Clinical characteristics of Covid-19 patients with re-positive test results: an observational study

BackgroundWith coronavirus disease 2019 (Covid-19) ravaging the global, concern has been aroused whether discharged Covid-19 patients with reappeared positive nucleic acid test results are infected again. ObjectiveTo analyze the clinical characteristics of discharged Covid-19 patients with reappeared positive nucleic acid test results and to track clinical outcomes of them. MethodsWe extracted clinical data on 938 Covid-19 patients from Wuhan Union Hospital (West Branch), and we obtained information about residual symptoms and nucleic acid tests after discharge through follow-up study. We evaluated the relationship of clinical characteristics and reappeared positive results. Each patient had at least 44 days of follow-up. ResultsOf 938 discharged patients, a total of 58 (6.2%) had reappeared positive nucleic acid test results and 880 remain negative. Among patients over the age of 50, the factors we found to be associated with re-positive results were coronary artery disease (14.1%, vs. 5.5% among those without coronary artery disease; odds ratio, 2.81; 95% confidence interval [CI], 1.28 to 6.15), and hypertension (9.5%, vs. 4.9% among those without hypertension; odds ratio, 2.05; 95% CI, 1.10 to 3.82). As of May 11, 2020, 54 (93.1%) re-positive patients turned negative again while two patients remained positive, and two patients was lost to the second follow-up. ConclusionCoexisting diseases including coronary artery disease and hypertension were substantial risk factors for re-positive outcomes among patients over 50. And most re-positive patients tended to return negative eventually.

Insights on the peacetime-wartime combination mechanism for general hospitals in the face of emerging infectious diseases / 中华医院管理杂志

General hospitals play an important role in the prevention and control of emerging infectious diseases, making it imperative to stand by for outbreaks of epidemics in peacetime. This study analyzed the necessity of the mechanism of adapting these hospitals to both peacetime and wartime against emerging infectious diseases. In addition, the authors identified existing problems in dealing with emerging infectious diseases, and put forward corresponding suggestions: readiness in the conversion into epidemic-control; strengthened comprehensive prevention and control of nosocomial infection; strengthened construction of epidemic prevention teambuilding; an emergency material supply guarantee mechanism; an optimized monitoring and early warning mechanism; enhanced risk management and joint prevention and control.

Analysis on strategies of tertiary public hospitals in hierarchical medical system / 中华医院管理杂志

Hierarchical medical system is a high priority in China ’s health reform,bearing significant impacts on remolding of its healthcare system,in which tertiary public hospitals must redefine its role.Five strategies have been proposed as follows:the first is internal management;The second is high-tech;Third is paring assistance;Fourth is telemedicine;Fifth is better medical conditions.