To keep a COVID-19-free hospital ward: mission possible?
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LETTER TO THE EDITOR
To keep a COVID‑19‑free hospital ward: mission possible? Mario Bo1 · Enrico Brunetti1 · Roberto Presta1 · Marta Rota1 · Francesca Dutto1 · Alessia Cortese1 · Gianluca Isaia1 Received: 26 May 2020 / Accepted: 19 June 2020 © Springer Nature Switzerland AG 2020
Keywords COVID-19 · SARS-CoV-2 · Hospital transmission During the pandemic outbreaks of coronavirus disease 2019 (COVID-19), in Italy, some hospitals became fullydedicated COVID-hospitals, whereas in most of the others, a large number of units with different degrees of intensity of care were converted or created to treat COVID-19 patients. However, some “no-COVID-19” wards were kept to assist patients in need of hospital care and without COVID-19 disease. At the Città della Salute e della Scienza, Molinette, a University-teaching hospital in Turin, north-western Italy, four medical units were converted as COVID-19 wards, and two were designated to remain no-COVID-19 wards. We report our experience within a no-COVID-19 acute Internal Medicine and Geriatric ward, where patients without clinical signs and symptoms of COVID-19 and/or with negative SARS-CoV2 viral genome detection using real-time reverse-transcription polymerase chain reaction (RT-PCR) on samples obtained with naso-pharyngeal swabs (NPSs), were admitted. To increase the safety of patients and personnel, since the beginning of March 2020, we defined two separate sections within our 28-bed ward: one was dedicated to patients with confirmed or suspected infectious diseases and the other was reserved for patients admitted for non infectious diseases. Relatives’ visits were not allowed in both parts of the ward. In keeping with the recommendations from the national Superior Institute of Health, SARS-CoV2 NPS testing in the Emergency Department (ED) was initially addressed to persons with symptoms and/or signs suspected for COVID-19 and/or suspected exposure to a SARS-CoV-2 positive person, and the same rules applied to hospital staff [1]. During * Roberto Presta [email protected] 1
Section of Geriatrics, Department of Medical Sciences, AOU Città della Salute e della Scienza-Molinette, Corso Bramante 88‑90, 10126 Turin, Italy
the study period, along with rapid community spreading of COVID-19, there was a wider adoption of SARS-CoV2 NPS testing in patients admitted to the ED. Due to shortage of personal protective equipment (PPE) use of protection dressing (coat, surgical face mask, gloves) for medical staff and nurses was initially authorized within the infectious area when caring for patients with recognized or suspected respiratory infections. During the period between March 18th and April 24th, 2020, 81 patients (mean age 81.5 ± 9.3 years, 64.2% men) were admitted. Main causes of admission were decompensated heart failure (24.7%), infections (23.5%), anemia and other blood disorders (6.2%), acute renal failure (4.9%), malignancy (4.9%), and respiratory failure (3.7%). A negative SARS-CoV2 NPS test in the ED was available in 47 of the 81 admitted patients (58%). Du
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