COVID 19 Pandemic: Impact on Admission, Diagnosis and Treatment of Non-Covid 19 Patients Admitted in SARI ICU

Abstract

BackgroundHealthcare systems worldwide are overwhelmed in the treatment of ever-increasing number of COVID 19 patients which has affected the management of non COVID 19 patients as well. We tested the adherence to Severe Acute Respiratory Illness (SARI) definition laid down by The Government of India for triaging of suspected COVID 19 cases, and the impact of this strategy on the non covid patients admitted to SARI ICU as suspected cases of covid 19 disease.MethodsA cross-sectional study was conducted to reflect the appropriateness and adherence of SARI definition in two tertiary care medical college hospitals in triaging COVID 19 suspect cases and assessed the challenges in admission, diagnosis and treatment of non COVID 19 diseases. The study involved 78 patients in two multidisciplinary units of medical college hospitals in the month of June – July 2020. Data related to demographics, severity of illness, advanced life supports required, delay in diagnosis, intervention and treatment of patients in SARI ICU due to suspect COVID 19 status was documented. ResultsAdherence to SARI definition for triaging COVID suspect cases was 19.2%. Respiratory symptoms amounted to 24% of presenting complaints. Despite hindrance in the diagnosis (17.9%) and treatment (12.8%), mortality among patients in SARI ICU was limited to 14.10%. The results were in-significant when checked for the various factors associated with mortality.ConclusionThe adherence to SARI definition while triaging COVID suspect cases to intensive care units was low among the clinicians. There were hindrances in the diagnosis and treatment of non COVID diseases due to COVID suspect status of the patient. However, treatment outcomes of these patients were comparable to critically ill population with similar disease severity scores suggesting that quality of care may not have been compromised despite the pandemic. Poor adherence to SARI definition while triaging might have led to economic implications on patients and healthcare systems but further studies are required to comment regarding the same.