SARS-CoV-2 management in Emergency Department: risk stratification and care setting identification proposal based on first pandemic wave in Pisa University Hospital

Barbieri, Greta; Cipriano, Alessandro; Carrara, Stella; Spinelli, Stefano; Caputo, Francesco; Foltran, Francesca; Filippi, Matteo; Aquilini, Ferruccio; Tonerini, Michele; Santini, Massimo; Paolo, Malacarne; Ghiadoni, Lorenzo

doi:10.4081/ecj.2021.9859

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…19 A progressive improvement in COVID patient mortality has been described, 20,21 but this was not demonstrated in our cohort's three consecutive waves. The reduction in mortality is most likely the result of a multifactorial process that cannot be well interpreted Male sex, cardiovascular comorbidities, acute cardiac or kidney injury, lymphocytopenia, and D-dimer were all associated with an increased risk of in-hospital death, 8,22,23 but none of these variables were found to be predictors in our study.…”

Section: Articlecontrasting

confidence: 57%

COVID-19 in sub-intensive care unit: An italian single-center experience along the three epidemic waves

et al. 2022

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The goal was to characterize COVID-19 patients who needed treatment in Sub-Intensive Care Units (SICUs) for hypoxemic respiratory failure, describe their six-month mortality, and identify clinical and laboratory characteristics that were associated with death. Data from 216 consecutive patients admitted to the COVIDSICU of Turin’s San Giovanni Bosco Hospital were analyzed retrospectively. A total of 216 patients (24.5% of whom were female) were enrolled. The average age was 63±11.9 years. In the three waves, the six-month mortality rate was 32.8%, 35.1%, and 26.6%, respectively (p=0.52). The mortality rate was significantly higher in intubated patients compared to those not requiring intubation (60.8% versus 29.9%, p<0.01). On admission, deceased patients were older (69±7.7 versus 60.2±12.6 y.o., p<0.01), with a higher prevalence of dyslipidemia, coronary artery disease, chronic heart failure, and higher serum creatinine. However, only age was predictive of death at multivariate analysis (OR 5.29, p<0.01), with 63 years old as the best cut-point. At six months, mortality in COVID patients managed in a SICU is around 30%. Age is a significant negative prognostic factor, with 63 years of age being the best predicting cut-off.

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Section: Articlecontrasting

confidence: 57%

COVID-19 in sub-intensive care unit: An italian single-center experience along the three epidemic waves

et al. 2022

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“…Baseline characteristics of our study population, dating back to the very first pandemic wave, showed a high prevalence of males, cardiovascular diseases and hospital management influenced not only by clinical conditions but also by organizational difficulties [22] , [23] , [24] , [25] .…”

Section: Discussionmentioning

confidence: 99%

Long-term lung ultrasound follow-up in patients after COVID-19 pneumonia hospitalization: A prospective comparative study with chest computed tomography

Barbieri¹,

Gargani²,

Lepri³

et al. 2023

European Journal of Internal Medicine

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Outcomes of critically ill COVID-19 patients boarding in the emergency department of a tertiary care center in a developing country: a retrospective cohort study

Zahran,

Al Hassan,

Al Karaki

et al. 2023

Int J Emerg Med

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Background Boarding of critically ill patients in the emergency department (ED) has long been known to compromise patient care and affect outcomes. During the COVID-19 pandemic, multiple hospitals worldwide experienced overcrowded emergency rooms. Large influx of patients outnumbered hospital beds and required prolonged length of stay (LOS) in the ED. Our aim was to assess the ED LOS effect on mortality and morbidity, in addition to the predictors of in-hospital mortality, intubation, and complications of critically ill COVID-19 ED boarder patients. Methods This was a retrospective cohort study, investigating 145 COVID-19-positive adult patients who were critically ill, required intensive care unit (ICU), and boarded in the ED of a tertiary care center in Lebanon. Data on patients who boarded in the emergency from January 1, 2020, till January 31, 2021, was gathered and studied. Results Overall, 66% of patients died, 60% required intubation, and 88% developed complications. Multiple risk factors were associated with mortality naming age above 65 years, vasopressor use, severe COVID pneumonia findings on CT chest, chemotherapy treatment in the previous year, cardiovascular diseases, chronic kidney diseases, prolonged ED LOS, and low SaO2 < 95% on triage. In addition, our study showed that staying long hours in the ED increased the risk of developing complications. Conclusion To conclude, all efforts need to be drawn to re-establish mitigation strategies and models of critical care delivery in the ED to alleviate the burden of critical boarders during pandemics, thus decreasing morbidity and mortality rates. Lessons from this pandemic should raise concern for complications seen in ED ICU boarders and allow the promotion of health measures optimizing resource allocation in future pandemic crises.

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SARS-CoV-2 management in Emergency Department: risk stratification and care setting identification proposal based on first pandemic wave in Pisa University Hospital

Cited by 4 publications

References 24 publications

COVID-19 in sub-intensive care unit: An italian single-center experience along the three epidemic waves

COVID-19 in sub-intensive care unit: An italian single-center experience along the three epidemic waves

Long-term lung ultrasound follow-up in patients after COVID-19 pneumonia hospitalization: A prospective comparative study with chest computed tomography

Outcomes of critically ill COVID-19 patients boarding in the emergency department of a tertiary care center in a developing country: a retrospective cohort study

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