Transition of care interventions to manage severe COVID-19 in the ambulatory setting: a systematic review

Fried, Sabrina; Bar-Shai, Amir; Frydman, Shir; Freund, Ophir

doi:10.1007/s11739-023-03493-4

Cited by 5 publications

(4 citation statements)

References 39 publications

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“…This strategy would be an important element to facilitate patient transition from hospital-based care to home-based care. 8 A booster dose with viral vector-based vaccine or mRNA-based vaccine after primary series of inactivated vaccine was safe and provided good immunogenicity in Thai healthy adult. 9 The incremental cost-effectiveness ratio (ICER) demonstrated that a booster dose either with viral vector-based vaccine or mRNA-based vaccine in Thai population during the omicron period was cost-effective as a booster dose could reduce both numbers of infected cases and death.…”

Section: Introductionmentioning

confidence: 96%

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Monitoring of adaptive immune responses in healthcare workers who received a Coronavirus disease 2019 vaccine booster dose

Klinmalai,

Srisala,

Sahakijpicharn

et al. 2024

Health Science Reports

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Background and AimsCoronavirus disease 2019 (COVID‐19) has become a global pandemic and led to increased mortality and morbidity. Vaccines against the etiologic agent; severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) were approved for emergency use on different platforms. In the early phase of the pandemic, Thai healthcare workers (HCWs) received CoronaVac, an inactivated vaccine, as the first vaccine against SARS‐CoV‐2, followed by ChAdOx1 nCoV‐19, a viral vector‐based vaccine, or BNT162b2, an mRNA vaccine, as a booster dose. This preliminary study evaluated the immunogenicity of ChAdOx1 nCoV‐19 and BNT162b2 as a booster dose in HCWs who previously received two doses of CoronaVac.MethodsTen HCW participants received ChAdOx1 nCoV‐19 and another 10 HCWs received BNT162b2 as a booster dose after two doses of CoronaVac. Anti‐RBD IgG, neutralizing antibodies (NAb), and cellular immunity, including interferon‐gamma (IFN‐γ)‐releasing CD4, CD8, double negative T cells, and NK cells, were measured at 3 and 5 months after the booster dose.ResultsThere was no significant difference in anti‐RBD IgG levels at 3 and 5 months between the two different types of booster vaccine. The levels of anti‐RBD IgG and NAb were significantly decreased at 5 months. HCWs receiving BNT162b2 had significantly higher NAb levels than those receiving ChAdOx1 nCoV‐19 at 5 months after the booster dose. IFN‐γ release from CD4 T cells was detected at 3 months with no significant difference between the two types of booster vaccines. However, IFN‐γ‐releasing CD4 T cells were present at 5 months in the ChAdOx1 nCoV‐19 group only.ConclusionChAdOx1 nCoV‐19 or BNT162b2 can be used as a booster dose after completion of the primary series primed by inactivated vaccine. Although the levels of immunity decline at 5 months, they may be adequate during the first 3 months after the booster dose.

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Section: Introductionmentioning

confidence: 96%

“…This strategy would be an important element to facilitate patient transition from hospital‐based care to home‐based care. 8 …”

Section: Introductionmentioning

confidence: 99%

Monitoring of adaptive immune responses in healthcare workers who received a Coronavirus disease 2019 vaccine booster dose

Klinmalai,

Srisala,

Sahakijpicharn

et al. 2024

Health Science Reports

View full text Add to dashboard Cite

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“…The use of EWS scales may also play a key role in making decisions about which patients should be admitted to the hospital emergency department and receive treatment in the hospital setting and which can be discharged for outpatient treatment. This aspect of patient management is particularly important in light of a recent study by Fried et al, who demonstrated that with correct patient selection, even severe COVID-19 cases can be safely treated in the outpatient setting [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Predicting Mortality for COVID-19 Patients Admitted to an Emergency Department Using Early Warning Scores in Poland

Rzońca,

Butkiewicz,

Dobosz

et al. 2024

Healthcare

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COVID-19 disease is characterised by a wide range of symptoms that in most cases resemble flu or cold. Early detection of infections, monitoring of patients’ conditions, and identification of patients with worsening symptoms became crucial during the peak of pandemic. The aim of this study was to assess and compare the performance of common early warning scores at the time of admission to an emergency department in predicting in-hospital mortality in patients with COVID-19. The study was based on a retrospective analysis of patients with SARS-CoV-2 infection admitted to an emergency department between March 2020 and April 2022. The prognostic value of early warning scores in predicting in-hospital mortality was assessed using the receiver operating characteristic (ROC) curve. Patients’ median age was 59 years, and 52.33% were male. Among all the EWS we assessed, REMS had the highest overall accuracy (AUC 0.84 (0.83–0.85)) and the highest NPV (97.4%). REMS was the most accurate scoring system, characterised by the highest discriminative power and negative predictive value compared to the other analysed scoring systems. Incorporating these tools into clinical practice in a hospital emergency department could provide more effective assessment of mortality and, consequently, avoid delayed medical assistance.

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“…Accurately identifying patients who are unlikely to worsen is essential for the consideration of transitioning their care to an ambulatory setting, thereby reducing the burden on the healthcare system and enhancing patient experiences. Such a strategy has been validated as both safe and highly effective in a systematic review, contingent upon the careful optimization of patient selection criteria [22]. Research has consistently highlighted several risk factors for severe COVID-19, including older age, the presence of pre-existing comorbidities (such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer), obesity, and specific laboratory markers indicative of systemic inflammation or organ dysfunction [21,23,24].…”

Section: Introductionmentioning

confidence: 99%

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

Ince,

Alkan Bilik,

Ince

2024

Diagnostics

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Introduction: Numerous studies suggest that alterations in blood parameters, such as changes in platelet, lymphocyte, hemoglobin, eosinophil, and basophil counts; increased neutrophil counts; and elevated neutrophil/lymphocyte and platelet/lymphocyte ratios, signal COVID-19 infection and predict worse outcomes. Leveraging these insights, our study seeks to create a predictive mortality model by assessing age and crucial laboratory markers. Materials and Methods: Patients were categorized into two groups based on their hospital outcomes: 130 survivors who recovered from their Intensive Care Unit (ICU) stay (Group 1) and 74 who died (Group 2). We then developed a predictive mortality model using patients’ age, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), procalcitonin levels, and ferritin lactate (FL) index results. Results: A total of 204 patients were included. Patients in Group 2 had a notably higher mean age compared to those in Group 1 (76 ± 11 vs. 66 ± 15 years) (p < 0.001). Using specific cut-off values, our analysis revealed varying effectiveness in predicting COVID-19 mortality: Those aged over 73 years showed 74% sensitivity and 60% specificity, with an area under the curve (AUC) of 0.701. Procalcitonin levels above 0.35 ng/mL balanced true-positive and -negative identifications well, achieving an AUC of 0.752. The FL index, with a threshold of 1228 mg/dL, had 68% sensitivity and 65% specificity with an AUC of 0.707. A PLR higher than 212 resulted in 48% sensitivity and 69% specificity, with an AUC of 0.582. An NLR higher than 5.8 resulted in 55% sensitivity and 63% specificity, with an AUC of 0.640, showcasing diverse predictive accuracies across parameters. The statistical analysis evaluated the effects of age (>73), procalcitonin levels (>0.35), FL > 1228, PLR > 212, and NLR > 5.8 on mortality variables using logistic regression. Ages over 73 significantly increased event odds by 2.1 times (p = 0.05), procalcitonin levels above 0.35 nearly quintupled the odds (OR = 5.6, p < 0.001), high FL index levels more than tripled the odds (OR = 3.5, p = 0.003), a PLR > 212 significantly increased event odds by 3.5 (p = 0.030), and an NLR > 5.8 significantly increased event odds by 1.6 (p = 0.043). Conclusions: Our study highlights significant predictors of mortality in COVID-19 ICU patients, including advanced age, elevated procalcitonin, FL index levels, the PLR, and the NLR.

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Transition of care interventions to manage severe COVID-19 in the ambulatory setting: a systematic review

Cited by 5 publications

References 39 publications

Monitoring of adaptive immune responses in healthcare workers who received a Coronavirus disease 2019 vaccine booster dose

Monitoring of adaptive immune responses in healthcare workers who received a Coronavirus disease 2019 vaccine booster dose

Predicting Mortality for COVID-19 Patients Admitted to an Emergency Department Using Early Warning Scores in Poland

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

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