RESUMEN
Coronavirus disease 2019 (COVID-19) is an acute infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The first case of COVID-19 was identi-fied in Wuhan, China, and quickly spread to the world, resulting in the COVID-19 pandemic more than three years ago. The incubation pe-riod varies from 2-14 days. People who are either immunocompromised due to a medical condition or by medications or treatments are more likely to be sick with COVID-19 for longer periods when compared to immunocompetent people. We report a case of an 83-year-old gentleman who has reported a positive reverse transcription polymerase chain reaction (RT-PCR) test for COVID-19 for 360 days. He had been hospitalized six times since the onset of symptoms in Feb-ruary 2022. He had a history of melanoma and non-Hodgkin's lymphoma.Copyright © 2023, The Indonesian Foundation of Critical Care Medicine. All rights reserved.
RESUMEN
Background: The transition period from hospital to home is a highly vulnerable time for patients after stroke. COVID-19 restrictions have exacerbated safety concerns, stressed the health care system, and put patients at high risk after discharge. Here we describe pilot results from the Joint Stroke Transitional Technology-Enhanced Program (JSTTEP) designed to reduce post-stroke complications, avoid hospital readmission, and enhance recovery. Methods: JSTTEP is a novel, interprofessional program for patients discharged from the Johns Hopkins Comprehensive Stroke Center. In the first weeks after hospital discharge, stroke patients complete a series of multidisciplinary telemedicine visits to (1) reduce the risks of adverse events in the transition from hospital to home, and (2) develop a plan to facilitate a full recovery. The first joint visit is with stroke neurology and physical therapy for risk mitigation, and the second is with physiatry and occupational therapy for a recovery plan. Patients and caregivers participate in an interactive, online group education session covering topics about vascular risk factor modification, nutrition, exercise, fall prevention, and self-management skills. Results: In the first 4 months of the program, 50 patients were enrolled. Average age was 61 years;26/50 (52%) were women, 23/50 (46%) were African American, and mean baseline NIHSS was 5.4. Of those 45/50 (90%) completed their visit, with 4/50 (8%) requiring conversion from video to phone visit. Unexpected 30-day hospital readmission rate was 3/50 (6%), one of whom was readmitted due to neurological issues identified during the JSTTEP appointment. Interpreter services were utilized for 5 completed video visits (Arabic, Mandarin, Spanish, Twi, Urdu). Patients reported the ability to include family members remotely in the visit as an advantage. Conclusions: The data demonstrate the feasibility and potential benefit of an interprofessionalstroke telemedicine program designed to enhance post-stroke recovery. JSTTEP increased accessto post-hospital care and reduced risks for adverse outcomes. The ongoing benefits and scaling ofsuch a clinic will rely on permanent legislative and insurance changes to support such a care model.