Chevallier Lugon Chloé, Smit Mikaela, Salamun Julien, Abderrahmane Meriem, Braillard Olivia, Nehme Mayssam, Jacquerioz Bausch Frédérique, Guessous Idris, Spechbach Hervé
Department of Community Medicine Primary Care and Emergency Medicine, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
Department of Medicine, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
PLoS One. 2021 Mar 4;16(3):e0247774. doi: 10.1371/journal.pone.0247774. eCollection 2021.
Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2), the novel coronavirus that causes coronavirus disease (COVID-19), is creating an unprecedented burden on health care systems across the world due to its high rate of pneumonia-related hospitalizations. This study presents recommendations for the outpatient management of moderate SARS-CoV-2 pneumonia implemented at the Geneva University Hospital, Switzerland, from April 4 to June 30, 2020 and evaluated the impact of these recommendations on patient safety, patient satisfaction, and overall hospital capacity.
Recommendations for the outpatient management of moderate pneumonia implemented in the Geneva University Hospital (PneumoCoV-Ambu) between April 4 and June 30, 2020, were evaluated prospectively. The primary endpoint was hospitalization. Secondary endpoints were: severity of COVID-19 disease based on a 7-points ordinal scale assessed at 1 and 2 months following SARS-CoV-2 infection; patient satisfaction using a satisfaction survey and the analysis of number of beds and costs potentially averted.
A total of 36 patients with COVID-19-related pneumonia were followed between April 4 and May 5, 2020. Five patients (14%) were hospitalized and none died over a median of 30 days follow-up. The majority of patients (n = 31; 86%) were satisfied with the ambulatory care they received. These novel recommendations for outpatient management resulted in sparing an estimated potential 124 hospital bed-nights and CHF 6'826 per capita averted hospitalization costs over the three months period.
Recommendations developed for the outpatient management of COVID-19-related pneumonia were able to spare hospital capacity without increasing adverse patient outcomes. Widely implementing such recommendations is crucial in preserving hospital capacity during this pandemic.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2），即导致冠状病毒病（COVID-19）的新型冠状病毒，因其肺炎相关住院率高，给全球医疗系统带来了前所未有的负担。本研究提出了2020年4月4日至6月30日在瑞士日内瓦大学医院实施的中度SARS-CoV-2肺炎门诊管理建议，并评估了这些建议对患者安全、患者满意度和医院整体容量的影响。
对2020年4月4日至6月30日在日内瓦大学医院实施的中度肺炎门诊管理建议（PneumoCoV-Ambu）进行前瞻性评估。主要终点是住院情况。次要终点包括：根据SARS-CoV-2感染后1个月和2个月评估的7分序贯量表评估COVID-19疾病的严重程度；使用满意度调查评估患者满意度，并分析潜在避免的床位数和成本。
2020年4月4日至5月5日期间，共对36例COVID-19相关肺炎患者进行了随访。5例患者（14%）住院，在中位30天的随访期内无死亡病例。大多数患者（n = 31；86%）对所接受的门诊护理感到满意。这些新型门诊管理建议在三个月期间估计节省了124个住院床日，并避免了人均6826瑞士法郎的住院费用。
为COVID-19相关肺炎门诊管理制定的建议能够节省医院容量，而不增加患者不良结局。在此次疫情期间广泛实施此类建议对于维持医院容量至关重要。
