IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, Via Francesco Sforza 35, 20122, Milan, Italy.
University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
Respir Res. 2020 Oct 9;21(1):260. doi: 10.1186/s12931-020-01516-8.
COVID-19 is a complex and heterogeneous disease. The pathogenesis and the complications of the disease are not fully elucidated, and increasing evidence shows that SARS-CoV-2 causes a systemic inflammatory disease rather than a pulmonary disease. The management of hospitalized patients in COVID-19 dedicated units is advisable for segregation purpose as well as for infection control. In this article we present the standard operating procedures of our COVID-19 high dependency unit of the Policlinico Hospital, in Milan. Our high dependency unit is based on a multidisciplinary approach. We think that the multidisciplinary involvement of several figures can better identify treatable traits of COVID-19 disease, early identify patients who can quickly deteriorate, particularly patients with multiple comorbidities, and better manage complications related to off-label treatments. Although no generalizable to other hospitals and different healthcare settings, we think that our experience and our point of view can be helpful for countries and hospitals that are now starting to face the COVID-19 outbreak.
COVID-19 是一种复杂且异质性的疾病。其发病机制和并发症尚未完全阐明，越来越多的证据表明，SARS-CoV-2 引起的是全身性炎症性疾病，而不仅仅是肺部疾病。将住院患者安置在 COVID-19 专用病房，不仅有助于隔离和感染控制，也有利于管理。本文介绍了米兰 Policlinico 医院 COVID-19 高依赖病房的标准操作流程。我们的高依赖病房基于多学科方法。我们认为，多名医生共同参与，可以更好地识别出 COVID-19 疾病的可治疗特征，及早发现可能迅速恶化的患者，尤其是合并多种基础疾病的患者，并更好地管理与超说明书治疗相关的并发症。尽管我们的经验和观点无法推广至其他医院和不同的医疗环境，但我们认为，对于现在才开始应对 COVID-19 疫情的国家和医院来说，这些经验和观点可能会有所帮助。
