Hospital at home for the management of COVID-19: preliminary experience with 63 patients
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BRIEF REPORT
Hospital at home for the management of COVID‑19: preliminary experience with 63 patients Juan M. Pericàs1,2,3,4 · David Cucchiari5 · Orla Torrallardona‑Murphy2 · Júlia Calvo1 · Júlia Serralabós2 · Elisenda Alvés2 · Aleix Agelet2 · Judit Hidalgo2 · Eduarda Alves1,2 · Eva Castells2 · Nuria Seijas2 · Carme Hernández2,6,7 · Marta Bodro2,3,7 · Celia Cardozo2,3,7 · Emmanuel Coloma1,2,7 · David Nicolás1,2,7 · Hospital Clínic 4H Team (Hospital at Home-Health Hotel) Received: 2 July 2020 / Accepted: 14 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Alternatives to conventional hospitalization are needed to increase health systems resilience in the face of COVID-19 pandemic. Herein, we describe the characteristics and outcomes of 63 patients admitted to a single HaH during the peak of COVID-19 in Barcelona. Our results suggest that HaH seems to be a safe and efficacious alternative to conventional hospitalization for accurately selected patients with COVID-19. Keywords COVID-19 · Hospital at home · Alternative medical care facilities · Alternatives to conventional hospitalization
Introduction The COVID-19 pandemic poses a serious challenge to health system resilience across the globe [1]. Particularly, hospital capacity and availability of intensive care unit (ICUs) beds and respirators have been identified among the upmost relevant factors, which have been critically exceeded in a number of countries during the first wave of COVID-19 [1]. Members of the Hospital Clínic 4H Team are listed in the Appendix. * Juan M. Pericàs [email protected] 1
Internal Medicine Service, Hospital Clinic Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain
2
Hospital at Home Unit, Medical and Nurse Direction, Hospital Clinic Barcelona, Barcelona, Spain
3
Infectious Disease Department, Hospital Clínic Barcelona, Barcelona, Spain
4
Vall D’Hebron Institute for Research (VHIR), Barcelona, Spain
5
Renal Transplantation Service, Hospital Clinic Barcelona, Barcelona, Spain
6
University of Barcelona, Barcelona, Spain
7
Institut D’Investigació Biomèdica August Pi I Sunyer (IDIBAPS), Barcelona, Spain
As many hospitals devoted the bulk of their resources in COVID-19, various alternative medical facilities have been used to alleviate hospitals and avoid collapse [1]. Hospital at home (HaH) units have proven to be an effective and safe alternative to conventional hospitalization for admission avoidance and early discharge [2]. HaH units have been successfully used in a variety of conditions, e.g., serious bacterial infections and respiratory viral infections, including potentially health system-collapsing situations such as the annual peak of seasonal influenza [3–6]. We aimed to describe the characteristics and outcomes of patients with COVID-19 transferred from the hospital to a HaH unit during the peak of the first wave of the pandemic in Barcelona, Spain.
Methods Patients Consecutive patients with COVID-19 from March 10 to April 5 2020 admitted to the HaH Unit were i
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