Dedicated Team to Ambulatory Care for Patients with COVID-19 Requiring Oxygen: Low Rate of Hospital Readmission

Overview

Journal Int J Infect Dis

Publisher Elsevier

Specialty Infectious Diseases

Date 2022 Aug 19

PMID 35985569

Authors

Sophie Viel

Samuel Markowicz

Larbi Ait-Medjber

Rachida Ouissa

Delphine Delta

Patrick Portecop

Tania Foucan

Pierre-Marie Roger

Affiliations

Soon will be listed here.

Abstract

Objectives: We aimed to determine the impact of a dedicated medical team (DMT) on ambulatory care for patients requiring oxygen.

Methods: The DMT selected patients requiring oxygen for less than 5 l/min in the emergency department (ED). The rate of ED readmission was compared in patients managed by the DMT and those managed by the ED physicians (EDPs). Consensual treatment for COVID-19 pneumonia with oxygen requirement was steroids + preventive anticoagulation.

Results: A total of 1397 patients with COVID-19 came to our ED from the first to the 31 of August, 2021, among whom 580 (41%) had ambulatory care. A total of 82 (14.1%) patients were managed by the DMT, with a rate of ED readmission of 4.8% (4/82), compared with 13.6% (68/498) for those managed by EDPs (P <0.001). Focusing on the 45/498 (9.0%) patients requiring oxygen and managed by EDPs, the rate of ED readmission was 20%, P = 0.017. Prescription of the consensual treatment concerned 96% versus 40% for those patients requiring oxygen for the DMT and the EDP, respectively (P <0.001).

Conclusion: A DMT for ambulatory care of patients with COVID-19 requiring oxygen was associated with less return to the ED than usual practices.

Citing Articles

Antibiotic Consumption 2017-2022 in 30 Private Hospitals in France: Impact of Antimicrobial Stewardship Tools and COVID-19 Pandemic.

Roger P, Lesselingue D, Gerard A, Roghi J, Quint P, Un S Antibiotics (Basel). 2024; 13(2).

PMID: 38391566 PMC: 10886305. DOI: 10.3390/antibiotics13020180.

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

Fried S, Bar-Shai A, Frydman S, Freund O Intern Emerg Med. 2023; 19(3):765-775.

PMID: 38104299 DOI: 10.1007/s11739-023-03493-4.

Home oxygen therapy from the emergency department for COVID-19 an observational study.

Schoenling A, Frisch A, Callaway C, Yealy D, Weissman A Am J Emerg Med. 2023; 68:47-51.

PMID: 36933333 PMC: 9993732. DOI: 10.1016/j.ajem.2023.03.012.

Starting Home Telemonitoring and Oxygen Therapy Directly after Emergency Department Assessment Appears to Be Safe in COVID-19 Patients.

van den Berg R, Meccanici C, de Graaf N, van Thiel E, Schol-Gelok S J Clin Med. 2022; 11(23).

PMID: 36498810 PMC: 9736754. DOI: 10.3390/jcm11237236.

References

Nicolas M, Perez J, Carme B . [Intestinal parasitosis in French West Indies: endemic evolution from 1991 to 2003 in the University Hospital of Pointe-a-Pitre, Guadeloupe]. Bull Soc Pathol Exot. 2006; 99(4):254-7. View

Rajter J, Sherman M, Fatteh N, Vogel F, Sacks J, Rajter J . Use of Ivermectin Is Associated With Lower Mortality in Hospitalized Patients With Coronavirus Disease 2019: The Ivermectin in COVID Nineteen Study. Chest. 2020; 159(1):85-92. PMC: 7550891. DOI: 10.1016/j.chest.2020.10.009. View

McCullough P, Kelly R, Ruocco G, Lerma E, Tumlin J, Wheelan K . Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection. Am J Med. 2020; 134(1):16-22. PMC: 7410805. DOI: 10.1016/j.amjmed.2020.07.003. View

Banerjee J, Canamar C, Voyageur C, Tangpraphaphorn S, Lemus A, Coffey Jr C . Mortality and Readmission Rates Among Patients With COVID-19 After Discharge From Acute Care Setting With Supplemental Oxygen. JAMA Netw Open. 2021; 4(4):e213990. PMC: 8017465. DOI: 10.1001/jamanetworkopen.2021.3990. View

Dutey-Magni P, Gill M, McNulty D, Sohal G, Hayward A, Shallcross L . Feasibility study of hospital antimicrobial stewardship analytics using electronic health records. JAC Antimicrob Resist. 2021; 3(1):dlab018. PMC: 8210026. DOI: 10.1093/jacamr/dlab018. View

Susen S, Tacquard C, Godon A, Mansour A, Garrigue D, Nguyen P . Prevention of thrombotic risk in hospitalized patients with COVID-19 and hemostasis monitoring. Crit Care. 2020; 24(1):364. PMC: 7303590. DOI: 10.1186/s13054-020-03000-7. View

Fadel R, Morrison A, Vahia A, Smith Z, Chaudhry Z, Bhargava P . Early Short-Course Corticosteroids in Hospitalized Patients With COVID-19. Clin Infect Dis. 2020; 71(16):2114-2120. PMC: 7314133. DOI: 10.1093/cid/ciaa601. View

Hu B, Guo H, Zhou P, Shi Z . Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2020; 19(3):141-154. PMC: 7537588. DOI: 10.1038/s41579-020-00459-7. View

Nutman T . Human infection with Strongyloides stercoralis and other related Strongyloides species. Parasitology. 2016; 144(3):263-273. PMC: 5563389. DOI: 10.1017/S0031182016000834. View

10.

Prado Jeronimo C, Farias M, Val F, Sampaio V, Alexandre M, Melo G . Methylprednisolone as Adjunctive Therapy for Patients Hospitalized With Coronavirus Disease 2019 (COVID-19; Metcovid): A Randomized, Double-blind, Phase IIb, Placebo-controlled Trial. Clin Infect Dis. 2020; 72(9):e373-e381. PMC: 7454320. DOI: 10.1093/cid/ciaa1177. View

11.

Borgen I, Romney M, Redwood N, Delgado B, Alea P, George B . From Hospital to Home: An Intensive Transitional Care Management Intervention for Patients with COVID-19. Popul Health Manag. 2020; 24(1):27-34. DOI: 10.1089/pop.2020.0178. View

12.

Horby P, Lim W, Emberson J, Mafham M, Bell J, Linsell L . Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2020; 384(8):693-704. PMC: 7383595. DOI: 10.1056/NEJMoa2021436. View

13.

Ramzi Z . Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis. Am J Emerg Med. 2021; 51:267-279. PMC: 8570797. DOI: 10.1016/j.ajem.2021.10.059. View

14.

Rahman S, Montero M, Rowe K, Kirton R, Kunik Jr F . Epidemiology, pathogenesis, clinical presentations, diagnosis and treatment of COVID-19: a review of current evidence. Expert Rev Clin Pharmacol. 2021; 14(5):601-621. PMC: 8095162. DOI: 10.1080/17512433.2021.1902303. View

15.

Levine-Tiefenbrun M, Yelin I, Alapi H, Katz R, Herzel E, Kuint J . Viral loads of Delta-variant SARS-CoV-2 breakthrough infections after vaccination and booster with BNT162b2. Nat Med. 2021; 27(12):2108-2110. DOI: 10.1038/s41591-021-01575-4. View

16.

Ye S, Hiura G, Fleck E, Garcia A, Geleris J, Lee P . Hospital Readmissions After Implementation of a Discharge Care Program for Patients with COVID-19 Illness. J Gen Intern Med. 2021; 36(3):722-729. PMC: 7808120. DOI: 10.1007/s11606-020-06340-w. View

17.

Weinreich D, Sivapalasingam S, Norton T, Ali S, Gao H, Bhore R . REGN-COV2, a Neutralizing Antibody Cocktail, in Outpatients with Covid-19. N Engl J Med. 2020; 384(3):238-251. PMC: 7781102. DOI: 10.1056/NEJMoa2035002. View