scholarly journals Emergency calls are early indicators of ICU bed requirement during the COVID-19 epidemic

2020 ◽  
Author(s):  
◽  
Bruno Riou
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Icu Patients ◽  
Ambulance Dispatch ◽  
Polymerase Chain ◽  
Gp Visits ◽  
Second Wave

AbstractBackgroundAlthough the number of intensive care unit (ICU) beds is crucial during the COVID-19 epidemic caring for the most critically ill infected patients, there is no recognized early indicator to anticipate ICU bed requirements.MethodsIn the Ile-de-France region, from February 20 to May 5, 2020, emergency medical service (EMS) calls and the response provided (ambulances) together the percentage of positive reverse transcriptase polymerase chain reaction (RT-PCR) tests, general practitioner (GP) and emergency department (ED) visits, and hospital admissions of COVID-19 patients were recorded daily and compared to the number of COVID-19 ICU patients. Correlation curve analysis was performed to determine the best correlation coefficient (R), depending on the number of days the indicator has been shifted. A delay ≥7 days was considered as an early alert, and a delay ≥14 days a very early alert.FindingsEMS calls, percentage of positive RT-PCR tests, ambulances used, ED and GP visits of COVID-19 patients were strongly associated with COVID-19 ICU patients with an anticipation delay of 23, 15, 14, 13, and 12 days respectively. Hospitalization did not anticipate ICU bed requirement.InterpretationThe daily number of COVID19-related telephone calls received by the EMS and corresponding dispatch ambulances, and the proportion of positive RT-PCR tests were the earliest indicators of the number of COVID19 patients requiring ICU care during the epidemic crisis in the Ile-de-France region, rapidly followed by ED and GP visits. This information may help health authorities to anticipate a future epidemic, including a second wave of COVID19 or decide additional social measures.FundingOnly institutional funding was provided.Research in contextEvidence before the studyWe searched PubMed and preprint archives for articles published up to May 17, 2020, that contained information about the anticipation of intensive care unit (ICU) bed requirement during the COVID-19 outbreak using the terms “coronavirus”, “2009-nCOV”, “COVID-19”, SARS-CoV2”, “prediction” “resource” and “intensive care”. We also reviewed relevant references in retrieved articles and the publicly available publication list of the COVID-19 living systematic review.22 This list contains studies on covid-19 published on PubMed and Embase through Ovid, bioRxiv, and medRxiv, and is continuously updated. Although many studies estimated the number of patients who would have severe COVID-19 requiring ICU, very few contained assessment for early signals (from internet or social media), and we retrieved no study whose data came from suspected or infected patients.Added values of this studyDuring the COVID-19 epidemic, emergency medical system (EMS) calls, percentage of positive reverse transcriptase polymerase chain reaction (RT-PCR) tests, ambulance dispatch, emergency department (ED) and general practitioner (GP) visits of COVID-19 patients were strongly associated with COVID-19 ICU patients with an anticipation delay of 23, 15, 14, 13, and 12 days respectively. Hospitalization did not anticipated COVID-19 ICU bed requirement.Implication of all available evidenceEMS calls and ambulance dispatch, percent of positive RT-PCR, and ED and GP visits could be valuable tools as daily alert signals to set up plan to face the burden of ICU bed requirement during the initial wave of the COVID-19 epidemic, and may possibly also help anticipating a second wave. These results are important since mortality has been reported being correlated to health care resources.

scholarly journals Early indicators of intensive care unit bed requirement during the COVID-19 epidemic: A retrospective study in Ile-de-France region, France

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241406 ◽  
Author(s):  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Hospital Admissions ◽  
Rt Pcr ◽  
Icu Patients ◽  
Health Authorities ◽  
Ed Visits ◽  
Gp Visits ◽  
Second Wave

The aim of our retrospective study was to evaluate the earliest COVID19-related signal to anticipate requirements of intensive care unit (ICU) beds. Although the number of ICU beds is crucial during the COVID-19 epidemic, there is no recognized early indicator to anticipate it. In the Ile-de-France region, from February 20 to May 5, 2020, emergency medical service (EMS) calls and the response provided (ambulances) together the percentage of positive reverse transcriptase polymerase chain reaction (RT-PCR) tests, general practitioner (GP) and emergency department (ED) visits, and hospital admissions of COVID-19 patients were recorded daily and compared to the number of ICU patients. Correlation curve analysis was performed to determine the best correlation coefficient, depending on the number of days the indicator has been shifted. Primary endpoint was the number of ICU patients. EMS calls, percentage of positive RT-PCR tests, ambulances used, ED and GP visits of COVID-19 patients were strongly associated (R2 ranging between 0.79 to 0.99, all P<0.001) with COVID-19 ICU patients with an anticipation delay of 23, 15, 14, 13, and 12 days respectively. Hospitalization did not anticipate ICU bed requirement. A qualitative analysis of the onset of the second wave period of the epidemic (August 1 to September 15, 2020) in the same region provided similar results. The daily number of COVID19-related telephone calls received by the EMS and corresponding dispatch ambulances, and the proportion of positive RT-PCR tests were the earliest indicators of the number of COVID19 patients requiring ICU care during the epidemic crisis, rapidly followed by ED and GP visits. This information may help health authorities to anticipate a future epidemic, including a second wave of COVID19, or decide additional social measures.

Emergency calls are early indicators of ICU bed requirement during the COVID-19 epidemic A retrospective study in Ile-de-France region, France

2020 ◽  
Author(s):  
Frédéric Adnet ◽  
Marin Boyet ◽  
Jean-Jacques Avrane ◽  
Frédéric Batteux ◽  
Pierre-Yves Boëlle ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hospital Admissions ◽  
Rt Pcr ◽  
Icu Patients ◽  
Health Authorities ◽  
Ed Visits ◽  
Polymerase Chain ◽  
Telephone Calls ◽  
Gp Visits ◽  
Second Wave

Abstract Background The aim of our retrospective study was to evaluate the earliest COVID19-related signal to anticipate requirements of intensive care unit (ICU) beds. Although the number of ICU beds is crucial during the COVID-19 epidemic, there is no recognized early indicator to anticipate it. Methods In the Ile-de-France region, from February 20 to May 5, 2020, emergency medical service (EMS) calls and the response provided (ambulances) together the percentage of positive reverse transcriptase polymerase chain reaction (RT-PCR) tests, general practitioner (GP) and emergency department (ED) visits, and hospital admissions of COVID-19 patients were recorded daily and compared to the number of ICU patients. Correlation curve analysis was performed to determine the best correlation coefficient, depending on the number of days the indicator has been shifted. Primary endpoint was the number of ICU patients. Results EMS calls, percentage of positive RT-PCR tests, ambulances used, ED and GP visits of COVID-19 patients were strongly associated with COVID-19 ICU patients with an anticipation delay of 23, 15, 14, 13, and 12 days respectively. Hospitalization did not anticipate ICU bed requirement. Conclusion The daily number of COVID19-related telephone calls received by the EMS and corresponding dispatch ambulances, and the proportion of positive RT-PCR tests were the earliest indicators of the number of COVID19 patients requiring ICU care during the epidemic crisis, rapidly followed by ED and GP visits. This information may help health authorities to anticipate a future epidemic, including a second wave of COVID19 or decide additional social measures.

scholarly journals Gambaran Klinis dan Karakteristik Neonatus dari Ibu Terkonfimasi Covid-2019 di Rumah Sakit Dr. Soetomo

Sari Pediatri ◽  
2021 ◽  
Vol 22 (5) ◽  
pp. 285
Author(s):  
Risa Etika ◽  
Kartika Darma Handayani ◽  
Setya Mithra Hartiastuti ◽  
Virani Diana ◽  
Aminuddin Harahap ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Polymerase Chain Reaction ◽  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Neonatal Intensive Care Unit ◽  
Reverse Transcription ◽  
Neonatal Intensive Care ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain

Latar belakang. Penyakit Coronavirus 2019 (COVID-19) merupakan penyakit yang pertama kali dilaporkan di Wuhan, China dan telah menyebar ke seluruh dunia. Data ibu hamil dan bayi baru lahir belum banyak dipublikasikan.Tujuan. Untuk mendeskripsikan gambaran dan karakteristik klinis neonatus yang lahir dari ibu dengan infeksi severe acute respiratory syndrome-coronavirus (SARS-CoV-2) perinatal.Metode. Penelitian ini merupakan penelitian retrospektif yang dilaksanakan di ruang perawatan neonatal intensive care unit (NICU) Rumah Sakit Umum Daerah Dr.Soetomo Surabaya pada tanggal April - Oktober 2020. Populasi adalah neonatus yang lahir dari ibu terkonfimasi COVID-19 di di Rumah Sakit Dr. Soetomo Surabaya. Data diperoleh dari rekam medik.Hasil. Total terdapat 109 ibu dengan hasil pemeriksaan positif reverse transcription - polymerase chain reaction (RT PCR) COVID-19, dan hanya 2 bayi dengan hasil RT-PCR COVID-19 positif. Usia rata-rata ibu hamil 28±5,9 tahun. Duapuluh sembilan bayi (26,61%) lahir kurang bulan. Cara persalinan didominasi oleh sectio caesaria sebanyak 64 ibu hamil (58,72%). Terdapat 23 bayi (21,11%) lahir dengan berat badan lahir <2500 gram dan 3 bayi dengan hasil negatif RT-PCR COVID-19 meninggal.Kesimpulan. Saat ini belum terbukti adanya penularan secara vertikal COVID 19, sementara itu transmisi horizontal diperkirakan sebagai sumber infeksi pada neonatus. Penerapan protokol kesehatan terbukti efektif mencegah infeksi terhadap neonatus. 

scholarly journals COVID outcome prediction in the emergency department (COPE): using retrospective Dutch hospital data to develop simple and valid models for predicting mortality and need for intensive care unit admission in patients who present at the emergency department with suspected COVID-19

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051468
Author(s):  
David van Klaveren ◽  
Alexandros Rekkas ◽  
Jelmer Alsma ◽  
Rob J C G Verdonschot ◽  
Dick T J J Koning ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Outcome Prediction ◽  
Characteristic Curve ◽  
Hospital Death ◽  
Hospital Data ◽  
Dutch Hospital ◽  
Icu Admission ◽  
Second Wave

ObjectivesDevelop simple and valid models for predicting mortality and need for intensive care unit (ICU) admission in patients who present at the emergency department (ED) with suspected COVID-19.DesignRetrospective.SettingSecondary care in four large Dutch hospitals.ParticipantsPatients who presented at the ED and were admitted to hospital with suspected COVID-19. We used 5831 first-wave patients who presented between March and August 2020 for model development and 3252 second-wave patients who presented between September and December 2020 for model validation.Outcome measuresWe developed separate logistic regression models for in-hospital death and for need for ICU admission, both within 28 days after hospital admission. Based on prior literature, we considered quickly and objectively obtainable patient characteristics, vital parameters and blood test values as predictors. We assessed model performance by the area under the receiver operating characteristic curve (AUC) and by calibration plots.ResultsOf 5831 first-wave patients, 629 (10.8%) died within 28 days after admission. ICU admission was fully recorded for 2633 first-wave patients in 2 hospitals, with 214 (8.1%) ICU admissions within 28 days. A simple model—COVID outcome prediction in the emergency department (COPE)—with age, respiratory rate, C reactive protein, lactate dehydrogenase, albumin and urea captured most of the ability to predict death. COPE was well calibrated and showed good discrimination for mortality in second-wave patients (AUC in four hospitals: 0.82 (95% CI 0.78 to 0.86); 0.82 (95% CI 0.74 to 0.90); 0.79 (95% CI 0.70 to 0.88); 0.83 (95% CI 0.79 to 0.86)). COPE was also able to identify patients at high risk of needing ICU admission in second-wave patients (AUC in two hospitals: 0.84 (95% CI 0.78 to 0.90); 0.81 (95% CI 0.66 to 0.95)).ConclusionsCOPE is a simple tool that is well able to predict mortality and need for ICU admission in patients who present to the ED with suspected COVID-19 and may help patients and doctors in decision making.

scholarly journals Seven Years Leptospirosis Follow-Up in a Critical Care Unit of a French Metropolitan Hospital; Role of Real Time PCR for a Quick and Acute Diagnosis

2020 ◽  
Vol 9 (9) ◽  
pp. 3011
Author(s):  
Olivier Bahuaud ◽  
Adeline Pastuszka ◽  
Cécile Le Brun ◽  
Stephan Ehrmann ◽  
Philippe Lanotte
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multiple Organ ◽  
Biological Data ◽  
Chain Reaction ◽  
Metropolitan Hospital ◽  
Polymerase Chain ◽  
Molecular Biology Method

(1) Background: Leptospirosis infection can lead to multiple organ failure, requiring hospitalization in an intensive care unit for supportive care, along with initiation of an adapted antibiotic therapy. Achieving a quick diagnosis is decisive in the management of these patients. (2) Methods: We present here a review of leptospirosis cases diagnosed in the intensive care unit of our hospital over seven years. Clinical and biological data were gathered, and we compared the differences in terms of diagnostic method. (3) Results: Molecular biology method by Polymerase Chain Reaction (PCR) allowed quick and reliable diagnosis when performed in the first days after the symptoms began. Moreover, we identified that sampling blood and urine for PCR was more efficient than performing PCR on only one type of biological sample. (4) Conclusions: Our results confirm the efficiency of PCR for the quick diagnosis of leptospirosis and suggest that testing both blood and urine early in the disease might improve diagnosis.

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