Safety and outcomes of an early discharge strategy with oxygen home therapy in stable severe COVID-19 patients

Freund, Ophir; Weiss, Tali; Tau, Luba; Meidan, Roni; Liron, Yael; Tchebiner, Joseph Zvi; Bornstein, Gil

doi:10.1080/23744235.2023.2168047

Cited by 7 publications

(4 citation statements)

References 17 publications

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“…This might also cause the extension of hospital stay in our research. Although the conventional strategy of early discharge with home oxygen resulted in higher readmission rates [ 26 ], for the mildly COVID-19 patients in our study, this may also be a way to shorten hospital stays and save healthcare resources.…”

Section: Discussionmentioning

confidence: 85%

Associations between laboratory variables and clinical features in patients hospitalized with COVID-19 after non-mRNA vaccination in China: A cross-sectional study

Zhu

Chen

et al. 2023

Heliyon

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Section: Discussionmentioning

confidence: 85%

Associations between laboratory variables and clinical features in patients hospitalized with COVID-19 after non-mRNA vaccination in China: A cross-sectional study

Zhu

Chen

et al. 2023

Heliyon

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“…28,29 During the COVID-19 pandemic, this strategy was successfully implemented to create surge capacity in overwhelmed hospitals. 30,31 Limitations Firstly, the data search did not cover gray literature, hence anecdotal experiences and reports might have been missed. Secondly, all but one study is based on simulated events and results could be different once more evidence from real events is collected.…”

Section: Discussionmentioning

confidence: 99%

“… 28 , 29 During the COVID-19 pandemic, this strategy was successfully implemented to create surge capacity in overwhelmed hospitals. 30 , 31 …”

Section: Discussionmentioning

confidence: 99%

Primary Health Care and Disasters: Applying a “Whole-of-Health System” Approach through Reverse Triage in Mass-Casualty Management

Alesi,

Bortolin,

Ragazzoni

et al. 2023

Prehosp. Disaster med.

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Introduction: In 2019, the World Health Organization (WHO) published the Health Emergency and Disaster Risk Management (H-EDRM) framework detailing how effective management of disasters, including mass-casualty incidents (MCIs), can be achieved through a whole-of-health system approach where each level of the health care system is involved in all phases of the disaster cycle. In light of this, a primary health care (PHC) approach can contribute to reducing negative health outcomes of disasters, since it encompasses the critical roles that primary care services can play during crises. Hospitals can divert non-severe MCI victims to primary care services by applying reverse triage (RT), thereby preventing hospital overloading and ensuring continuity of care for those who do not require hospital services during the incident. Study Objective: This study explores the topic by reviewing the literature published on early discharge of MCI victims through RT criteria and existing referral pathways to primary care services. Methods: A scoping literature review was performed and a total of ten studies were analyzed. Results: The results showed that integrating primary care facilities into disaster management (DM) through the use of RT may be an effective strategy to create surge during MCIs, provided that clear referral protocols exist between hospitals and primary care services to ensure continuity of care. Furthermore, adequate training should be provided to primary care professionals to be prepared and be able to provide quality care to MCI victims. Conclusion: The results of this current review can serve as groundwork upon which to design further research studies or to help devise strategies and policies for the integration of PHC in MCI management.

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“…At the same time, COV-AKI has been shown to be a predictor of mortality [ 8 ] and for survivors, renal recovery varies according to the operational definition used in different studies, but remains lower when compared with other causes of AKI [ 9 ]. AKI was found to be also a predictor for readmission and mortality in COVID-19 patients discharged early from the hospital [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with acute kidney injury (AKI) and mortality in COVID-19 patients in a Sub-Saharan African intensive care unit: a single-center prospective study

Nlandu,

Makulo,

Essig

et al. 2023

Renal Failure

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Introduction Acute kidney injury (AKI) is a complication of severe coronavirus disease 2019 (COVID-19). Kidney damage associated with COVID-19 could take specific features due to environmental and socio-cultural factors. This study evaluates the incidence of AKI, the associated factors, and mortality in COVID-19 patients in a Sub-Saharan African intensive care unit. Methods In a prospective cohort study conducted in the intensive care unit (ICU) of the Centre Médical de Kinshasa (CMK), consecutive patients admitted for COVID-19 were screened for the presence of AKI between 27 March, 2020 and 27 January 2022. AKI was defined according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines. The primary outcome was occurrence of AKI. The secondary outcome was 48 days’ mortality and recovery of the renal function at intensive care unit (ICU) discharge. Survival (time-to death) curves were built using the Kaplan Meier methods. Multivariate analyses were performed by logistic regression to identify factors associated with AKI and Cox regression to explore the association between AKI and in-hospital mortality. The significance level of the p -value was set at 0.05. Results The median(IQR) sequential organ failure assessment score (SOFA) score and mean age of patients (215) including in our cohort were respectively 3(2-4) and 58.9 ± 14.9 years. The incidence of AKI was 28.4% with stages 1, 2, or 3 AKI accounted for 39.3%, 11.5%, and 49.2%, respectively. Hemodialysis was required in 16 out 215 (7.4%) patients. Dyspnea (adjusted odds ratio (aOR):2.27 [1.1–-4.57] p = 0.021), SOFA ≥5 (aOR:3.11[1.29–7.53] p = 0.012), AST/ALT ratio (aOR: 1.53 [1.09–1.79] p = 0.015), N/L ratio (aOR:2.09 [1.09–3.20] p = 0.016), mechanical ventilation (aOR: 3.20 [1.66–10.51] p = 0.005) and Amikacin (aOR: 2.91 [1.37–6.18] p = 0.006) were the main factors associated with AKI. Patients with AKI had a mortality rate of 52.5% and 67.2% of the survivors did not recover kidney function at the end of hospitalization. Adjusted Cox regression analysis revealed that COVID-19-associated AKI was independently associated with in-hospital death (HR:2.96 [1.93–4.65] p = 0.013) compared to non-AKI patients. Conclusions AKI was present in three out of ten COVID-19 patients. The most significant factors associated with AKI were dyspnea, SOFA ≥ 5, AST/ALT and N/L ratio, mechanical ventilation and Amikacin. AKI has been associated with an almost threefold increase in overall mortality and seven out of ten survivors did not recover kidney function after AKI.

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Safety and outcomes of an early discharge strategy with oxygen home therapy in stable severe COVID-19 patients

Cited by 7 publications

References 17 publications

Associations between laboratory variables and clinical features in patients hospitalized with COVID-19 after non-mRNA vaccination in China: A cross-sectional study

Associations between laboratory variables and clinical features in patients hospitalized with COVID-19 after non-mRNA vaccination in China: A cross-sectional study

Primary Health Care and Disasters: Applying a “Whole-of-Health System” Approach through Reverse Triage in Mass-Casualty Management

Factors associated with acute kidney injury (AKI) and mortality in COVID-19 patients in a Sub-Saharan African intensive care unit: a single-center prospective study

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