COVID-19 versus applied infection control policies in a Major Transplant Center in Iran

Abstract

Background Since Shiraz Transplant Center is one of the major transplant centers in Iran and the Middle East, this study was conducted to evaluate outcomes of the applied policies on COVID-19 detection and management. Methods During 4 months from March to June 2020, patient's data diagnosed with the impression of COVID-19 were extracted and evaluated based on demographic and clinical features, along with the length of hospital stay and expenses. Results Our data demonstrated that a total of 190 individuals, with a median age of 58, were diagnosed with COVID-19 during the mentioned period. Among these, 21 patients had a positive PCR test and 56 patients had clinical symptoms in favor of COVID-19. Also, 113 (59%) patients were classified as mild based on clinical evidence and were treated on an outpatient basis. Furthermore, 81 out of 450 cases (18%) of the healthcare workers at our center had either PCR of clinical features in favor of COVID-19. The mortality rate of our study was 11% and diabetes mellitus, hypertension were considered risk factors for obtaining COVID-19 infection. The direct cost of treatment and management of patients with COVID-19 amounted to 2,067,730,919 IRR, which considering the 77 patients admitted to Gary Zone per capita direct cost of treatment each patient was 26,853,648 IRR. Conclusion We demonstrated that the COVID-19 pandemic had a noticeable influence on our transplant center in aspects of delaying surgery and increased hospital costs and burden. However, by implanting proper protocols, we were able to was able to provide early detection for COVID-19 and apply necessary treatment and prevention protocols to safeguard the patients under its coverage, especially immunocompromised patients.

The trend of mortality rates following hospitals downgrading and closures due to outbreak of COVID‐19 in Fars province: A comparative cohort study

“…The main findings demonstrated that the COVID‐19 pandemic had a discernible impact in terms of postponing surgery and raising hospital expenses and workload. However, by implementation of proper policies, early diagnosis for COVID‐19, and application of the required treatment and preventative protocols to protect the patients, the center was able to deliver satisfactory medical services for patients and limit the spread of infection 9 . In a report from the New York hospitals in the United States, the result of the collaboration across private, public, community, and federal hospital systems was able to develop multiple strategies for communication, surge capacity, clinical guidelines, and staff wellness during the COVID‐19 pandemic 17 .…”

“…Among the other published reports on the applied policies and downgrading, one case was mentioned from a private transplant referral hospital in our province. 9 The main findings demonstrated that the COVID-19 pandemic had a discernible impact in terms of postponing surgery and raising hospital expenses and workload.…”

“…However, by implementation of proper policies, early diagnosis for COVID-19, and application of the required treatment and preventative protocols to protect the patients, the center was able to deliver satisfactory medical services for patients and limit the spread of infection. 9 In a report from the New York hospitals in the United…”

“…These newly faced situations called for an appropriate response and alterations in healthcare management. 9 Patients' access to proper care could significantly be disturbed by hospital closures and this condition led to increased mortality rates due to delays in receiving treatment in many studies. 10,11 Several studies revealed that hospital closures were associated with a remarkable increase in deaths, especially from trauma and heart attacks.…”

“…On the other hand, many patients avoided referring to hospitals due to the risk of infection; this resulted in a significant decrease in hospital admissions. These newly faced situations called for an appropriate response and alterations in healthcare management 9 . Patients' access to proper care could significantly be disturbed by hospital closures and this condition led to increased mortality rates due to delays in receiving treatment in many studies 10,11 .…”