Home management of COVID-19 symptomatic patients: a safety study on COVID committed home medical teams.

Q2 Medicine Infezioni in Medicina Pub Date : 2022-09-01 eCollection Date: 2022-01-01 DOI:10.53854/liim-3003-9
Sergio Venturini, Daniele Orso, Francesco Cugini, Francesco Martin, Cecilia Boccato, Laura De Santi, Elisa Pontoni, Silvia Tomasella, Fabrizio Nicotra, Alessandro Grembiale, Maurizio Tonizzo, Silvia Grazioli, Sara Fossati, Astrid Callegari, Giovanni Del Fabro, Massimo Crapis
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Abstract

To reduce the overburden in the hospital, during the COVID-19 pandemic, some "COVID Committed Home Medical Teams" (CCHTs) were created in Italy. These units consist of a small pool of general practitioners who aim to evaluate all patients with COVID-19 who require a medical examination directly at home. After the first visit (which can end with patient hospitalisation or home management), CCHTs periodically monitor the patients' clinical conditions and vital signs (usually a revaluation every 24-48 hours, except for a sudden worsening). However, this strategy - which reduces the pressure on hospitals - has never been evaluated for patient safety. Our study aims to determine whether a home-based monitoring and treatment strategy for non-severe COVID-19 patients was safe as direct hospital admission by the emergency department. We conducted a retrospective observational study about 1,182 patients admitted to the hospital for COVID-19 between September 2020 and April 2021, confronting in-hospital and 30-day mortality in both CCHT-referred (n=275) and directly admitted by emergency department (n=907). Patients assessed by the CCHT had lower in-hospital and 30-day mortality (18% vs 28%, p=0.001; and 20% vs 30%, p=0.002); but, in the propensity score matching comparison, there was no characteristic between the two groups turned out significantly different. CCHT did not correlate with in-hospital or 30-day mortality. CCHT is a safe strategy to reduce hospital overburden for COVID-19 during pandemic surges.

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COVID-19症状患者家庭管理:家庭医疗团队的安全性研究
为了减轻医院的负担,在COVID-19大流行期间,意大利创建了一些“COVID承诺家庭医疗队”(CCHTs)。这些单位由一小群全科医生组成,他们的目标是评估所有需要直接在家进行体检的COVID-19患者。在首次就诊后(可能以患者住院或家庭管理结束),CCHTs定期监测患者的临床状况和生命体征(通常每24-48小时重新评估一次,除非突然恶化)。然而,这种减轻医院压力的策略从未在患者安全方面进行过评估。我们的研究旨在确定非重症COVID-19患者的家庭监测和治疗策略是否安全,作为急诊科直接住院治疗。我们对2020年9月至2021年4月期间因COVID-19入院的1182例患者进行了一项回顾性观察研究,其中ccht转诊患者(n=275)和急诊科直接入院患者(n=907)在医院和30天内死亡。接受CCHT评估的患者住院死亡率和30天死亡率较低(18% vs 28%, p=0.001;20% vs 30%, p=0.002);但是,在倾向得分匹配比较中,两组之间没有显著差异的特征。CCHT与住院死亡率或30天死亡率无关。CCHT是在大流行期间减少COVID-19医院负担过重的安全策略。
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来源期刊
Infezioni in Medicina
Infezioni in Medicina Medicine-Infectious Diseases
CiteScore
8.40
自引率
0.00%
发文量
62
期刊介绍: The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.
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