) pharmacists, 41.3% (n=164) paramedics, 16.1% (n=64) cleaning staff and 32.7% (n=131) administrative staff. The rapid discovery of the vaccine was hoped by 97% (n=386). Vaccination was considered a means of collective protection by 84.7% (n=337). However, only 58% (n=231) agreed to be vaccinated by the COVID-19 vaccine. The main factors significantly associated with acceptance of the COVID-19 vaccine was previous influenza vaccination (aOR: 2.58, 95% CI 1.69-3.94; p=0.000). Conclusion: apprehension about vaccination does not appear to be sparing the future COVID-19 vaccine. Fear of vaccine side effects outweighs fear of the disease, even among hospital staff. To achieve vaccination coverage, several awareness and communication activities must be carried out.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Vaccination Coverage/statistics & numerical data , Vaccination/statistics & numerical data , Adult , Attitude of Health Personnel , Cross-Sectional Studies , Fear/psychology , Female , Health Knowledge, Attitudes, Practice , Hospitals, General , Humans , Immunization Programs , Male , Middle Aged , Personnel, Hospital , Surveys and Questionnaires , Tunisia , Vaccination/psychology , Young Adult
8.
BMJ Case Rep ; 14(9)2021 Sep 17.
Article in English | MEDLINE | ID: covidwho-1416641

ABSTRACT

A 47-year-old woman presented with a headache to the acute medical unit, 10 days after receiving AstraZeneca vaccination for COVID-19. Brain imaging was normal, but her blood tests showed a remarkably low platelet count, mildly deranged liver function tests and a high D-dimer. Further within her hospital admission, she developed right-sided abdominal pain and chest pain, and subsequent cross-sectional imaging confirmed a small segmental pulmonary embolism, and an acute portal vein thrombosis extending to the splenic and superior mesenteric veins. On the basis of her investigations, she was diagnosed as a case of vaccine-induced thrombotic thrombocytopenia and was treated with intravenous immunoglobulins. In a time where there is a strategic goal to vaccinate the global population from COVID-19 to inhibit the spread of infection and reduce hospitalisation, this particular clinical scenario emphasises the need of all clinicians to remain vigilant for rare complications of the COVID-19 vaccination.


Subject(s)
COVID-19 , Hypertension, Pulmonary , Thrombocytopenia , Thrombosis , Vaccines , COVID-19 Vaccines , Female , Hospitals, General , Humans , Middle Aged , Pulmonary Artery , SARS-CoV-2 , United Kingdom
9.
Ann Biol Clin (Paris) ; 79(4): 325-330, 2021 Aug 01.
Article in English | MEDLINE | ID: covidwho-1412311

ABSTRACT

Health care workers (HCWs) are at major risk to be infected by SARS-CoV-2 and transmit the virus to the patients. Furthermore, travels are a major factor in the diffusion of the virus. We report our experience regarding the screening of asymptomatic HCWs returning from holidays, following the issue of a national guideline on 08/20/2020. The organization of the occupational health department and the clinical laboratory was adapted in order to start the screening on August, 24, 2020. All HCWs tested for SARS-CoV-2 the week before and 4 weeks after the implementation of the screening were included. The mean number of tests was analyzed per working day and working week. Overall, 502 (31.4%) HCWs were tested for SARS-CoV-2 during the study period. The mean number of HCWs tested per working day was 27.1. HCWs accounted for 36.9% (n = 167) and 11.2% (n = 84) of the tests performed in the 1st and the 4th week following the implementation of the guidelines. The number of tests performed each week in HCWs increased by at least 20-fold after the implementation of the guidelines. No asymptomatic HCW was tested positive. Screening of asymptomatic HCWs was poorly effective in the context of low circulation of the virus. We suggest giving priority to infection prevention and control measures and screening of symptomatic subjects and asymptomatic contacts.


Subject(s)
COVID-19 Testing , COVID-19/diagnosis , Health Personnel , Asymptomatic Infections , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing/methods , COVID-19 Testing/standards , Cross Infection/prevention & control , France/epidemiology , Guideline Adherence/organization & administration , Guideline Adherence/standards , Guideline Adherence/statistics & numerical data , Health Personnel/statistics & numerical data , Hospitals, General , Humans , Implementation Science , Infection Control/methods , Infection Control/organization & administration , Infection Control/standards , Mass Screening/methods , Mass Screening/organization & administration , Mass Screening/standards , Occupational Health Services/organization & administration , Occupational Health Services/standards , Occupational Health Services/statistics & numerical data , Return to Work/statistics & numerical data , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification
10.
Cir Cir ; 89(4): 435-442, 2021.
Article in English | MEDLINE | ID: covidwho-1339796

ABSTRACT

INTRODUCCIÓN: en la actual pandemia de COVID-19, existe evidencia creciente que ha identificado el neurotropismo del virus SARS-CoV-2 y sus complicaciones neurológicas, incluida la enfermedad cerebrovascular isquémica y escasamente hemorragia cerebral (HC). OBJETIVO: describir las características clínicas, radiológicas, de laboratorio y pronósticas de los pacientes con HC asociada al SARS-CoV-2. MÉTODOS: se incluyeron pacientes consecutivos con prueba de PCR confirmatoria para infección por SARS-CoV-2 y HC. RESULTADOS: en un período de 90 días, en un centro de referencia COVID-19 en México, de 1108 pacientes con infección por SARS-CoV-2, se encontraron 4 pacientes (0.36%) con HC. Tenían una edad de 71(±12.2) años, 2 eran mujeres. Se encontró que dos tenían factores de riesgo cardiovascular previos. En dos casos se encontró el origen en el núcleo dentado mientras que los otros dos correspondieron al tálamo. Tres de los cuatro pacientes murieron. Postulamos que el descontrol hipertensivo, coagulopatía, trombocitopenia y la respuesta inmune inducida por el virus SARS-CoV-2 podrían desencadenar HC en un paciente con riesgo previo. CONCLUSIONES: la HC se asocia a la infección por SARS-CoV-2 con mal pronóstico cuando se presenta. Los equipos de neurocirugía deben estar preparados para el tratamiento oportuno de estos pacientes. INTRODUCTION: In the current COVID-19 pandemic, there is a growing body of evidence that has identified the neurotropism of the SARS-CoV-2 virus and its neurological complications, including cerebrovascular disease, focusing mainly in ischemic and scarcely about hemorrhagic stroke (HS). OBJECTIVE: The objective of the study was to describe clinical, radiological, laboratory tests, and prognostic characteristics of patients with SARS-CoV-2 associated HS. METHODS: Consecutive patients with a confirmatory PCR test for SARS-CoV-2 infection and a HS demonstrated by head CT were included in the study. RESULTS: Over a period of 90 days, in a COVID-19 reference center in Mexico, out of a total of 1108 patients with SARS-CoV-2 infection, it found 4 patients (0.36%) who meet criteria. They had an age of 71 (±12.2) years, 2 were women. It was found that two had prior cardiovascular risk factors. Two of the HS originated in the dentate nucleus while the other two corresponded to the thalamus. Three of the four patients died. We suggest that catastrophic uncontrolled blood pressure, coagulopathy, thrombocytopenia, and immune response induced by SARS-CoV-2 could in a specific patient trigger HS. CONCLUSIONS: HS is associated to SARS-CoV-2 infection with poor prognosis when it presented. Neurosurgery teams should prepare for the timely and appropriate treatment of this patients.


Subject(s)
COVID-19/complications , Hemorrhagic Stroke/etiology , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19 Nucleic Acid Testing , Fatal Outcome , Female , Heart Disease Risk Factors , Hemorrhagic Stroke/diagnosis , Hemorrhagic Stroke/diagnostic imaging , Hospitals, General , Humans , Male , Mexico/epidemiology , Middle Aged , Prognosis , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed
12.
Arch Argent Pediatr ; 119(4): 224-229, 2021 08.
Article in English, Spanish | MEDLINE | ID: covidwho-1325943

ABSTRACT

INTRODUCTION: Appendicitis is the leading cause of surgical acute abdomen in pediatrics. During the COVID-19 pandemic, management strategies were reassessed and the number of visits to the emergency department dropped down, which may be associated with delayed diagnoses and complications. The objective of this study was to analyze the impact of the pandemic on children with acute appendicitis. METHODS: Analytical, retrospective, comparative study of pediatric patients with acute appendicitis in the 5 months of COVID-19 lockdown versus the same period in the previous year. Incidence, clinical data, stage, surgical approach, and complications were analyzed. RESULTS: The total number of appendicitis cases went down by 25% (n = 67 versus n = 50 in 2020). The mean time to consultation was 24 hours in both periods (p = 0.989). The incidence of peritonitis was 44% (n = 22) versus 37% (n = 22) (p = 0.22) in 2019. No differences were observed in terms of appendicitis stage based on surgery reports. In 2019, all surgeries were laparoscopic; while in 2020, only 42% (n = 21). The incidence of complications was 6% versus 7.5% in the previous period (p = 0.75). One patient was COVID-19 positive. CONCLUSION: Although in our population the number of appendicitis cases dropped down, consultation was not delayed. The greater impact was associated with the reformulation of management strategies, in which the laparoscopic approach is avoided to reduce virus transmission.


Introducción. La apendicitis constituye la principal causa de abdomen agudo quirúrgico en pediatría. Durante la pandemia por COVID-19, se replantearon las estrategias de manejo y disminuyeron las consultas en las guardias, lo que podría asociarse a diagnósticos tardíos y complicaciones. El objetivo de este estudio fue analizar el impacto de la pandemia en los niños con apendicitis aguda. Métodos. Estudio analítico retrospectivo comparativo de pacientes pediátricos con apendicitis aguda durante los cinco meses del confinamiento por COVID-19 versus los meses equivalentes del año previo. Se analizaron la incidencia, la clínica, el estadio, el abordaje quirúrgico y las complicaciones. Resultados. Los casos totales de apendicitis se redujeron un 25% (n = 67 versus n = 50 en 2020). El tiempo medio hasta la consulta fue de 24 horas en ambos períodos (p = 0,989). La incidencia de peritonitis fue del 44% (n = 22) versus el 37% (n = 22) (p = 0,22) en 2019. No se evidenció diferencia en los estadios de enfermedad de acuerdo con lo informado en los partes quirúrgicos. En 2019, todas las cirugías se realizaron por vía laparoscópica; en 2020, solo un 42% (n = 21). La incidencia de complicaciones fue del 6%, contra 7,5% en el período previo (p = 0,75). Un paciente fue COVID-19 positivo. Conclusión. A pesar de la reducción en el número de casos de apendicitis, no se evidenció una demora en la consulta en nuestra población. El mayor impacto se asoció a la readecuación del manejo, evitando el abordaje laparoscópico para reducir la diseminación del virus.


Subject(s)
Appendectomy/trends , Appendicitis , COVID-19/prevention & control , Delayed Diagnosis/trends , Health Services Accessibility/trends , Practice Patterns, Physicians'/trends , Acute Disease , Adolescent , Appendectomy/methods , Appendicitis/diagnosis , Appendicitis/epidemiology , Appendicitis/surgery , Argentina/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , Child , Child, Preschool , Female , Hospitals, General , Humans , Incidence , Infant , Infant, Newborn , Laparoscopy/trends , Male , Pandemics/prevention & control , Retrospective Studies , Tertiary Care Centers
14.
Am J Otolaryngol ; 42(5): 103157, 2021.
Article in English | MEDLINE | ID: covidwho-1303422

ABSTRACT

BACKGROUND: Dysphonia is a feature of the COVID-19 disease with different prevalence rates of occurrence among various nations. OBJECTIVES: To determine the prevalence of dysphonia in hospitalized patients with COVID-19 disease. MATERIALS AND METHODS: The study was conducted at Salahaddin General Hospital during the period from January to March 2021. Hospitalized COVID-19 patients with or without dysphonia were enrolled in the study. Demographic and clinical data were recorded. The severity, duration, laryngoscopic finding, and fate of the dysphonia were registered too. RESULTS: Out of 94 subjects, there were 21 (22.3%) with dysphonia. The age was ranged from 23 to 101 years, with nearly equal gender distribution. Non-smokers were found in 52.1% of the cases. Dyspnea (100%), fever (100%), and cough (98.9%) were the most common presenting symptoms. There was a statistically significant difference between the dysphonic and non-dysphonic groups regarding fatigue, nasal obstruction, and diarrhea (P-value<0.05). Mild dysphonia was found in 10 (47.6%) of the dysphonic cases. The most common laryngoscopic finding was the bowing of the vocal cords (5/18). Most of the patients (11/18) were with dysphonia for more than a month duration. Similar numbers were not recovered for a one-month follow-up. CONCLUSION: The prevalence of dysphonia was 22.3%. Dyspnea, fever, and cough were the commonest symptoms. Fatigue, nasal obstruction, and diarrhea affected dysphonia. Bowing of the vocal cords was the most common abnormality. Most of the cases were with mild dysphonia, persisting for more than a month, and were not resolved during the follow-up period of one month.


Subject(s)
COVID-19/complications , Dysphonia/epidemiology , Dysphonia/virology , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/therapy , Dysphonia/diagnosis , Female , Hospitalization , Hospitals, General , Humans , Iraq , Laryngoscopy , Male , Middle Aged , Prevalence , Retrospective Studies , Young Adult
15.
Int J Lab Hematol ; 43(6): 1302-1308, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1288297

ABSTRACT

INTRODUCTION: We aimed to identify the associations between the lymphocytes (LYM) absolute count on admission and clinical outcomes in COVID-19 patients. METHODS: In this retrospective study, 224 COVID-19 patients who were admitted to General Hospital of Central Theater Command of the PLA from January 22 to April 4, 2020, were consecutively included. These patients were divided into the lymphopenia group and the nonlymphopenia group according to whether the LYM count on admission was below the normal range. RESULTS: During hospitalization, patients in the lymphopenia group have a much higher all-cause mortality (14.5% vs 0.0%; P < .001) and an evidently longer length of hospital stay (24.0 vs 17.5 days; P < .001) than patients in the nonlymphopenia group. The correlation analysis results indicated that the LYM count was negatively correlated with the values of NEU (R = -.2886, P < .001), PT (R = -.2312, P < .001), FIB (R = -.2954, P < .001), D-D (R = -.3554, P < .001), CRP (R = -.4899, P < .001), IL-6 (R = -.5459, P < .001), AST (R = -.2044, P < .01), Cr (R = -.1350, P < .05), CPK (R = -.2119, P < .01), CK-Mb (R = -.1760, P < .01), and LDH (R = -.4330, P < .001), and was positively correlated with the count of PLT (R = .2679, P < .001). In addition, LYM as a continuous variable was associated with 97% decreased risk of in-hospital mortality in the fully adjusted models (OR = 0.03, 95%CI, 0.00-0.37, P < .001). DISCUSSION: LYM screening on admission is a critical predictor for assessment of disease severity and clinical outcomes in patients with COVID-19, and lymphopenia substantially correlates with poor clinical outcomes.


Subject(s)
COVID-19/blood , Lymphocyte Count , SARS-CoV-2 , Adult , Aged , Biomarkers/blood , Blood Cell Count , Blood Coagulation Tests , Blood Proteins/analysis , COVID-19/mortality , China/epidemiology , Creatinine/blood , Female , Hospital Mortality , Hospitals, General/statistics & numerical data , Humans , Lymphopenia/blood , Lymphopenia/etiology , Male , Mass Screening , Middle Aged , Patient Admission , Prognosis , Retrospective Studies , Severity of Illness Index , Treatment Outcome
16.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 50(1): 74-80, 2021 02 25.
Article in English | MEDLINE | ID: covidwho-1266773

ABSTRACT

To develop a quality control checklist for the prevention and control of coronavirus disease 2019 (COVID-19) in fever clinic and isolation ward of the general hospital and to assess its application. Based on the relevant prevention and control plans and technical guidelines for COVID-19,Delphi method was used to identity items for evaluation,and a quality control checklist for the prevention and control of COVID-19 in the fever clinic and isolation ward was developed in Sir Run Run Shaw Hospital. The checklists included 8 dimensions and 32 items for fever clinic,7 dimensions and 27 items for the isolation ward. The appointed inspectors conducted daily quality control for each shift with this checklist. The expert authority coefficient was 0.88,the mean of the importance of each index in the quality control table was not less than 4.8,and the coefficient of variation was not more than 0.07. During the entire February 2020,8 problems were found and rectified on-the-spot with the application of the checklist. Quality inspection rate was 100% in both isolation wards and fever clinic. The compliance rate and accuracy rate of hand hygiene were 100%; the correct rate of wearing and removing protective equipment increased from 96% to 100%. During the same period,a total of 1915 patients were admitted to the fever clinic,including 191 suspected patients (all were isolated in the hospital,3 were confirmed). There were no medical staff infected with COVID-19,no cross infection of patients and their families in the hospital. A quality control checklist for the prevention and control of COVID-19 has been developed and applied in the isolation wards and fever clinic,which plays an important role in preventing nosocomial infection.


Subject(s)
COVID-19 , Checklist , Fever , Hospitals, General , Humans , SARS-CoV-2
20.
Vox Sang ; 116(5): 574-580, 2021 May.
Article in English | MEDLINE | ID: covidwho-1241035

ABSTRACT

BACKGROUND: The COVID-19 outbreak has affected almost all hospital departments, including transfusion services. However, the demand for transfusions in a general hospital designated to deal with COVID-19 patients has not been analysed before. STUDY DESIGN AND METHODS: A retrospective study was conducted to evaluate blood transfusion practices from 15 March to 14 April 2020 at Hospital Universitario Infanta Leonor (Madrid, Spain). During this month, with few exceptions, the hospital became a 'COVID-19' centre. In addition, transfusion rates during this time frame and the same period over the last 4 years were compared. RESULTS: From 15 March to 14 April 2020, only 254 blood components were transfused, resulting in a 49·3% reduction over the previous year. Interestingly, in critically ill patients, the red blood cell (RBC) transfusion/bed ratio significantly decreased during this period (0·92) compared to the same ratio over the past 4 years (2·70) (P = 0·02). Of note, 106 blood components (95 RBC; 11 platelet concentrates) were transfused to only 36 out of 1348 COVID-19 patients (2·7%). The main reason for RBC transfusion in COVID-19 patients was a previous underlying disease (44%) followed by bleeding (25%) and inflammatory anaemia (25%). CONCLUSION: This is the first study to report a decrease in blood transfusions during the COVID-19 pandemic in a general hospital and especially in the intensive care unit. The results of this study suggest that COVID-19 does not generally induce transfusion requiring anaemia, being the main causes for transfusion in these patients underlying conditions or bleeding.


Subject(s)
Blood Transfusion/statistics & numerical data , COVID-19/therapy , Hospitals, General/statistics & numerical data , Blood Transfusion/methods , Blood Transfusion/standards , COVID-19/epidemiology , Humans , Spain
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