Khazaal Fadi, Okleh Nawaf, Ahmad Fida, Baroudy Ghiath, Omosola Ayobami, Alsehli Ziad, El Hassan Mawahib, Alataresh Ezeddin, Al-Suwaidi Jassim, Al-Qahtani Awad, Asaad Nidal, Rafie Ihsan, Arabi Abdulrahman
Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Heart Views. 2020 Jul-Sep;21(3):157-160. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_142_20. Epub 2020 Oct 13.
The novel coronavirus disease-2019 (COVID-19) spread rapidly around the world and was declared as the second pandemic of the 21 century. The first case was detected in Qatar on February 29, 2020. In order to protect patients and staff in Heart Hospital, the only tertiary cardiac center in Qatar, new measures were implemented to reduce the spread of infection in our hospital.
A 13-bed high dependency isolation unit was allocated to receive cardiac patients with appreciate infection control measures. Another isolation unit was also established in coronary care unit for critical patients. All patients admitted to Heart Hospital were tested for COVID-19 on admission. Patients were transferred out of isolation, if result was negative. Patients with positive results were either transferred to a COVID facility before or after planned cardiac procedure depending on their cardiovascular disease risk.
Six hundred and seven patients were admitted to both the isolation units, most of them were men (89%). Forty-four percent were diagnosed with ST elevation myocardial infarction, 22% were non-STEMI or unstable angina, 17% were decompensated heart failure, 7% were elective cases for coronary angiography or electrophysiology procedures, 8% for other diagnosis, and 1% for both cardiac arrest and post cardiac surgery. 85.2% of the patients admitted to isolation units were tested negative and transferred to normal wards to complete their treatment. Eighty percent of the patients tested positive or reactive for COVID-19 had epidemiological risk, 8.4% had suggestive symptoms, and 11.6% had abnormal chest X-ray.
This study demonstrated the importance of the isolation unit with infection control measures in controlling the transmission of COVID-19 in a hospital setting such as the Heart Hospital. Epidemiological risk factors including recent travel, close contact with suspected or confirmed cases within 14 days or less, living in shared accommodation or living in lockdown area were the main risk factors for spreading COVID-19 infection which can be managed by minimizing social activities.
2019年新型冠状病毒病（COVID-19）在全球迅速传播，并被宣布为21世纪的第二次大流行。2020年2月29日在卡塔尔发现了首例病例。为保护卡塔尔唯一的三级心脏中心——心脏医院的患者和工作人员，实施了新措施以减少我院感染传播。
分配了一个有13张床位的高依赖隔离单元，用于接收采取适当感染控制措施的心脏病患者。冠心病监护病房也为危重症患者设立了另一个隔离单元。所有入住心脏医院的患者入院时均接受COVID-19检测。如果结果为阴性，患者转出隔离病房。检测结果呈阳性的患者根据其心血管疾病风险，在计划心脏手术之前或之后被转至COVID设施。
两个隔离单元共收治607例患者，其中大多数为男性（89%）。44%被诊断为ST段抬高型心肌梗死，22%为非ST段抬高型心肌梗死或不稳定型心绞痛，17%为失代偿性心力衰竭，7%为冠状动脉造影或电生理检查的择期病例，8%为其他诊断，1%为心脏骤停和心脏手术后患者。入住隔离单元的患者中85.2%检测呈阴性，并转至普通病房完成治疗。COVID-19检测呈阳性或反应性的患者中，80%有流行病学风险，8.4%有提示性症状，11.6%胸部X光异常。
本研究证明了配备感染控制措施的隔离单元在控制COVID-19在心脏医院等医院环境中传播的重要性。包括近期旅行、14天内或更短时间内与疑似或确诊病例密切接触、居住在合租住房或封锁区域等在内的流行病学风险因素是传播COVID-19感染的主要风险因素，可通过尽量减少社交活动来管控。
