COVID-19: our experience and quality of management analysis
(Topolšica Hospital case report)
DOI:
https://doi.org/10.6016/ZdravVestn.3332Keywords:
epidemy, mortality, intensive care, guidelines, infectionAbstract
Various Slovenian hospitals were recruited to treat COVID-19 patients in Slovenia during the COVID-19 epidemic. Centrally coordinated hospital utilisation - depending on the needs, available hospital bed capacity, and considering the professional orientation of individual hospitals - left these facilities with different experiences. We present our experience and COVID-19 treatment management during the fourth epidemic wave in our peripheral, pulmonary-oriented hospital, representing the first treatment quality analysis of these patients in Slovenia. The basic hospitalization characteristics were analysed using integrated Birpis information system solutions and the electronic temperature-therapeutic charts (eTTL) review. The quality of management was assessed through adherence to professional recommendations. The analysis was carried out with the in-built statistical functions of Microsoft Excel software. 99 patients (58 women, 41 men) aged 67.9 years were hospitalised for an average of 8.1 days. The majority were residents of our region (61%), unvaccinated (61.6%), and experienced a severe form of the disease with the need for oxygen supplementation (88.9%). The majority received steroids (73.7%), antibiotics (68.7%) and vitamin D (71.7%), to a lesser extent specific therapy (remdesivir 25.3%, combination casirivimab/imdevimab 2%, tocilizumab 1%). No adverse reactions were noted. 17 people died (total mortality rate 17.2%). There was no infection transmission among the COVID department staff. Results show successful treatment of patients with COVID-19 in Topolsica Hospital. They also suggest the possibility of further improvements, particularly in prescribing antibiotic therapy.
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References
1. Kim Y A, Gandhi R T. Management in hospitalized adults. UptoDate. Alphen aan den Rijn: Wolters Kluwer; 2021 [cited 2021 Jan 12]. Available from: https://www.uptodate.com/contents/covid-19-management-in-hospitalized-adults.
2. Mušič E, Osolnik K, Tomič V, Eržen R, Košnik M, Beovič B, et al. Priporočila za obravnavo zunajbolnišnične pljučnice odraslih (prenovljena in dopolnjena izdaja, 2010). Recommendations for the Management of Community-acquired Pneumonia in Adults (Updated and revised Edition, 2010. Zdrav Vestn. 2010;79(3):245-64.
3. Rees EM, Nightingale ES, Jafari Y, Waterlow NR, Clifford S, B Pearson CA, et al. COVID-19 length of hospital stay: a systematic review and data synthesis. BMC Med. 2020;18(1):270.
DOI: 10.1186/s12916-020-01726-3
PMID: 32878619
4. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020;324(8):782-93.
DOI: 10.1001/jama.2020.12839
PMID: 32648899
5. Tenforde MW, Self WH, Adams K, Gaglani M, Ginde AA, McNeal T, et al.; Influenza and Other Viruses in the Acutely Ill (IVY) Network. Association Between mRNA Vaccination and COVID-19 Hospitalization and Disease Severity. JAMA. 2021;326(20):2043-54.
DOI: 10.1001/jama.2021.19499
PMID: 34734975
6. Kim L, Garg S, O?Halloran A, Whitaker M, Pham H, Anderson EJ, et al. Risk Factors for Intensive Care Unit Admission and In-hospital Mortality Among Hospitalized Adults Identified through the US Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET). Clin Infect Dis. 2021;72(9):e206-14.
DOI: 10.1093/cid/ciaa1012
PMID: 32674114
7. Macedo A, Gon?alves N, Febra C. COVID-19 fatality rates in hospitalized patients: systematic review and meta-analysis. Ann Epidemiol. 2021;57:14-21.
DOI: 10.1016/j.annepidem.2021.02.012
PMID: 33662494
8. Gray WK, Navaratnam AV, Day J, Babu P, Mackinnon S, Adelaja I, et al. Variability in COVID-19 in-hospital mortality rates between national health service trusts and regions in England: A national observational study for the Getting It Right First Time Programme. EClinicalMedicine. 2021;35:100859.
DOI: 10.1016/j.eclinm.2021.100859
PMID: 33937732
9. Splošna bolnišnica Slovenj Gradec. Strokovno poročilo za leto 2020. Slovenj Gradec: Splošna bolnišnica Slovenj Gradec; 2020 [cited 2022 Jan 12]. Available from: https://www.sb-sg.si/Portals/0/e-SBSG-strokovno-porocilo-2020-2.pdf.
10. Serafim RB, Póvoa P, Souza-Dantas V, Kalil AC, Salluh J. Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic review. Clin Microbiol Infect. 2021;27(47):54.
DOI: 10.1016/j.cmi.2020.10.017
PMID: 33190794
11. Skupina za zdravljenje COVID-19 Klinike za infekcijske bolezni in vročinska stanja UKC LjubljanaPriporočila za farmakološko zdravljenje hospitaliziranih bolnikov s COVID-19 na navadnem oddelku. Verzija 11, z dne 26.5.2021. Ljubljana: Klinike za infekcijske bolezni in vročinska stanja UKC Ljubljana; 2021. pp. 1-11.
12. Lukić M, Vovko M, Turel M, Logar M, Šoštarič N, Furlan N, et al. Priporočila za zdravljenje Covid-19 na oddelku za intenzivno terapijo. Verzija 11, z dne 26.5.2021. Ljubljana: Klinike za infekcijske bolezni in vročinska stanja UKC Ljubljana; 2021. pp. 12-14.
13. Lejko Zupanc T. Uporaba monoklonskih protiteles (kasirivimab in imdevimab) pri bolnikih s COVID-19. Dopis Klinike za infekcijske bolezni in vročinska stanja z dne 15.9.2021, Opr. Št 1-15/2021. Ljubljana: Klinike za infekcijske bolezni in vročinska stanja UKC Ljubljana; 2021.
14. Pfeifer M, Siuka D, Pravst I, Ihan A. Priporočila za nadomeščanje holekalciferola (vitamina D) v obdobjih respiratornih okužb in nadomeščanje holekalciferola pri posameznikih s COVID-19. Ljubljana: UKC; 2020 [cited 2022 Jan 15]. Available from: https://www.kclj.si/dokumenti/FINAL_Okt_2020_PRIPOROCILA_VITAMIN_D_in_covid-19_za_infektologe.pdf.
15. Karami Z, Knoop BT, Dofferhoff AS, Blaauw MJ, Janssen NA, van Apeldoorn M, et al. Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19: results from a multicentre retrospective cohort study in The Netherlands. Infect Dis (Lond). 2021;53(2):102-10.
DOI: 10.1080/23744235.2020.1839672
PMID: 33103530
16. Musuuza JS, Watson L, Parmasad V, Putman-Buehler N, Christensen L, Safdar N. Prevalence and outcomes of co-infection and superinfection with SARS-CoV-2 and other pathogens: A systematic review and meta-analysis. PLoS One. 2021;16(5):e0251170.
DOI: 10.1371/journal.pone.0251170
PMID: 33956882
17. Nacionalni inštitut za javno zdravje. Poraba protimikrobnih zdravil v Sloveniji v letu 2020. Ljubljana: NIJZ; 2021 [cited 2022 Jan 15]. Available from: https://www.nijz.si/sites/www.nijz.si/files/uploaded/poraba_protimikrobnih_zdravil_15112021_2.pfd.
18. Rojko T, Tomažič J. Kemoprofilaksa Pneumocystis jirovecii pljučnice pri bolnikih s COVID-19 zdravljenih z glukokortikoidi. Verzija 11, z dne 26.5.2021. Ljubljana: Klinika za infekcijske bolezni in vročinska stanja UKC Ljubljana; 2021.
19. Nacionalna Ekspertna skupina za virusne hepatitise; Skupina za zdravljenje COVID-19 KIBVS UKC LjubljanaPreprečevanje reaktivacije virusa hepatitisa B (HBV) pri bolnikih s covid-19, ki potrebujejo zdravljenje s kortikosteroidi. Verzija 11, z dne 26.5.2021. Ljubljana: Klinika za infekcijske bolezni in vročinska stanja UKC Ljubljana; 2021.
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