Impact of the SARS-CoV-2 pandemic on the Internal Medicine ward: 2018-2019 vs 2020-2021 admission outcomes

ABSTRACT

Background: Since March 2020 hospitals were required to respond to the SARS-CoV-2 pandemic by creating specialized isolation wards;our Internal Medicine (IM) was also called to continue caring for non-COVID-19 patients. Aim of our study was to compare the outcomes of admissions to IM between 2018- 2019 and 2020-2021. Methods: All admissions to IM for from 2018 to 2021 were included in a prospective database. Demographic and clinical data, length of stay (LOS) and outcome (discharge, death, transfer to Intensive Care Unit [ICU]) were analysed and compared between pre- and post-pandemic biennia. Results: 2577 admissions were included in the analysis (males, 48.4%, median age 80 years, median LOS 9 days, range 0-91). There were no differences in mortality or rate of transfer to ICU between the two biennia. Patients in 2020-2021 were significantly younger (mean age 75.5±14.8 vs 77.1±14.6 years, p=0.008) and had longer LOS (12.5±11.0 vs 11.0±9.1 days, p<0.001) compared to 2018-2019. LOS in 2020-2021 remained significantly longer after excluding SARS CoV2 cases (n=161, 14.4%). SARS CoV2-positive patients were significantly younger, had significantly longer LOS, and higher rate of transfer to ICU than SARS CoV2- nagative patients. In-hospital mortality did not differ between SARS CoV2-positive and negative patients. Conclusions: Our IM ward treated COVID-19 as well as non-SARSCoV- 2 acute patients throughout the pandemic. The challenges have resulted in an increased strain on hospital resources and LOS increased significantly.