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1.
Korean J Intern Med ; 35(5): 1027-1030, 2020 09.
Article in English | MEDLINE | ID: covidwho-646555

ABSTRACT

Following the coronavirus disease 2019 outbreak in China, more than 10,765 patients tested positive for severe acute respiratory syndrome coronavirus 2 from February 18, 2020 to April 30, 2020 in South Korea. Performing emergency endoscopy is extremely challenging from the clinicians' viewpoint during the viral outbreak. There are no available guidelines for emergency endoscopy in tertiary hospitals during this pandemic. We set up an algorithm as a guide for emergency endoscopy in patients presenting to the emergency room with bleeding, foreign body, or impending cholangitis. From February 18, 2020 to April 30, 2020 of outbreak, 130 patients underwent emergency endoscopy in our center. Owing to the simple and streamlined algorithm for performing emergency endoscopy, no endoscopy-related infection to other patients or medical workers was reported in our center.


Subject(s)
Algorithms , Betacoronavirus , Coronavirus Infections/epidemiology , Emergency Service, Hospital , Endoscopy , Patient Selection , Pneumonia, Viral/epidemiology , Cholangitis/diagnosis , Cholangitis/etiology , Cholangitis/therapy , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Foreign Bodies/diagnosis , Foreign Bodies/etiology , Foreign Bodies/therapy , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/therapy , Humans , Infection Control/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Republic of Korea , Retrospective Studies , Tertiary Care Centers
2.
Diabetes Res Clin Pract ; 166: 108316, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-640886

ABSTRACT

Providing scheduled consultations to persons with diabetes during the COVID-19 induced lockdowns posed a major challenge. With the clinicians occupied in COVID management, a strategy of using telemedicine and engaging a team of para-clinical doctors was devised. Telephonic follow up consults were given and diabetes care was efficiently delivered.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/complications , Diabetes Mellitus/drug therapy , Insulin/therapeutic use , Pneumonia, Viral/complications , Referral and Consultation/statistics & numerical data , Telemedicine/methods , Tertiary Care Centers/statistics & numerical data , Blood Glucose/analysis , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Diabetes Mellitus/physiopathology , Diabetes Mellitus/virology , Female , Humans , Hypoglycemic Agents/therapeutic use , India/epidemiology , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology
4.
Circ Heart Fail ; 13(9): e007516, 2020 09.
Article in English | MEDLINE | ID: covidwho-748835

ABSTRACT

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.


Subject(s)
Cardiology/organization & administration , Coronavirus Infections/epidemiology , Delivery of Health Care/organization & administration , Heart Failure/therapy , Pneumonia, Viral/epidemiology , Telemedicine/organization & administration , Advance Care Planning , Ambulatory Care/organization & administration , Betacoronavirus , Heart Transplantation , Heart-Assist Devices , Humans , New York City/epidemiology , Nurse Practitioners , Pandemics , Physicians , Professional Role , Self-Help Groups , Telecommunications , Tertiary Care Centers/organization & administration , Videoconferencing
5.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 495-500, 2020 May 28.
Article in English, Chinese | MEDLINE | ID: covidwho-745315

ABSTRACT

OBJECTIVES: To summarize the emergency management of the kidney transplantation for a large tertiary first-class hospital in response to the epidemic of coronavirus disease 2019 (COVID-19). METHODS: The clinical data of inpatients in the Department of Kidney Transplantation from January 24, 2020 to February 29, 2020 were retrospectively analyzed. Since the outbreak of COVID-19, we conducted telephone, Wechat follow-up, and online education for kidney transplant recipients and patients on waiting-list for kidney transplantation one by one. We also strictly screened for COVID-19 in outpatients. To guarantee the security of medical staff and recipients and to reduce the transmission risk of COVID-19, we have made detailed approaches to prevent COVID-19, which mainly included 6 aspects of preventive approaches, such as kidney transplant clinic, kidney transplant ward, patients on waiting-list for kidney transplantation, kidney transplant operation, medical staff self-protection, and postoperative follow-up of kidney transplant recipients. RESULTS: There were altogether 47 inpatients which included 20 recipients who had just received kidney transplantation in the meantime, 2 577 kidney transplant recipients, 1 689 patients on waiting-list for kidney transplantation, and 794 outpatients in our hospital. No case of COVID-19 occurred in this period. CONCLUSIONS: Through strictly implementing proactive and preventive approaches, we avoid the occurrence of COVID-19 in carrying out kidney transplantation in the epidemic period.


Subject(s)
Coronavirus Infections/epidemiology , Kidney Transplantation , Pneumonia, Viral/epidemiology , Betacoronavirus , Coronavirus Infections/prevention & control , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Retrospective Studies , Tertiary Care Centers , Transplant Recipients , Waiting Lists
6.
S Afr Med J ; 110(9): 910-915, 2020 08 31.
Article in English | MEDLINE | ID: covidwho-745268

ABSTRACT

BACKGROUND: With COVID-19 having spread across the globe, it has become standard to implement infection control strategies (colloquially known as lockdown) with the intention of reducing the magnitude and delaying the peak of the epidemiological curve. Personal infection mitigation strategies coupled with lockdown have caused a change in healthcare-seeking behaviour, with individuals not attending to their ill health as they previously did. OBJECTIVES: To determine whether admissions for urgent and emergency surgical pathologies have declined during the COVID-19 lockdown period, and the magnitude of the decline. METHODS: A retrospective analysis was conducted, comparing pre-lockdown (3 February - 26 March 2020) and lockdown (27 March - 30 April 2020) admission incidences for surgical pathologies at a tertiary healthcare complex in North West Province, South Africa. Poisson regression models were created to determine admission incidence rate ratios (IRRs). RESULTS: Of 769 surgical admissions included in the analysis, 49.7% were male and 67.2% were unemployed. There was a 44% reduction in the incidence of non-trauma admissions during lockdown (IRR 0.56; 95% confidence interval (CI) 0.47 - 0.68; p<0.001) and a 53% reduction in the incidence of trauma-related admissions (IRR 0.47; 95% CI 0.34 - 0.66; p<0.001). CONCLUSIONS: Even when the prevalence of SARS-CoV-2 infection was minimal, COVID-19 lockdown in North West was associated with a significant reduction in surgical admissions. In order to ensure an overall benefit to public health, a balance between maintaining the integrity of COVID-19 control mechanisms and access to healthcare services is essential.


Subject(s)
Appendicitis/epidemiology , Coronavirus Infections/epidemiology , Hospitalization/statistics & numerical data , Neoplasms/epidemiology , Pneumonia, Viral/epidemiology , Soft Tissue Infections/epidemiology , Surgery Department, Hospital , Wounds and Injuries/epidemiology , Adult , Aged , Betacoronavirus , Emergencies , Employment/statistics & numerical data , Female , Gastrointestinal Hemorrhage/epidemiology , Humans , Intestinal Obstruction/epidemiology , Male , Middle Aged , Pandemics , Retrospective Studies , South Africa/epidemiology , Tertiary Care Centers , Young Adult
7.
ESMO Open ; 5(5)2020 09.
Article in English | MEDLINE | ID: covidwho-744875

ABSTRACT

BACKGROUND: During the COVID-19 outbreak, healthcare professionals (HCP) are at the frontline of clinical management and at increased risk for infection. The SARS-CoV-2 seroprevalence of oncological HCP and their patients has significant implications for oncological care. METHODS: HCP and patients with cancer at the Division of Oncology, Medical University of Vienna were included between 21 March and 4 June and tested for total antibodies against SARS-CoV-2 employing the Roche Elecsys Anti-SARS-CoV-2 immunoassay. Reactive samples were confirmed or disproved by the Abbott SARS-CoV-2 IgG test. Additionally, a structured questionnaire regarding basic demographic parameters, travel history and COVID-19-associated symptoms had to be completed by HCP. RESULTS: 146 subjects (62 HCP and 84 patients with cancer) were enrolled. In the oncological HCP cohort, 20 (32.3%) subjects were medical oncologists, 28 (45.2%) nurses at our ward and 14 (22.6%) fulfil other functions such as study coordinators. In the patient cohort, most individuals are on active anticancer treatment (96.4%). 26% of the HCP and 6% of the patients had symptoms potentially associated with COVID-19 since the end of February 2020. However, only in 2 (3.2%) HCP and in 3 (3.6%) patients, anti-SARS-Cov-2 total antibodies were detected. The second assay for anti-SARS-Cov-2 IgG antibodies confirmed the positive result in all HCP and in 2 (2.4%) patients, suggesting an initial assay's unspecific reaction in one case. In individuals with a confirmed test result, an active COVID-19 infection was documented by a positive SARS-CoV-2 RNA PCR test. CONCLUSION: Specific anti-SARS-CoV-2 antibodies were found solely in persons after a documented SARS-CoV-2 viral infection, thus supporting the test methods' high sensitivity and specificity. The low prevalence of anti-SARS-CoV-2 antibodies in our cohorts indicates a lack of immunity against SARS-CoV-2. It highlights the need for continued strict safety measures to prevent uncontrolled viral spread among oncological HCPs and patients with cancer.


Subject(s)
Antibodies, Viral/blood , Betacoronavirus/immunology , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Medical Staff, Hospital , Oncology Service, Hospital , Patients , Pneumonia, Viral/diagnosis , Serologic Tests , Tertiary Care Centers , Adolescent , Adult , Aged , Aged, 80 and over , Austria/epidemiology , Betacoronavirus/pathogenicity , Biomarkers/blood , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Female , Host-Pathogen Interactions , Humans , Male , Middle Aged , Nursing Staff, Hospital , Oncologists , Oncology Nursing , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Predictive Value of Tests , Prospective Studies , Reproducibility of Results , Retrospective Studies , Seroepidemiologic Studies , Young Adult
8.
Transfus Clin Biol ; 27(3): 147-151, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-738780

ABSTRACT

Due to the government's early intervention such as mass lockdown and curtailment strategies towards mass gatherings, amid the COVID-19 outbreak, the organization of the voluntary blood donation camps have been suspended. It's most significant impact on the blood community has been a dramatic decrease in the number of blood donors. Therefore, our blood stock has almost dried up and put our inventory in a state of jeopardy. Additionally, all the elective surgeries and non-urgent clinical interventions have also been deferred during this time. This has led to a drop in the blood collection, demand as well as the issue at our blood center. With this backdrop, we intended to assess the effect of this mass lockdown on our blood supply management, particularly in two phases [phase-I prior to the outbreak] and phase-II [during the outbreak]. Transitioning back to the normal conditions would most likely depend on the extent and the time duration of this pandemic and associated behavioural change, which is foreseen to remain in effect well beyond the original estimates.


Subject(s)
Betacoronavirus , Blood Banks/organization & administration , Blood Donors/supply & distribution , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Academic Medical Centers , Blood Banks/statistics & numerical data , Blood Donors/statistics & numerical data , Blood Transfusion/statistics & numerical data , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Humans , India/epidemiology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Retrospective Studies , Tertiary Care Centers
9.
Epidemiol Infect ; 148: e203, 2020 08 28.
Article in English | MEDLINE | ID: covidwho-733552

ABSTRACT

As the Middle East respiratory syndrome coronavirus (MERS-CoV) continues to occur in small outbreaks in Saudi Arabia, we aimed to assess the knowledge, attitudes and intended practices of healthcare workers (HCWs) during the early stage of the COVID-19 pandemic and compare worry levels with previous findings during the MERS-CoV outbreak in 2015. We sent an adapted version of our previously published MERS-CoV questionnaire to the same cohort of HCWs at a tertiary hospital in Saudi Arabia. About 40% of our sample had previous experience with confirmed or suspected MERS-CoV patients, and those had a significantly higher knowledge score (13.16 ± 2.02 vs. 12.58 ± 2.27, P = 0.002) and higher adherence to protective hygienic practices (2.95 ± 0.80 vs. 2.74 ± 0.92, P = 0.003). The knowledge scores on COVID-19 were higher in the current cohort than the previous MERS-CoV outbreak cohort (68% vs. 79.7%, P < 0.001). HCWs from the current cohort who felt greater anxiety from COVID-19 compared to MERS-CoV were less likely to have been exposed to MERS-CoV infected/suspected cases (odds ratio (OR) = 0.646, P = 0.042) and were less likely to have attended the hospital awareness campaign on COVID-19 (OR = 0.654, P = 0.035). We concluded that previous experience with MERS-CoV was associated with increased knowledge and adherence to protective hygienic practices, and reduction of anxiety towards COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Health Knowledge, Attitudes, Practice , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Tertiary Care Centers , Adult , Female , Health Personnel , Humans , Infection Control , Male , Middle Aged , Middle East Respiratory Syndrome Coronavirus , Pandemics , Saudi Arabia/epidemiology
10.
Am J Manag Care ; 26(8): e237-e238, 2020 08 01.
Article in English | MEDLINE | ID: covidwho-729864

ABSTRACT

This article gives recommendations for individual hemodialysis centers worldwide to ensure the safety and effectiveness of patients receiving maintenance hemodialysis based on the experience of such a patient with coronavirus disease 2019 (COVID-19) in the Sichuan province of China.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Kidney Failure, Chronic/therapy , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Renal Dialysis/statistics & numerical data , Tertiary Care Centers/organization & administration , Ambulatory Care Facilities/organization & administration , Betacoronavirus , China , Humans
11.
J Med Internet Res ; 22(9): e20953, 2020 09 02.
Article in English | MEDLINE | ID: covidwho-729604

ABSTRACT

Despite significant efforts, the COVID-19 pandemic has put enormous pressure on health care systems around the world, threatening the quality of patient care. Telemonitoring offers the opportunity to carefully monitor patients with a confirmed or suspected case of COVID-19 from home and allows for the timely identification of worsening symptoms. Additionally, it may decrease the number of hospital visits and admissions, thereby reducing the use of scarce resources, optimizing health care capacity, and minimizing the risk of viral transmission. In this paper, we present a COVID-19 telemonitoring care pathway developed at a tertiary care hospital in the Netherlands, which combined the monitoring of vital parameters with video consultations for adequate clinical assessment. Additionally, we report a series of medical, scientific, organizational, and ethical recommendations that may be used as a guide for the design and implementation of telemonitoring pathways for COVID-19 and other diseases worldwide.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Delivery of Health Care/methods , Monitoring, Physiologic/methods , Patient Care , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Telemedicine/methods , Tertiary Healthcare/methods , Betacoronavirus , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Delivery of Health Care/organization & administration , Hospitalization/statistics & numerical data , Humans , Netherlands/epidemiology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Telemedicine/organization & administration , Tertiary Care Centers , Tertiary Healthcare/organization & administration
12.
Pathog Glob Health ; 114(6): 309-317, 2020 09.
Article in English | MEDLINE | ID: covidwho-727006

ABSTRACT

BACKGROUND: The aim of this study is to describe the successful emergency plan implemented by Padova University Hospital (AOUP) during the COVID-19 pandemic. METHODS: The emergency plan included early implementation of procedures aimed at meeting the increasing demand for testing and care while ensuring safe and timely care of all patients and guaranteeing the safety of healthcare workers. RESULTS: From 21 February to 1 May 2020, there were 3,862 confirmed cases of SARS-CoV-2 infection in the Province of Padua. A total of 485 patients were hospitalized in AOUP, of which 91 were admitted to the ICU; 12 .6% of admitted patients died. The average bed occupancy rate in the ICU was 61.1% (IQR 43.6%:77.4%). Inpatient surgery and inpatient admissions were kept for 76% and 74%, respectively, compared to March 2019. A total of 123,077 swabs were performed, 19.3% of which (23,725 swabs) to screen AOUP workers. The screening of all staff showed that 137 of 7,649 (1.8%) hospital workers were positive. No healthcare worker died. DISCUSSION: AOUP strategy demonstrated effective management of the epidemic thanks to the timely implementation of emergency procedures, a well-coordinated effort shared by all hospital Departments, and their continuous adjustment to the ongoing epidemic. Timely screening of all hospital workers proved to be particularly important to defend the hospital, avoiding epidemic clusters due to unknown positive cases.


Subject(s)
Betacoronavirus/physiology , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Aged , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Emergencies , Female , Health Personnel , Hospitalization , Hospitals, University , Humans , Intensive Care Units , Italy/epidemiology , Male , Mass Screening , Middle Aged , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Tertiary Care Centers
13.
Handchir Mikrochir Plast Chir ; 52(4): 272-279, 2020 Aug.
Article in German | MEDLINE | ID: covidwho-726954

ABSTRACT

BACKGROUND: To manage the expected COVID-19 patient load major restrictions in in- and outpatient treatment had to be made. Depending on local conditions and order supply differences SARS-CoV-2 restrictions had a massive impact on medical care. To show the impact of plastic surgery on emergency surgery during SARS-CoV-2 pandemic, the amount of surgical emergencies in a single center plastic surgery division were evaluated. METHOD: The number of plastic surgery cases in a university hospital was evaluated during 16.03.2020 to 27.04.2020 and compared with previous years. RESULTS: Due to cancelling of elective surgery the number of cases dropped to 57,3 % of the caseload of previous years. There was no change in ratio of emergency (2020: 56,4 %; 2017-2019: 54,9 %) and urgent (2020: 44,6 %; 2017-2019: 45 %) surgery. No changes in regard to the etiology of trauma cause nor insurance status (occupational insurance/health insurance) were noted. CONCLUSION: Based on the data of this evaluation there is a clear relevance of Plastic Surgery in the setting of general medical care. Even during the pandemic crises a sufficient plastic surgery service is mandatory in a tertiary referral center.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Surgery, Plastic/statistics & numerical data , Betacoronavirus , Elective Surgical Procedures/statistics & numerical data , Hospitals, University , Humans , Pandemics , Tertiary Care Centers/statistics & numerical data
14.
BMJ Open ; 10(8): e039177, 2020 08 20.
Article in English | MEDLINE | ID: covidwho-725772

ABSTRACT

OBJECTIVE: COVID-19 started spreading widely in China in January 2020. Outpatient fever clinics (FCs), instituted during the SARS epidemic in 2003, were upgraded to serve for COVID-19 screening and prevention of disease transmission in large tertiary hospitals in China. FCs were hoped to relieve some of the healthcare burden from emergency departments (EDs). We aimed to evaluate the effect of upgrading the FC system on rates of nosocomial COVID-19 infection and ED patient attendance at Peking Union Medical College Hospital (PUMCH). DESIGN: A retrospective cohort study. PARTICIPANTS: A total of 6365 patients were screened in the FC. METHODS: The FC of PUMCH was upgraded on 20 January 2020. We performed a retrospective study of patients presenting to the FC between 12 December 2019 and 29 February 2020. The date when COVID-19 was declared an outbreak in Beijing was 20 January 2020. Two groups of data were collected and subsequently compared with each other: the first group of data was collected within 40 days before 20 January 2020; the second group of data was collected within 40 days after 20 January 2020. All necessary data, including patient baseline information, diagnosis, follow-up conditions and the transfer records between the FC and ED, were collected and analysed. RESULTS: 6365 patients were screened in the FC, among whom 2912 patients were screened before 21 January 2020, while 3453 were screened afterward. Screening results showed that upper respiratory infection was the major disease associated with fever. After the outbreak of COVID-19, the number of patients who were transferred from the FC to the ED decreased significantly (39.21% vs 15.75%, p<0.001), and patients generally spent more time in the FC (55 vs 203 min, p<0.001), compared with before the outbreak. For critically ill patients waiting for their screening results, the total length of stay in the FC was 22 min before the outbreak, compared with 442 min after the outbreak (p<0.001). The number of in-hospital deaths of critically ill patients in the FC was 9 out of 29 patients before the outbreak and 21 out of 38 after the outbreak (p<0.05). Nineteen cases of COVID-19 were confirmed in the FC during the period of this study. However, no other patients nor any healthcare providers were cross-infected. CONCLUSION: The workload of the FC increased significantly after the COVID-19 outbreak. New protocols regarding the use of FC likely helped prevent the spread of COVID-19 within the hospital. The upgraded FC also reduced the burden on the ED.


Subject(s)
Coronavirus Infections/diagnosis , Emergency Service, Hospital/organization & administration , Fever/virology , Outpatient Clinics, Hospital/organization & administration , Pneumonia, Viral/diagnosis , Tertiary Care Centers/organization & administration , Workload , Adult , Betacoronavirus , China/epidemiology , Coronavirus Infections/transmission , Cross Infection/prevention & control , Emergency Service, Hospital/statistics & numerical data , Facilities and Services Utilization , Female , Humans , Length of Stay , Male , Middle Aged , Outpatient Clinics, Hospital/statistics & numerical data , Pandemics , Patient Transfer/statistics & numerical data , Pneumonia, Viral/transmission , Retrospective Studies , Tertiary Care Centers/statistics & numerical data
15.
J Med Internet Res ; 22(8): e19678, 2020 08 06.
Article in English | MEDLINE | ID: covidwho-724323

ABSTRACT

BACKGROUND: Widespread access to the internet has boosted the emergence of online hospitals. A new outpatient service called "internet hospital plus drug delivery" (IHDD) has been developed in China, but little is known about this platform. OBJECTIVE: The aim of this study is to investigate the characteristics, acceptance, and initial impact of IHDD during the outbreak of COVID-19 in a tertiary hospital in South China. METHODS: The total number of and detailed information on online prescriptions during the first 2 months after work resumption were obtained. Patients' gender, age, residence, associated prescription department, time of prescription, payment, and drug delivery region were included in the analysis. RESULTS: A total of 1380 prescriptions were picked up or delivered between March 2 and April 20, 2020. The largest group of patients were 36-59 years old (n=680, 49.3%), followed by the 18-35 years age category (n=573, 41.5%). In total, 39.4% (n=544) of the patients chose to get their medicine by self-pickup, while 60.6% (n=836) preferred to receive their medicine via drug delivery service. The top five online prescription departments were infectious diseases (n=572, 41.4%), nephrology (n=264, 19.1%), endocrinology (n=145, 10.5%), angiocardiopathy (n=107, 7.8%), and neurology (n=42, 3%). Of the 836 delivered prescriptions, 440 (52.6%) were sent to Guangdong Province (including 363 [43.4%] to Shenzhen), and 396 (47.4%) were sent to other provinces in China. CONCLUSIONS: The IHDD platform is efficient and convenient for various types of patients during the COVID-19 crisis. Although offline visits are essential for patients with severe conditions, IHDD can help to relieve pressure on hospitals by reducing an influx of patients with mild symptoms. Further efforts need to be made to improve the quality and acceptance of IHDD, as well as to regulate and standardize the management of this novel service.


Subject(s)
Coronavirus Infections/epidemiology , Drug Prescriptions/statistics & numerical data , Internet , Pneumonia, Viral/epidemiology , Telemedicine/statistics & numerical data , Tertiary Care Centers/organization & administration , Transportation/statistics & numerical data , Adolescent , Adult , China/epidemiology , Disease Outbreaks , Female , Humans , Male , Middle Aged , Pandemics , Young Adult
16.
Acta Orthop Traumatol Turc ; 54(4): 355-363, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-723398

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the types and the frequency of fractures, both in the pediatric and adult population during the COVID-19 pandemic and to find out the differences in comparison to the non-pandemic period. METHODS: Patients who were admitted to the hospital with a new fracture during pandemic period (March 16 to May 22, 2020) were evaluated. Control group consisted of patients with new fractures admitted to the hospital in the same date range in 2018 and 2019. The patients were divided into two groups as ≤16 years old (group 1) and >16 years old (group 2). The evaluation was based on the age and gender of the patients and localization of the fractures. Hospitalized and surgically treated patients were evaluated as well. RESULTS: A total of 1794, 1747, and 670 fractures were observed in 2018, 2019, and 2020, respectively. Mean age of the patients in group 1 was found to have decreased in the pandemic period (p<0.001). The most common fracture sites in the pediatric population were the distal forearm and distal arm, whereas hand, distal forearm, and foot were most common fracture sites in adults, in both pandemic and non-pandemic periods. The proportional increase in femoral and tibial shaft fractures in group 1, and toe, tibial shaft, and metacarpal fractures in group 2 was found to be statistically significantly (p<0.05). In group 1; 6.8%, 7.7%, and 14.6% of the fractures were treated surgically in 2018, 2019, and 2020, respectively (p<0.001). For group 2, these rates were 20.1%, 18.6%, and 18.1%, respectively (p=0.67). There were 48, 29, and 26 open fractures in 2018, 2019 and 2020, respectively (p=0.066). In pandemic period, duration of the hospital stay was significantly shorter for distal humerus and proximal femur fractures (p values= 0.001 and 0.017, respectively). CONCLUSION: We observed that the frequency of fractures decreased by approximately one-third during the pandemic period compared with that in the non-pandemic period. The mean age of the patients with a fracture in the pediatric group was found to have decreased also. Finger fractures in pediatric patients and metatarsal fractures in adult patients were found to have significantly decreased during the pandemic. LEVEL OF EVIDENCE: Level III, Diagnostic study.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Fractures, Bone/epidemiology , Pneumonia, Viral/epidemiology , Tertiary Care Centers/statistics & numerical data , Adolescent , Adult , Child , Coronavirus Infections/complications , Female , Fractures, Bone/complications , Humans , Incidence , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Retrospective Studies , Turkey/epidemiology
18.
JNMA J Nepal Med Assoc ; 58(227): 480-486, 2020 Jul 31.
Article in English | MEDLINE | ID: covidwho-709636

ABSTRACT

INTRODUCTION: The lack of knowledge among health care professionals leads to diagnostic delays, further spread of disease, and poor infection control practices. Health care professionals must be updated knowledge regarding COVID-19. This study aims to assess the knowledge of health care professionals regarding COVID -19 in a medical college in Chitwan. METHODS: A Knowledge, Attitude and Practice Study was carried out in a tertiary care hospital in Chitwan, Nepal from April 22, 2020, to April 28, 2020. The institutional review committee of Chitwan Medical College provided ethical approval for the research. Data were collected with an online questionnaire using Google forms. The questionnaire was sent out to 724 potential responders who included health care professionals from medical, dental, nursing, and allied health sciences in Chitwan Medical College. A convenient sampling method was used for data collection. Data were analyzed using Statistical Package of Social Sciences. RESULTS: A total of 181 respondents completed the web survey. Overall, a total of 35 (19.3%) respondents were found to have "Good" knowledge; 105 (58%) respondents had "Fair" knowledge and 41 (22.7%) respondents had "Poor" knowledge regarding various aspects of COVID-19. There was no significant difference among the various health professional groups in their knowledge scores under the four knowledge domains. CONCLUSIONS: The study of knowledge of health care professionals could act as a reference for the prevention and better management of COVID-19. This study shows that there is a need to implement periodic educational interventions and training programs on infection control practices for COVID-19 across all healthcare professions.


Subject(s)
Allied Health Personnel , Clinical Competence , Coronavirus Infections , Dentists , Nurses , Pandemics , Physicians , Pneumonia, Viral , Students, Medical , Adult , Betacoronavirus , Female , Humans , Male , Middle Aged , Nepal , Tertiary Care Centers , Young Adult
19.
Med Oncol ; 37(9): 83, 2020 Aug 09.
Article in English | MEDLINE | ID: covidwho-706674

ABSTRACT

The COVID-19 pandemic has deeply impacted the activity of interventional oncology in cancer centers. Since the first COVID case was diagnosed in Italy on February 21st, our Hospital, located in Milan downtown, has been at the frontline to manage this emergency and to try to ensure essential services. In the present article, we discuss the changes that need to be done for the organization, safety, and patient management in interventional oncology.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Medical Oncology/standards , Neoplasms/epidemiology , Pneumonia, Viral/epidemiology , Tertiary Care Centers/standards , Coronavirus Infections/therapy , Health Personnel/standards , Humans , Italy/epidemiology , Medical Oncology/methods , Neoplasms/therapy , Pandemics , Personal Protective Equipment/standards , Pneumonia, Viral/therapy , Workflow
20.
Crit Pathw Cardiol ; 19(3): 112-114, 2020 09.
Article in English | MEDLINE | ID: covidwho-705771

ABSTRACT

Since December 2019, the coronovirus disease-2019 (COVID-19) pandemic has resulted in more than 2,160,000 positive cases and more than 145,000 deaths until April 18, 2020. The pressure to the health services worldwide has been unprecedented. The redeployment of staff and resources to treat more efficiently COVID-19 cases along with the need to reduce disease transmission has affected the field of electrophysiology among many others. Amendments to clinical pathways are obligatory in this perspective to continue to provide the necessary health services to the people who need them, although at the same time, infection control and prevention are not compromised by inadvertent disease transmission or unnecessary use of resources. We aim to provide a guide of the logistic aspects of electrophysiology procedures derived from our tertiary cardiac center during the current COVID-19 pandemic.


Subject(s)
Cardiac Electrophysiology , Coronavirus Infections , Critical Pathways/trends , Pandemics , Patient Care Management , Pneumonia, Viral , Betacoronavirus/isolation & purification , Cardiac Electrophysiology/methods , Cardiac Electrophysiology/organization & administration , Cardiac Electrophysiology/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Humans , Infection Control/methods , Infection Control/organization & administration , Organizational Innovation , Pandemics/prevention & control , Patient Care Management/methods , Patient Care Management/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Tertiary Care Centers/organization & administration , United Kingdom
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