Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Infection Control Committee, Hospitals of Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Turk J Med Sci. 2022 Feb;52(1):1-10. doi: 10.3906/sag-2104-152. Epub 2022 Feb 22.
We aimed to analyze the usefulness of such a reserved area for the admission of the patients' symptoms suggesting COVID-19 and compare the demographic and clinical characteristics of the patients with COVID-19 and without COVID-19 who were admitted to C1 during the first month of the COVID-19 outbreak in our hospital.
A new area was set up in Hacettepe University Adult Hospital to limit the contact of COVID-19 suspicious patients with other patients, which was named as COVID-19 First Evaluation Outpatient Clinic (C1). C1 had eight isolation rooms and two sampling rooms for SARS-CoV-2 polymerase-chain-reaction (PCR). All rooms were negative-pressurized. Patients who had symptoms that were compatible with COVID-19 were referred to C1 from pretriage areas. All staff received training for the appropriate use of personal protective equipment and were visited daily by the Infection Prevention and Control team.
One hundred and ninety-eight (29.4%) of 673 patients who were admitted to C1were diagnosed with COVID-19 between March 20, 2020, and April 19, 2020. SARS-CoV-2 PCR was positive in 142 out of 673 patients. Chest computerized tomography (CT) was performed in 421 patients and COVID-19 was diagnosed in 56 of them based on CT findings despite negative PCR. Four hundred and ninety-three patients were tested for other viral and bacterial infections with multiplex real-time reverse-transcriptase PCR (RTPCR). Blood tests that included complete blood count, renal and liver functions, d-dimer levels, ferritin, C- reactive protein, and procalcitonin were performed in 593 patients. Only one out of 44 healthcare workers who worked at C1 was infected by SARS-CoV-2.
Early diagnosis of infected patients and ensuring adequate isolation are very important to control the spread of COVID-19. The purpose of setting up the COVID-19 first evaluation outpatient clinic was to prevent the overcrowding of ER due to mild or moderate infections, ensure appropriate distancing and isolation, and enable emergency services to serve for real emergencies. A wellplanned outpatient care area and teamwork including internal medicine, microbiology, and radiology specialists under the supervision of infectious diseases specialists allowed adequate management of the mild-to-moderate patients with suspicion of COVID-19.
我们旨在分析为疑似 COVID-19 患者预留专门区域的作用，并比较我院 COVID-19 疫情爆发初期入住 C1 的 COVID-19 患者和非 COVID-19 患者的人口统计学和临床特征。
在哈塞泰佩大学成人医院设立了一个新区域，以限制 COVID-19 疑似患者与其他患者的接触，该区域被命名为 COVID-19 首次评估门诊（C1）。C1 设有 8 个隔离室和 2 个用于 SARS-CoV-2 聚合酶链反应（PCR）的采样室。所有房间均采用负压设计。具有与 COVID-19 相符症状的患者从预检区被转至 C1。所有工作人员都接受了正确使用个人防护设备的培训，并由感染预防和控制团队每天进行检查。
2020 年 3 月 20 日至 4 月 19 日期间，有 198 名（29.4%）入住 C1 的 673 名患者被诊断为 COVID-19。673 名患者中，有 142 名的 SARS-CoV-2 PCR 检测结果呈阳性。对 421 名患者进行了胸部计算机断层扫描（CT）检查，根据 CT 结果，尽管 PCR 检测结果为阴性，但仍有 56 名患者被诊断为 COVID-19。采用多重实时逆转录聚合酶链反应（RT-PCR）对 493 名患者进行了其他病毒和细菌感染检测。对 593 名患者进行了全血细胞计数、肾功能和肝功能、D-二聚体水平、铁蛋白、C 反应蛋白和降钙素检测。在在 C1 工作的 44 名医护人员中，只有 1 人感染了 SARS-CoV-2。
早期诊断感染患者并确保充分隔离对于控制 COVID-19 的传播非常重要。设立 COVID-19 首次评估门诊的目的是防止因轻度或中度感染导致急诊室过度拥挤，确保适当的距离和隔离，并使急诊服务能够应对真正的紧急情况。在传染病专家的监督下，由内科、微生物学和放射学专家组成的团队，规划良好的门诊护理区域以及团队合作，使对疑似 COVID-19 的轻度至中度患者进行充分管理成为可能。
