Miyamoto Yuki, Matsuyama Tasuku, Kunimitsu Katsutomo, Nagano Hiroyuki, Yamada Yoshie, Murakami Shigemi, Yamahata Yoshihiro, Ohta Bon, Morikami Yoshiki, Nakagawa Masanori
Department of Emergency and Disaster Medical Systems, Graduate School of Medicine, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan.
Yoshiki Home Care Clinic, Kyoto 6158262, Japan.
J Clin Med. 2022 Mar 26;11(7):1850. doi: 10.3390/jcm11071850.
Hospital-at-home (HaH) care is useful for patients with COVID-19 and an alternative strategy when hospital capacity is under pressure due to patient surges. However, the efficacy and safety of HaH in elderly patients with COVID-19 remain unknown. In Kyoto city, we conducted a retrospective medical record review of HaH care focused on elderly COVID-19 patients from 4 February to 25 June 2021. Eligible patients were (1) COVID-19 patients aged ≥70 years and those who lived with them or (2) COVID-19 patients aged <70 years with special circumstances and those who lived with them. During the study period, 100 patients received HaH care. Their median age was 76 years (interquartile range 56−83), and 65% were over 70 years. Among 100 patients, 36 (36%) had hypoxia (oxygen saturation ≤ 92%), 21 (21%) received steroid medication, and 34 (34%) received intravenous fluids. Although 22 patients were admitted to the hospital and 3 patients died there, no patients died during HaH care. HaH care may be safe and effective in elderly patients with COVID-19. Our study shows that HaH provides an alternative strategy for treating COVID-19 patients and can reduce the healthcare burden at hospitals.
居家医院（HaH）护理对新冠肺炎患者有用，并且在因患者激增导致医院容量承压时是一种替代策略。然而，HaH在老年新冠肺炎患者中的疗效和安全性仍不明确。在京都市，我们对2021年2月4日至6月25日期间接受HaH护理的老年新冠肺炎患者进行了回顾性病历审查。符合条件的患者为：（1）年龄≥70岁的新冠肺炎患者及其同住者，或（2）年龄<70岁且有特殊情况的新冠肺炎患者及其同住者。在研究期间，100名患者接受了HaH护理。他们的中位年龄为76岁（四分位间距56 - 83），65%的患者年龄超过70岁。在100名患者中，36名（36%）有低氧血症（血氧饱和度≤92%），21名（21%）接受了类固醇药物治疗，34名（34%）接受了静脉输液。虽然有22名患者被收治入院，3名患者在医院死亡，但在接受HaH护理期间无患者死亡。HaH护理对老年新冠肺炎患者可能是安全有效的。我们的研究表明，HaH为治疗新冠肺炎患者提供了一种替代策略，并且可以减轻医院的医疗负担。
