Jiménez-Blanco Bravo Marta, Cordero Pereda David, Sánchez Vega Diego, Del Prado Díaz Susana, Monteagudo Ruiz Juan Manuel, Zamorano Gómez José Luis, Alonso Salinas Gonzalo Luis
Heart Failure Unit, Cardiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
Cardiology. 2020;145(8):481-484. doi: 10.1159/000509181. Epub 2020 Jun 26.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a new threat to healthcare systems. In this setting, heart failure units have faced an enormous challenge: taking care of their patients while at the same time avoiding patients' visits to the hospital.
The aim of this study was to evaluate the results of a follow-up protocol established in an advanced heart failure unit at a single center in Spain during the coronavirus disease 2019 (COVID-19) pandemic.
During March and April 2020, a protocolized approach was implemented in our unit to reduce the number of outpatient visits and hospital admissions throughout the maximum COVID-19 spread period. We compared emergency room (ER) visits, hospital admissions, and mortality with those of January and February 2020.
When compared to the preceding months, during the COVID pandemic there was a 56.5% reduction in the ER visits and a 46.9% reduction in hospital admissions, without an increase in mortality (9 patients died in both time periods). A total of 18 patients required a visit to the outpatient clinic for decompensation of heart failure or others.
Our study suggests that implementing an active-surveillance protocol in acutely decompensated heart failure units during the SARS-CoV-2 pandemic can reduce hospital admissions, ER visits and, potentially, viral transmission, in a cohort of especially vulnerable patients.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)已成为医疗系统面临的新威胁。在这种情况下,心力衰竭病房面临着巨大挑战:既要照顾患者,又要避免患者前往医院就诊。
本研究旨在评估西班牙一家单中心的晚期心力衰竭病房在2019年冠状病毒病(COVID-19)大流行期间建立的随访方案的结果。
在2020年3月和4月期间,我们的病房实施了一种规范化方法,以在COVID-19传播高峰期减少门诊就诊次数和住院人数。我们将急诊室(ER)就诊、住院人数和死亡率与2020年1月和2月的数据进行了比较。
与前几个月相比,在COVID大流行期间,急诊室就诊次数减少了56.5%,住院人数减少了46.9%,死亡率没有增加(两个时间段均有9名患者死亡)。共有18名患者因心力衰竭失代偿或其他原因需要到门诊就诊。
我们的研究表明,在SARS-CoV-2大流行期间,在急性失代偿性心力衰竭病房实施主动监测方案可以减少住院人数、急诊室就诊次数,并可能减少病毒传播,该方案针对的是一群特别脆弱的患者。