Pandemic hospitals and reorganizing emergency departments

Emergency departments have always been the first point of contact for hospitals in many situations, including man-made and natural disasters. The first places where patients with symptoms of COVID-19 were met in health institutions were also emergency departments. Emergency departments play an important role in diagnosing the disease and isolating patients (by hospitalization if necessary). The process, which starts with the triage of outpatients admitted to the emergency department and brought by ambulance, continues as isolation of the patients in appropriate areas including physical evaluation, management of laboratory and scanning processes and, if necessary, providing cardiopulmonary resuscitation with airway support. Afterwards, patients can be treated as an outpatient, or hospitalized, or treated at the intensive care unit in line with their preliminary diagnosis and clinical conditions. Disruptions that may occur in one or more of these stages can lead to crowds and lengthy queues in the emergency department by prolonging the follow-up period of the patients. One of the strengths of Turkey at this point is that emergency departments are accustomed to the heavy patient load. The experiences gained from these conditions have facilitated the organization of pre-hospital emergency medical services, pandemic hospitals, and their emergency departments. In this organization, the main goal should be to provide uninterrupted and high-quality patient care through personnel training, personal protection measures, and the creation of physical conditions. Turkey's emergency departments are accustomed to managing the intensive patient flow, as they work at full capacity during normal times. Thanks to the experiences of emergency healthcare workers, health service was provided without any patient being turned away from the door of the emergency departments during the COVID-19 pandemic. In this review, we aimed to present the organization of pandemic hospitals and emergency departments during the COVID-19 pandemic. We made a schematic representation of the architectural areas through the emergency department of Ankara City Hospital, which has a bed capacity of 4200 with 256 beds in emergency department.

The factors predicting pneumonia in COVID-19 patients: preliminary results from a university hospital in Turkey

Background/aim: Pneumonia is the most serious clinical presentation of COVID-19. This study aimed to determine the demographic, clinical, and laboratory findings that can properly predict COVID-19 pneumonia. Materials and methods: This study was conducted in the Gazi University hospital. All hospitalized patients with confirmed and suspected SARS-CoV-2 infection between 16 March 2020 and 30 April 2020 were analyzed retrospectively. COVID-19 patients were separated into two groups, pneumonia and nonpneumonia, and then compared to determine predicting factors for COVID-19 pneumonia. Variables that had a P-value of less than 0.20 and were not correlated with each other were included in the logistic regression model. Results: Of the 247 patients included in the study 58% were female, and the median age was 40. COVID-19 was confirmed in 70.9% of these patients. Among the confirmed COVID-19 cases, 21.4% had pneumonia. In the multivariate analysis male sex (P = 0.028), hypertension (P = 0.022), and shortness of breath on hospital admission (P = 0.025) were significant factors predicting COVID-19 pneumonia. Conclusion: Shortness of breath, male sex, and hypertension were significant for predicting COVID-19 pneumonia on admission. Patients with these factors should be evaluated more carefully for diagnostic procedures, such as thorax CT.