The Clinical Characteristics of Early Cases with 2019 Novel Coronavirus Disease in Tabriz, Iran

Background and Purpose: COVID-19 is a new infectious-disease first identified in December 2019 in China, and since it spread globally, it resulted in a Pandemic. Much research is needed to understand the disease, and especially its clinical characteristics. The aim of present study was to explore the clinical features, diagnosis, and treatment of COVID-19 in Tabriz, Iran. Materials and Methods: This was a case series single center study that focused retrospectively on the clinical characteristics of 140 early consecutive cases with confirmed COVID-19, who were hospitalized at one of the referral hospitals for COVID-19 patients of Tabriz, from March 20 to May 3, 2020. We used patients’ records to obtain the data, which were analyzed by SPSS Version 16 using descriptive and analytic statistics (Student’s t-test, Mann-Whitney’s, and Chi-square test). Results: Findings showed that 34 out of 140 patients deceased. The highest percentage of patients were in the age range of 65 years and over. The most common symptom on admission was dry-cough (67.9%), followed by shortness of breath (55.7%), and fever (51.5%). During hospitalization, 27.1% showed an increase in white-blood-cell count. Only 20% were ventilated and others received oxygen by cannula, and/or mask. Recovered patients reported significant lower rates of pre-existing comorbid conditions than patients who died (p= .02). Conclusion: This single center study with a relatively small sample size showed that the most common symptom on admission among patients with COVID-19 was dry-cough, shortness of breath, and fever. The finding is mostly in accordance with the current evidence seen around the World.

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213. Assessment of Compliance with Order Set and Bundle for Management of Staphylococcus aureus Bacteremia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.415 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S214-S215

Author(s):

Ryan R Flynn ◽

Marilee Obritsch ◽

Veronica Lesselyoung ◽

Joe Strain ◽

John Kappes

Keyword(s):

Staphylococcus Aureus ◽

Statistical Difference ◽

Small Sample Size ◽

Small Sample ◽

Single Center ◽

Recurrence Rates ◽

Adequate Treatment ◽

Single Center Study ◽

Center Study ◽

Order Set

Abstract Background Staphylococcus aureus (S. aureus) is an aerobic gram-positive coccus that causes a variety of infections. S. aureus bloodstream infections, also known as bacteremias, have significant morbidity and mortality and are difficult to eradicate. A single-center study showed a 9.4% recurrence rate for S. aureus bacteremia, despite adequate treatment. The Infectious Disease Society of America (IDSA) recognizes the seriousness of S. aureus infections, particularly methicillin-resistant S. aureus (MRSA), and has released guidance for treatment of these infections. Guidance for S. aureus bacteremias include identification and removal of the source and early optimization of antibiotics. Serial imaging and laboratory monitoring, including repeat blood cultures, are also necessary to establish the duration of therapy, ensure microbiologic eradication, and reduce the risk of long-term complications. Due to the complexity of S. aureus bacteremia, early involvement of infectious diseases (ID) specialists is strongly recommended. Methods This retrospective, single-center study was designed to evaluate the current management of S. aureus bacteremias, including compliance to the elements of the S. aureus order set and bundle. Patients 18 years and older who had a positive blood culture for S. aureus were included in this study. Recurrence of S. aureus infection was assessed at 6 months. Data was analyzed to compare patients with and without ID consults. Results Eighty-four patients met inclusion criteria. ID consultation resulted in a higher percentage of patients achieving 100% compliance with the bundle elements compared to patients without ID consults (73% vs 25%, respectively; p=0.009). For further breakdown of compliance see Table 1. No statistical difference was detected in recurrence rates (11% vs 33%, respectively; p=0.18) or mortality (8% vs 25%, respectively; p= 0.17) possibly due to the small sample size. Table 1. Outcomes Conclusion ID specialist involvement for the treatment of S. aureus bacteremia resulted in greater compliance with the S. aureus bacteremia bundle. No statistical difference in recurrence or mortality rates was detected. Disclosures All Authors: No reported disclosures

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