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1.
Saudi Med J ; 43(4): 394-400, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1789718

ABSTRACT

OBJECTIVES: To investigate the effect of tele-clinics on palliative care patients during the COVID-19 pandemic. METHODS: This is a retrospective cross-sectional study (chart review) carried out from March 17, 2020, to September 16, 2020, included all patients who were booked into the palliative care clinic. Patients were assessed by the palliative nurse specialist for COVID-19 symptoms using the acute respiratory illness screening form and Edmonton Symptoms Assessment System, also identifies the needs of the patient. Data were analyzed to investigate the effect of tele-clinics on the patients regarding ER visits and admission. RESULTS: A total of 167 individuals were analyzed and the results showed that 234 of 447 visits were virtual, supporting the increasing value of telemedicine. The number of virtual patients' visits dropped slightly at the beginning of the pandemic (46.4% in March to 39.8% in July). Subsequently, it increased steadily to 72.2% in September. The choice of virtual/non-virtual visits for individuals with cancer diagnosis significantly depends on other factors. Code status, palliative patients or follow-up service, and the frequency of oncology center visits, admissions, or ER visits were crucial in explaining the means of receiving treatment. CONCLUSION: Virtual visits in palliative care are efficient means of decreasing the threat of COVID-19 contagion. It is recommended to increase the palliative care patients' awareness of tele-clinics and their positive outcomes, particularly during the pandemic.


Subject(s)
COVID-19 , Neoplasms , Cross-Sectional Studies , Humans , Neoplasms/diagnosis , Neoplasms/epidemiology , Neoplasms/therapy , Palliative Care , Pandemics , Retrospective Studies , SARS-CoV-2 , Tertiary Healthcare
2.
J Med Internet Res ; 24(4): e29841, 2022 Apr 07.
Article in English | MEDLINE | ID: covidwho-1779869

ABSTRACT

Group-based health interventions are an important component of health promotion and management. To provide continuity of care throughout the COVID-19 pandemic, our institution undertook a rapid pivot to delivering group-based health interventions via a videoconferencing service which was securely embedded into both the electronic medical record and the patient portal to sustainably address immediate health service delivery needs during the pandemic and beyond. In this paper, we (1) describe the institutionally driven operationalization of a system to provide integrated synchronous video group visits across our hospital and (2) present a proposed strategy to comprehensively evaluate outcomes regarding their implementation, quality, and impact. Lessons for other institutions and the potential future role of synchronous video group visits to enhance how care can be scaled for delivery are discussed.


Subject(s)
COVID-19 , Telemedicine , Hospitals , Humans , Pandemics/prevention & control , SARS-CoV-2 , Tertiary Healthcare
3.
Indian J Ophthalmol ; 70(4): 1371-1375, 2022 04.
Article in English | MEDLINE | ID: covidwho-1760981

ABSTRACT

Purpose: Rhino-orbital-cerebral mucormycosis (ROCM) is a rare opportunistic fungal infection with a fulminant course and an often fatal outcome. It can occur in immune-compromised patients such as those having uncontrolled diabetes, on long-term corticosteroid or immunosuppressive therapy, with COVID-19 infection, renal failure, AIDS, malignancy, or organ transplant. The aim of our study was to study the epidemiology of mucormycosis in COVID-19 patients and identify its risk factors. Methods: Ours was an epidemiological study wherein we gathered the demographic, clinical, histopathological, and radiological data of 458 patients of mucormycosis who presented to us between August 2020 and May 2021. Mucormycosis was defined through clinical and radiological findings or positive culture reports. Results: Out of all, 20.74% of patients did not have any past or concurrent history of COVID-19. The most common symptom of mucormycosis was orbital/facial pain (38.64%) and the most common sign was periocular/facial edema (50.74%). Mucormycosis involving the nose and sinuses (94.54%) was most common followed by rhino-orbital (45.41%) and brain involvement (10.04%). The most common risk factor for mucormycosis was diabetes [81.92%], followed by corticosteroid use [79.69%] and supplemental oxygen [48.90%]. Most of the patients received similar treatment with IV amphotericin B [88.64%] and local debridement [80.74%]. Conclusion: With the third wave of COVID-19 still lurking, a fatal fungal infection should be kept in mind in COVID-19 active as well as recovered patients, especially those who have co-morbid medical conditions such as uncontrolled diabetes and who are treated with large doses of corticosteroids.


Subject(s)
COVID-19 , Mucormycosis , COVID-19/epidemiology , Epidemiologic Studies , Humans , India/epidemiology , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/microbiology , Tertiary Healthcare
5.
JCO Glob Oncol ; 8: e2100339, 2022 02.
Article in English | MEDLINE | ID: covidwho-1714671

ABSTRACT

PURPOSE: The COVID-19 pandemic has caused unprecedented health, social, and economic unrest globally, particularly affecting resource-limited low-middle-income countries. The resultant curfew had made the access to and delivery of cancer care services an arduous task. We have reported the patterns of care and 1-year outcome of head and neck squamous cell carcinoma (HNSCC) treatment before and during COVID-19 lockdown at our institution. MATERIALS AND METHODS: Patients who underwent radiation therapy (RT) for nonmetastatic HNSCC between March 1, 2020, and July 31, 2020, were included in the COVID-RT group, and those who were treated between October 1, 2019, and February 29, 2020, were included in the preCOVID-RT group. RESULTS: A total of 25 patients were in the COVID-RT group, and 51 patients were in the preCOVID-RT group. An increase in the incidence of locally advanced cancers across all subsites was observed in the COVID-RT group. There was a steep increase in the median overall RT treatment duration (52 v 44) and median break days during RT (10 v 2) in the COVID-RT group. The median follow-up period of all patients was 18 months. The progression-free survival at 1 year in the COVID-RT group and preCOVID-RT group was 84% and 90%, respectively (P = .08), and overall survival at 1 year was 86% and 96%, respectively (P = .06). CONCLUSION: Our study elucidates the adverse impact of the COVID-19 curfew on cancer care and has demonstrated safe delivery of RT for HNSCC without major acute adverse effects. Despite a significant increase in treatment breaks, early outcome data also suggest that 1-year progression-free survival and overall survival are comparable with that of the pre-COVID-19 times; however, longer follow-up is warranted.


Subject(s)
COVID-19 , Head and Neck Neoplasms , Communicable Disease Control , Head and Neck Neoplasms/radiotherapy , Humans , India/epidemiology , Pandemics , SARS-CoV-2 , Tertiary Healthcare
6.
PLoS One ; 17(2): e0263471, 2022.
Article in English | MEDLINE | ID: covidwho-1706281

ABSTRACT

BACKGROUND: We retrospectively data-mined the case records of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients hospitalized to a tertiary care centre to derive mortality predictors and formulate a risk score, for prioritizing admission. METHODS AND FINDINGS: Data on clinical manifestations, comorbidities, vital signs, and basic lab investigations collected as part of routine medical management at admission to a COVID-19 tertiary care centre in Chengalpattu, South India between May and November 2020 were retrospectively analysed to ascertain predictors of mortality in the univariate analysis using their relative difference in distribution among 'survivors' and 'non-survivors'. The regression coefficients of those factors remaining significant in the multivariable logistic regression were utilised for risk score formulation and validated in 1000 bootstrap datasets. Among 746 COVID-19 patients hospitalised [487 "survivors" and 259 "non-survivors" (deaths)], there was a slight male predilection [62.5%, (466/746)], with a higher mortality rate observed among 40-70 years age group [59.1%, (441/746)] and highest among diabetic patients with elevated urea levels [65.4% (68/104)]. The adjusted odds ratios of factors [OR (95% CI)] significant in the multivariable logistic regression were SaO2<95%; 2.96 (1.71-5.18), Urea ≥50 mg/dl: 4.51 (2.59-7.97), Neutrophil-lymphocytic ratio (NLR) >3; 3.01 (1.61-5.83), Age ≥50 years;2.52 (1.45-4.43), Pulse Rate ≥100/min: 2.02 (1.19-3.47) and coexisting Diabetes Mellitus; 1.73 (1.02-2.95) with hypertension and gender not retaining their significance. The individual risk scores for SaO2<95-11, Urea ≥50 mg/dl-15, NLR >3-11, Age ≥50 years-9, Pulse Rate ≥100/min-7 and coexisting diabetes mellitus-6, acronymed collectively as 'OUR-ARDs score' showed that the sum of scores ≥ 25 predicted mortality with a sensitivity-90%, specificity-64% and AUC of 0.85. CONCLUSIONS: The 'OUR ARDs' risk score, derived from easily assessable factors predicting mortality, offered a tangible solution for prioritizing admission to COVID-19 tertiary care centre, that enhanced patient care but without unduly straining the health system.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Hospital Mortality , Hospitalization , SARS-CoV-2/genetics , Tertiary Healthcare/methods , Adult , Aged , COVID-19/virology , Comorbidity , Female , Humans , India/epidemiology , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , Severity of Illness Index , Tertiary Care Centers
7.
J Trop Pediatr ; 68(2)2022 02 03.
Article in English | MEDLINE | ID: covidwho-1692142

ABSTRACT

This study was conducted at a tertiary care centre of Delhi, to assess the magnitude of SARS-CoV-2 disease and outcome in paediatric surgical inpatients. All the admitted patients were evaluated excluding outpatients and minor procedures. Out of 312 operated patients 2.88% patients were SARS-CoV-2 positive and out of 167 non-operative patients 6.58% were SARS-CoV-2 positive. These patients received standard care as per guidelines using standard protective measures and were discharged home. Only 1 death occurred due to perforation peritonitis with sepsis. The overall prevalence of SARS-CoV-2 in paediatric surgical patients was 4.17% and SARS-CoV-2 positive patients had similar outcomes as compared to non-SARS-CoV-2 patients.


Subject(s)
COVID-19 , Pandemics , Child , Humans , Inpatients , SARS-CoV-2 , Tertiary Care Centers , Tertiary Healthcare
8.
Viruses ; 14(2)2022 01 25.
Article in English | MEDLINE | ID: covidwho-1649410

ABSTRACT

Healthcare workers (HCWs) are at increased risk of SARS-CoV-2 infection. The aim of the study was to estimate the SARS-CoV-2 seroprevalence among HCWs in Cochabamba, Bolivia and to determine the potential risk factors. In January 2021, a cross-sectional SARS-CoV-2 seroprevalence study was conducted in 783 volunteer clinical and non-clinical HCWs in tertiary care facilities. It was based on IgG detection using ELISA, chemiluminiscence, and seroneutralisation tests from dried blood spots. Analysis revealed a high seroprevalence (43.4%) of SARS-CoV-2 IgG antibodies. The combination of anosmia and ageusia (OR: 68.11; 95%-CI 24.83-186.80) was predictive of seropositivity. Belonging to the cleaning staff (OR: 1.94; 95%-CI 1.09-3.45), having more than two children in the same house (OR: 1.74; 95%-CI 1.12-2.71), and having been in contact with a close relative with COVID-19 (OR: 3.53; 95%-CI 2.24-5.58) were identified as risk factors for seropositivity in a multivariate analysis. A total of 47.5% of participants had received medication for COVID-19 treatment or prevention, and only ~50% of symptomatic subjects accessed PCR or antigenic testing. This study confirms a massive SARS-CoV-2 attack rate among HCWs in Cochabamba by the end of January 2021. The main risk factors identified are having a low-skilled job, living with children, and having been in contact with an infected relative in the household.


Subject(s)
Antibodies, Viral/blood , COVID-19/epidemiology , COVID-19/immunology , Health Personnel/statistics & numerical data , Adolescent , Adult , Antibodies, Viral/immunology , Bolivia/epidemiology , Cross-Sectional Studies , Female , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Male , Middle Aged , Prevalence , Risk Factors , SARS-CoV-2/immunology , SARS-CoV-2/pathogenicity , Seroepidemiologic Studies , Tertiary Healthcare/statistics & numerical data , Young Adult
9.
Asian J Psychiatr ; 69: 103004, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1637202

ABSTRACT

Catatonia has been reported as one among many neuropsychiatric manifestations associated with COVID-19 infection. Catatonia and COVID-19 co-occurrence remain clinical concerns, often posing challenges pertaining to diagnosis, and especially management. Limited information is available regarding the appropriate approaches to the management of catatonia in COVID-19 infection, particularly with reference to the safety and efficacy of benzodiazepines and Electro-convulsive therapy (ECT). We present our experience of five patients with catatonia consequent to heterogeneous underlying causes and concurrent COVID-19 infection, who received care at the psychiatric COVID unit of our tertiary care psychiatric hospital. An interesting observation included varying underlying causes for catatonia and the potential role that COVID-19 infection may have played in the manifestation of catatonia. In our experience, new-onset catatonia with or without pre-existing psychiatric illness and concurrent COVID-19 can be safely and effectively managed with lorazepam and/or ECTs. However, critical to the same is the need to implement modified protocols that integrate pre-emptive evaluation for COVID-19 disease and proactive monitoring of its relevant clinical parameters, thereby permitting judicious and timely implementation of catatonia-specific treatment options.


Subject(s)
COVID-19 , Catatonia , Electroconvulsive Therapy , Catatonia/diagnosis , Catatonia/etiology , Catatonia/therapy , Hospitals, Psychiatric , Humans , SARS-CoV-2 , Tertiary Healthcare
10.
Drug Discov Ther ; 15(6): 310-316, 2021.
Article in English | MEDLINE | ID: covidwho-1622789

ABSTRACT

COVID-19 is associated with rarer extra-parenchymal manifestations, namely pneumothorax (PTX) and pneumomediastinum (PM) leading to complications and increased mortality. The study aims to describe the prevalence, risk factors for mortality, radiological characteristics and outcome of PTX/PM in patients admitted with COVID-19. This was a retrospective, single-centre, observational study in patients with confirmed COVID-19 presenting with non-iatrogenic PTX/PM from April 2020 to May 2021. Details pertaining to demographics, presentation, radiological characteristics, management and outcome were collected. Cases were classified into spontaneous and barotraumatic PTX/PM and a between-group comparison was performed using Chi-square and t-test. A total of 45 cases (mean age: 53.2 years, 82% males) out of 8,294 confirmed COVID-19 patients developed PTX/PM, the calculated incidence being 0.54%. 29 cases had spontaneous PTX/PM and the remaining 17 cases were attributed to barotrauma. The most common comorbidities were diabetes-mellitus (65.3%) and hypertension (42.3%). The majority of the cases had large PTX (62.1%) with tension in 8 cases (27.5%). There were predominant right-sided pneumothoraces and five were diagnosed with bronchopleural fistula. 37.7% of cases had associated subcutaneous emphysema. The median duration of PTX/PM from symptom onset was delayed at 22.5 and 17.6 days respectively. The mean CT severity score (CTSS) was 20.5 (± 4.9) with fibrosis (53.8%), bronchiectatic changes (50%) and cystic-cavitary changes (23%). There was no statistically significant difference between the spontaneous and barotrauma cohort. 71% of cases died and the majority belonged to the barotrauma cohort. It is imperative to consider the possibility of PTX/PM in patients having COVID-19, especially in those with deterioration in the disease course, both in spontaneously breathing and mechanically ventilated patients. These patients may also have a high incidence of death, reflecting the gravity of COVID-19.


Subject(s)
COVID-19 , Mediastinal Emphysema , Pneumothorax , Female , Humans , Male , Mediastinal Emphysema/diagnostic imaging , Mediastinal Emphysema/epidemiology , Middle Aged , Pneumothorax/diagnostic imaging , Pneumothorax/epidemiology , Pneumothorax/etiology , Respiration, Artificial , Retrospective Studies , SARS-CoV-2 , Tertiary Healthcare
11.
Saudi J Kidney Dis Transpl ; 32(2): 377-386, 2021.
Article in English | MEDLINE | ID: covidwho-1622688

ABSTRACT

Coronavirus disease-2019 (COVID-19) is a global pandemic, also affecting Pakistan with its first case reported on February 26, 2020. Since then, it has been declared a pandemic by the World Health Organization. Our study aimed to evaluate the renal derangements associated with COVID-19 infection in our population. A retrospective, observational study was conducted to include all the admitted patients having COVID-19 positive, and evaluated those for derangements of renal function (n = 362). Out of the 362 patients, 229were admitted in the ward, 133 were in intensive care unit (ICU), 258 of them recovered, while 104 deaths reported. At admission, the renal profile was deranged in almost one-half of ICU admissions and mortalities which increased to two-third during the hospital stay, with around 80% of deaths reported with increased urea and creatinine levels. Among the deceased patients, around one-third of the mortalities developed renal profile derangements during the hospital stay although they were admitted with a normal renal profile. An estimated glomerular filtration rate showed a mean increase of 13.37 mL/min/1.73 m2 during the hospital stay of surviving patients, while a decline of 19.92 in nonsurviving patients. A hazard ratio of 3.293 (P <0.001) for admitting serum urea and 3.795 (P = 0.009) at discharge and for serum creatinine at 5.392 (P <0.001) on discharge was associated significantly with mortality. Kaplan-Meier plot showed a significant decline in days of survival with deranged urea and creatinine (P <0.001). The deranged renal function in COVID-19 patients is associated with an increased number of ICU admissions as well as mortalities.


Subject(s)
Acute Kidney Injury/etiology , COVID-19/complications , Hospital Mortality , Intensive Care Units/statistics & numerical data , SARS-CoV-2 , Acute Kidney Injury/mortality , Acute Kidney Injury/therapy , COVID-19/mortality , COVID-19 Nucleic Acid Testing , Creatinine/blood , Glomerular Filtration Rate , Humans , Incidence , Kidney Function Tests , Pakistan/epidemiology , Renal Dialysis , Retrospective Studies , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Tertiary Healthcare , Urea/blood
13.
Ann Vasc Surg ; 80: 104-112, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1596282

ABSTRACT

BACKGROUND: The aim of this study was to examine the COVID-19 pandemic and its associated impact on the provision of vascular services, and the pattern of presentation and practice in a tertiary referral vascular unit. METHODS: This is a retrospective observational study from a prospectively maintained data-base comparing two time frames, Period 1(15th March-30th May 2019-P1) and Period 2(15th March-30th May 2020-P2)All the patients who presented for a vascular review in the 2 timeframes were included. Metrics of service and patient care episodes were collected and compared including, the number of emergency referrals, patient encounters, consultations, emergency admissions and interventions. Impact on key hospital resources such as critical care and imaging facilities during the two time periods were also examined. RESULTS: There was an absolute reduction of 44% in the number of patients who required urgent or emergency treatment from P1 to P2 (141 vs 79). We noted a non-significant trend towards an increase in the proportion of patients presenting with Chronic Limb Threatening Ischaemia (CLTI) Rutherford 5&6 (P=0.09) as well as a reduction in the proportion of admissions related to Aortic Aneurysm (P=0.21). There was a significant absolute reduction of 77% in all vascular interventions from P1 to P2 with the greatest reductions noted in Carotid (P=0.02), Deep Venous (P=0.003) and Aortic interventions (P=0.016). The number of lower limb interventions also decreased though there was a significant increase as a relative proportion of all vascular interventions in P2 (P=0.001). There was an absolute reduction in the number of scans performed for vascular pathology; Duplex scans reduced by 86%(P<0.002), CT scans by 68%(P<0.003) and MRIs by 74%(P<0.009). CONCLUSION: We report a decrease in urgent and emergency vascular presentations, admissions and interventions. The reduction in patients presenting with lower limb pathology was not as significant as other vascular conditions, resulting in a significant rise in interventions for CLTI and DFI as a proportion of all vascular interventions. These observations will help guide the provision of vascular services during future pandemics.


Subject(s)
COVID-19/epidemiology , Hospital Units/statistics & numerical data , Hospitalization/statistics & numerical data , Tertiary Healthcare/statistics & numerical data , Vascular Surgical Procedures/statistics & numerical data , Workload/statistics & numerical data , Ambulatory Care/statistics & numerical data , COVID-19/complications , COVID-19/therapy , Critical Care/statistics & numerical data , Facilities and Services Utilization , Humans , Magnetic Resonance Imaging/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Tomography, X-Ray Computed/statistics & numerical data , United Kingdom
14.
J Stroke Cerebrovasc Dis ; 31(4): 106275, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1587136

ABSTRACT

OBJECTIVES: To understand the hospital-to-outpatient care transition and how the discharge process of stroke patients is managed; and to identify potential opportunities to improve these processes, while contrasting pre- and during COVID-19 experiences in Peru. METHODS: A qualitative study was conducted between February and March 2021 consisting of in-depth interviews of patients with stroke, their caregivers and healthcare personnel regarding stroke care at a national tertiary referral center for stroke care in Lima, Peru. We explored the following phases of the patients' journeys: pre-hospitalization, emergency room, hospitalization, discharge process and post-discharge. For each phase, we explored experiences, feelings and expectations using thematic analysis. RESULTS: We conducted a total of 11 interviews with patients or caregivers and 7 with health care personnel and found disruption in the continuity of care for patients with stroke. Mainly, caregivers and patients referred to problems related to communication with healthcare personnel and an absence of training to provide post-discharge care at home. Potential solutions included increasing human resources and caregiver participation in care, implementation of electronic healthcare records, improving the referral system and reinforcing telemedicine services. CONCLUSION: The continuity of care of patients with stroke was negatively affected during the COVID-19 pandemic. In LMICs, the impact was likely greater due to the already weak and fragmented healthcare systems. The COVID-19 pandemic presents an opportunity to improve post-stroke care services, and address patients' experiences and feelings by developing solutions in a participatory manner.


Subject(s)
COVID-19 , Aftercare , Caregivers , Humans , Pandemics , Patient Discharge , Peru/epidemiology , Tertiary Care Centers , Tertiary Healthcare
15.
BMJ Open ; 11(12): e054010, 2021 12 08.
Article in English | MEDLINE | ID: covidwho-1559172

ABSTRACT

INTRODUCTION: In the wake of the unprecedented public health challenge of the COVID-19 pandemic, it is highly significant to recognise the mental health impact of this mounting threat on healthcare providers (HCPs) working in the obstetrics and gynaecology department. Experience from epidemics and emerging literature around COVID-19 show that the unparalleled amount of stress that HCPs are dealing with is linked with the increased burden of mental health conditions. We aim to conduct an exploratory qualitative descriptive study to assess HCPs' perceptions of mental health amid the COVID-19 pandemic in the obstetrics and gynaecology department of a public sector tertiary care hospital of Karachi, Pakistan. METHODS AND ANALYSIS: This study will use a qualitative descriptive approach where approximately 20-25 HCPs from the obstetrics and gynaecology department will be recruited using a purposive sampling approach. Data will be collected through semistructured interviews and it will be analysed thematically using NVivo V.12 Plus software. ETHICS AND DISSEMINATION: Ethical approval for this study has been obtained from the Institutional Review Board Committee of Jinnah Postgraduate Medical Center hospital. The study results will be disseminated to the scientific community and the HCPs participating in the study. The findings will help us to explore the doctor's perceptions of mental health during the current pandemic of COVID-19 and its impact on their daily lives and mental well-being.


Subject(s)
COVID-19 , Gynecology , Obstetrics , Health Personnel , Hospitals , Humans , Mental Health , Pakistan/epidemiology , Pandemics , Public Sector , SARS-CoV-2 , Tertiary Healthcare
16.
J Hosp Infect ; 121: 1-8, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1562025

ABSTRACT

BACKGROUND: The COVID-19 pandemic has prompted hospitals to respond with stringent measures. Accurate estimates of costs and resources used in outbreaks can guide evaluations of responses. We report on the financial expenditure associated with COVID-19, the bed-days used for COVID-19 patients and hospital services displaced due to COVID-19 in a Singapore tertiary hospital. METHODS: We conducted a retrospective cost analysis from January to December 2020 in the largest public hospital in Singapore. Costs were estimated from the hospital perspective. We examined financial expenditures made in direct response to COVID-19; hospital admissions data related to COVID-19 inpatients; and the number of outpatient and emergency department visits, non-emergency surgeries, inpatient days in 2020, compared with preceding years of 2018 and 2019. Bayesian time-series was used to estimate the magnitude of displaced services. RESULTS: USD $41.96 million was incurred in the hospital for COVID-19-related expenses. Facilities set-up and capital assets accounted for 51.6% of the expenditure; patient-care supplies comprised 35.1%. Of the 19,611 inpatients tested for COVID-19 in 2020, 727 (3.7%) had COVID-19. The total inpatient- and intensive care unit (ICU)-days for COVID-19 patients in 2020 were 8009 and 8 days, respectively. A decline in all hospital services was observed from February following a raised disease outbreak alert level; most services quickly resumed when the lockdown was lifted in June. CONCLUSION: COVID-19 led to an increase in healthcare expenses and a displacement in hospital services. Our findings are useful for informing economic evaluations of COVID-19 response and provide some information about the expected costs of future outbreaks.


Subject(s)
COVID-19 , Bayes Theorem , COVID-19/epidemiology , Communicable Disease Control , Hospital Costs , Hospitals, Public , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , Singapore/epidemiology , Tertiary Healthcare
17.
Indian J Med Microbiol ; 40(1): 30-34, 2022.
Article in English | MEDLINE | ID: covidwho-1521053

ABSTRACT

PURPOSE: Amidst the on-going SARS-CoV-2 pandemic, healthcare workers have been at a greater risk of disease exposure as they are working in environments chiefly involved in the COVID-19 patient care since March 2020. SARS-CoV-2 antibody testing can prove to be a valuable tool for better understanding of prevalence of disease exposure in this population. Therefore, we conducted this study to grasp the sero-prevalence of COVID-19 antibodies in our hospital to better comprehend the duration of IgG response. METHODS: This was a longitudinal study involving 305 healthcare workers at Rajiv Gandhi Super Speciality Hospital spanning over a period of four months starting from October 2020 to January 2021. Serum samples were obtained from the study group taken as Day 0 of the study and were screened for the presence of SARS-CoV-2 IgG antibodies using semi-quantitive enzyme linked immunoassay technology from ERBAlisa (India). The Antibody Index was determined. Those showing reactive in the screening test were further followed up on a monthly basis till January 2021 for serial antibody testing. RESULTS: The overall seroprevalence for IgG response among the workers was found to be 21.96%. Seropositivity rate was observed to be significantly higher in those having a history of RT-PCR confirmed COVID-19 infection (45.09%) CONCLUSIONS: Our study demonstrated that healthcare workers have a higher sero-prevalence. Our study also demonstrated that the antibodies developed following COVID-19 infection had a waning effect of protective response following infection.


Subject(s)
COVID-19 , Antibodies, Viral , Antibody Formation , COVID-19/diagnosis , COVID-19/epidemiology , Health Personnel , Hospitals , Humans , Longitudinal Studies , SARS-CoV-2 , Seroepidemiologic Studies , Tertiary Healthcare
19.
Clin Infect Dis ; 73(9): e3113-e3115, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1500993

ABSTRACT

We describe the impact of universal masking and universal testing at admission on high-risk exposures to severe acute respiratory syndrome coronavirus 2 for healthcare workers. Universal masking decreased the rate of high-risk exposures per patient-day by 68%, and universal testing further decreased those exposures by 77%.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19 Testing , Health Personnel , Humans , Tertiary Healthcare
20.
J Prim Care Community Health ; 12: 21501327211054281, 2021.
Article in English | MEDLINE | ID: covidwho-1496102

ABSTRACT

BACKGROUND: Length of hospital stay (LOS) for a disease is a vital estimate for healthcare logistics planning. The study aimed to illustrate the effect of factors elicited on arrival on LOS of the COVID-19 patients. MATERIALS AND METHODS: It was a retrospective, record based, unmatched, case control study using hospital records of 334 COVID-19 patients admitted in an East Indian tertiary healthcare facility during May to October 2020. Discharge from the hospital (cases/survivors) was considered as an event while death (control/non-survivors) as right censoring in the case-control survival analysis using cox proportional hazard model. RESULTS: Overall, we found the median LOS for the survivors to be 8 days [interquartile range (IQR): 7-10 days] while the same for the non-survivors was 6 days [IQR: 2-11 days]. In the multivariable cox-proportional hazard model; travel distance (>16 km) [adjusted hazard ratio (aHR): 0.69, 95% CI: (0.50-0.95)], mode of transport to the hospital (ambulance) [aHR: 0.62, 95% CI: (0.45-0.85)], breathlessness (yes) [aHR: 0.56, 95% CI: (0.40-0.77)], number of co-morbidities (1-2) [aHR: 0.66, 95% CI: (0.47-0.93)] (≥3) [aHR: 0.16, 95% CI: (0.04-0.65)], COPD/asthma (yes) [ [aHR: 0.11, 95% CI: (0.01-0.79)], DBP (<60/≥90) [aHR: 0.55, 95% CI: (0.35-0.86)] and qSOFA score (≥2) [aHR: 0.33, 95% CI: (0.12-0.92)] were the significant attributes affecting LOS of the COVID-19 patients. CONCLUSION: Factors elicited on arrival were found to be significantly associated with LOS. A scoring system inculcating these factors may be developed to predict LOS of the COVID-19 patients.


Subject(s)
COVID-19 , Case-Control Studies , Humans , India , Length of Stay , Retrospective Studies , Risk Factors , SARS-CoV-2 , Survival Analysis , Tertiary Healthcare
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