Clinical Experience with COVID-19 at a Specialty Orthopedic Hospital Converted to a Pandemic Overflow Field Hospital

Abstract

Background: COVID-19, the illness caused by the novel coronavirus, SARS-CoV-2, has sickened millions and killed hundreds of thousands as of June 2020. New York City was affected gravely. Our hospital, a specialty orthopedic hospital unaccustomed to large volumes of patients with lifethreatening respiratory infections, underwent rapid adaptation to care for COVID-19 patients in response to emergency surge conditions at neighboring hospitals. Purposes: We sought to determine the attributes, pharmacologic and other treatments, and clinical course in the cohort of patients with COVID-19 who were admitted to our hospital at the height of the pandemic in April 2020 in New York City. Methods: We conducted a retrospective observational cohort study of all patients admitted between April 1 and April 21, 2020, who had a diagnosis of COVID-19. Data were gathered from the electronic health record and by manual chart abstraction. Results: Of the 148 patients admitted with COVID-19 (mean age, 62 years), ten patients died. There were no deaths among non-critically ill patients transferred from other hospitals, while 26% of those with critical illness died. A subset of COVID-19 patients was admitted for orthopedic and medical conditions other than COVID-19, and some of these patients required intensive care and ventilatory support. Conclusion: Professional and organizational flexibility during pandemic conditions allowed a specialty orthopedic hospital to provide excellent care in a global public health emergency.

The Effects of COVID-19 Pandemic on Trauma Registry and Performance Improvement Operations and Workforce Nationwide: A Survey of Trauma Center Association of America Members

“… 23 , 24 Considering that the number of PINs employed is generally adequate to manage the trauma patient volume received, our findings that higher patient volumes are associated with higher delays may be attributable to the temporary conversion of PIN responsibilities to patient care, overwhelming of hospital capacity, and conversion of acute care facilities into overflow COVID-19 units to handle surges of infected patients. 25 , 26 , 27 Furthermore, it is worth noting that high-capacity Trauma Centers are generally located in highly populated areas where COVID-19 has had the highest burden on hospitals and further supports our findings of high-volume centers experiencing greater delays in Trauma Center operations. 28 However, our findings indicate that trauma registry activities and performance & quality improvement operations were not significantly impacted during the COVID-19 pandemic compared to pre-pandemic years.…”

Mortality in patients admitted to intensive care with COVID‐19: an updated systematic review and meta‐analysis of observational studies

“…[Correction added on 9 February 2021, after first online publication: In the preceding sentence, the median: (404 (21–50 [9–76]) was changed to (40 (21–50 [9–76])]. Studies reported on patients from China (n = 10) [24, 27, 29, 32, 34–36, 42, 62, 63]; USA (n = 8) [28, 30, 38, 40, 43, 44, 60, 61]; France (n = 4) [25, 37, 46, 48]; Spain (n = 4) [33, 47, 53, 58]; Switzerland (n = 3) [41, 54, 57]; Canada (n = 2) [45, 66]; Denmark (n = 2) [39, 65]; Australia [71]; Belgium [69]; Europe [20]; Germany [72]; Greece [55]; Hong Kong [31]; Iceland [59]; India [50]; Iran [49]; Israel [56]; Italy [16]; Kuwait [51]; Netherlands [73]; Poland [68]; Scotland [52]; Singapore [26]; Sweden [64]; UK [70]; and Yemen [67] (n = 1 each). Reported ICU mortality rates ranged from 0% to 84.6%, with values at both extremes arising from small case series.…”

“…To avoid duplication of cases, two earlier reports from the Netherlands [21, 22] and one from Germany [23] were excluded. A total of 52 reports were included in the analysis [16, 20, 24–73], comprising the 31 new reports and 21 of the 24 reports from our earlier review (removing the previous reports from ICNARC, Grasselli et al. and Klok et al.…”

“…[Correction added on 9 February 2021, after first online publication: In the preceding sentence, the median: (404 (21-50 ) was changed to (40 (21-50 [9-76])]. Studies reported on patients from China (n = 10) [24, 27, 29, 32, 34-36, 42, 62, 63]; USA (n = 8) [28,30,38,40,43,44,60,61];…”

COVID-19—A Qualitative Orthopaedic Nurse Perspective

“…Within a week, our organization began a physical transformation to accommodate COVID-19 patient overflow from a large nearby teaching facility ( Miller et al, 2020 ). Operating rooms and recovery settings were converted into intensive care units (ICUs) to meet anticipated demand for critical care of patients with COVID-19.…”