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Background: We reported clinical features of elderly COVID-19 patients who were initially asymptomatic or mildly ill, and characterized the clinical features of those requiring hospital transfer. Methods: Patients with confirmed COVID-19 infection admitted to a community isolation facility (CIF) from May 21 to July 12, 2021 were assessed on demographic data, clinical symptoms, and pulse oximetry. The determinants of hospital transfer in the elderly patients (>= 65 years) were analyzed. Residual symptoms were followed up among the elderly patients who left the CIF, regardless of hospital transfer or going home. Results: Of consecutive 408 patients (20 to 91 years old), 67 (16.4%) were older than 65 years old. The proportion of elderly people with hospital transfer was higher, compared to the non-elderly patients (49.3% vs. 15.2%, p < 0.001). Elderly patients were more prone to develop dyspnea and fatigue, but fewer headache, sore throat, and dysosmia, compared to the non-elderly patients (all p < 0.05). Factors determining hospitalization for the elderly patients included dyspnea, low oxygen saturation, and persistent fever. The elderly patients with hospital transfer were more likely to develop sequelae, and fatigue (20.8%) was the most common symptom. Two elderly patients died after hospitalization. Conclusion: The clinical profiles of the COVID-19 elderly diverged from those of the non-elderly. Admission to a CIF for asymptomatic or mildly ill elderly with daily monitoring of clinical presentation to decide hospital transfer is feasible during an outbreak. Early identification of elderly COVID-19 patients at risk of severe disease may deserve early intervention and improve treatment outcomes. Copyright (c) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.
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Background: To evaluate the feasibility, baseline characteristics, and satisfaction of patients receiving telemedicine care during the coronavirus 2019 (COVID-19) pandemic in Taiwan. Methods: We retrospectively analyzed patients during the COVID-19 pandemic between May 2021 and December 2021 in a tertiary medical center in northern Taiwan. Information on the distribution of physician divisions, patients' clinical characteristics, and patterns of prescription use in telemedicine care was analyzed. Data were extracted from both the ordinary outpatient department (OPD) and nursing home systems. Results: A total of 6587 patients (55.8% female, mean age: 57.3 +/- 25.8 years) included in our telemedicine care conducted during the pandemic COVID-19 epidemic. Those who were older, female, and patients of Internal Medicine and Family Medicine utilized telemedicine more frequently than ordinary OPD, with a high refill prescription rate (82.6%) and low mail-back prescription use (35.9%). Patients of Family Medicine comprised the majority (40.3%) of nursing home telemedicine, with lower refill pre-scription use (37.3%). Overall satisfaction was high regarding telemedicine care, physicians profession-alism, and medical problem solving (98.3% and 97.7%, respectively). Conclusion: Older age, female sex, and potentially more health conditions were associated with higher willingness to access telemedicine. We identified medical divisional and disease-based differences in prescription patterns. Copyright (c) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.
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Background: SARS-CoV-2 infection initially occurred in December 2019 and spread rapidly into a pandemic. The aims of this study were to assess the efficacy of measures taken to minimize intra-hospital transmission of COVID-19 at our hospital. Methods: An outdoor fever screening station and outdoor COVID-19 screening station were initially set up to isolate people with suspected COVID-19 infection from those within the hospital. Another outdoor outpatient department (OPD) was set up later in the pandemic for people visiting the hospital following 14 days of quarantine, during the next 15 to 30 days, or residents from high incidence areas. Rogers' model of diffusion of innovations was applied to the promotion of COVID-19 vaccination. Results: From 18 March 2020 to 17 April 2020,10 newly confirmed cases at our hospital were detected at the outdoor COVID-19 screening station, and no health care workers (HCWs) in the hospital contracted COVID-19. From May 2021 to November 2021 during the outbreak in Taiwan, there were 191 confirmed cases and 2 HCWs had COVID-19. Promoting COVID-19 vaccination led to 98.2% of employees receiving two doses by November 2021 and zero COVID-19 infection in HCWs from June to the end of November 2021. Conclusion: Having outdoor fever and COVID-19 screening stations and an "outdoor OPD" service to isolate patients suspected of or at risk of COVID-19 were effective strategies to minimize the risk of intra-hospital transmission. Promotion using Rogers' model resulted in nearly all employees receiving two doses of COVID-19 vaccine. Copyright (c) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.