Donno Francesca, Fedele Alberto
Department of Preventive Medicine and Public Health, Local Health Agency of Lecce (Apulia), Italy.
J Prev Med Hyg. 2020 Oct 6;61(3):E313-E320. doi: 10.15167/2421-4248/jpmh2020.61.3.1597. eCollection 2020 Sep.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the microorganism responsible for the aggressive Coronavirus Disease (COVID-19) pandemic. During the such pandemic, discharge and community reintegration of patients are critical phases in guaranteeing public health. A review of the international and Italian experiences that represent the best available evidence was carried out, mainly focusing on the precise allocation of tasks and related responsibilities. The report provides a proposal for a systematic management pathway dedicated to COVID-19 patients. The original result is a logigramme to guide health practitioners on discharge and community reintegration of COVID-19 patients. To standardize clinical attitudes helps in ensuring quality of care and patient safety, should be a core element even during a public health emergency. The logigramme suggests, after discharge, 14 days of further isolation with regular health monitoring and, finally, the execution of a nasopharyngeal swab for identification of SARS-CoV-2 viral RNA. Home-cared patients should be placed on 7 days of further isolation after at least 2 negative RT-PCR tests for respiratory tract samples (nasopharyngeal swab). The logigramme is already used in the Department of Prevention - Local Health Agency of Lecce (Apulia) but it will be updated according to the latest research findings.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是引发严重冠状病毒病(COVID-19)大流行的微生物。在这种大流行期间,患者的出院和重新融入社区是保障公众健康的关键阶段。我们对代表现有最佳证据的国际和意大利经验进行了回顾,主要侧重于任务和相关责任的精确分配。该报告提出了一个针对COVID-19患者的系统管理途径建议。最初的成果是一个流程图,以指导医护人员对COVID-19患者进行出院和社区重新融入管理。规范临床态度有助于确保医疗质量和患者安全,即使在突发公共卫生事件期间这也应是核心要素。该流程图建议,出院后进行14天的进一步隔离并定期进行健康监测,最后进行鼻咽拭子检测以鉴定SARS-CoV-2病毒RNA。居家护理的患者在呼吸道样本(鼻咽拭子)至少两次逆转录聚合酶链反应(RT-PCR)检测呈阴性后,应再进行7天的进一步隔离。该流程图已在莱切省(普利亚大区)地方卫生机构预防部使用,但将根据最新研究结果进行更新。