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      Providing essential clinical care for non-COVID-19 patients in a Seoul metropolitan acute care hospital amidst ongoing treatment of COVID-19 patients

      brief-report

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          Abstract

          We assessed infection control efforts by comparing data collected over 20 weeks during a pandemic under a dual-track healthcare system. A decline in non-COVID-19 patients visiting the ED by 37.6% (p<0.01) was observed since admitting COVID-19 cases. However, patients with acute myocardial infarction (AMI), stroke, severe trauma and acute appendicitis presenting for emergency care did not decrease. Door-to-balloon time (34.3〔±11.3〕min vs. 22.7〔±8.3〕min) for AMI improved significantly (p<0.01) while door-to-needle time (55.7〔±23.9〕min vs. 54.0〔±18.0〕min) in stroke management remained steady (p = 0.80). Simultaneously, time‐sensitive care involving other clinical services, including patients requiring chemotherapy, radiation therapy and hemodialysis did not change.

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          Case of the Index Patient Who Caused Tertiary Transmission of Coronavirus Disease 2019 in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Pneumonia Monitored by Quantitative RT-PCR

          Jaegyun Lim, Seunghyun Jeon, Hyun-Young Shin … (2020)
          Since mid-December of 2019, coronavirus disease 2019 (COVID-19) has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
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            Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: a meta-analysis

            Chee Foo, Kwadwo Osei Bonsu, Brahmajee K. Nallamothu … (2018)
            This study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers. We conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure. 32 studies involving 299 320 patients contained adequate data for quantitative reporting. Patients with ST-elevation MI who experienced longer (>90 min) door-to-balloon delay had a higher risk of short-term mortality (pooled OR 1.52, 95% CI 1.40 to 1.65) and medium-term to long-term mortality (pooled OR 1.53, 95% CI 1.13 to 2.06). A non-linear time – risk relation was observed (P=0.004 for non-linearity). The association between longer door-to-balloon delay and short-term mortality differed between those presented early and late after symptom onset (Cochran’s Q 3.88, P value 0.049) with a stronger relationship among those with shorter prehospital delays. Longer door-to-balloon delay in primary percutaneous coronary intervention for ST-elevation MI is related to higher risk of adverse outcomes. Prehospital delays modified this effect. The non-linearity of the time – risk relation might explain the lack of population effect despite an improved door-to-balloon time in the USA. PROSPERO (CRD42015026069).
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              Recommendations for protecting against and mitigating the COVID-19 pandemic in long-term care facilities

              Muh-Yong Yen, Jonathan C. Schwartz, Chwan-Chuen King … (2020)
              The COVID-19 outbreak has drawn heightened attention from public health scholars researching ways to limit its spread. Much of the research has been focused on minimizing transmission in hospitals and in the general community. However, a particularly vulnerable community that has received relatively little attention is elders residing in long-term care facilities (LTCFs). In this article we address this relative lack of attention, arguing that enhanced traffic control bundling (eTCB) can and should be adopted and implemented as a means of protecting LTCF residents and staff. Enhanced TCB has been widely applied in hospital settings and has proven effective at limiting droplet and fomite transmissions both within hospitals and between hospitals and the general community. By effectively adapting eTCB to LTCF conditions, particularly by incorporating compartmentalization within zones plus active surveillance, COVID-19 transmission into and throughout LTCFs can be minimized, thereby saving numerous lives among an especially vulnerable population.
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                Author and article information

                Contributors
                Ki Deok Lee: Role: Clinical Professor
                Seungbok Lee: Role: Clinical Professor
                Jaegyun Lim: Role: Clinical Associate Professor
                Yu Min Kang: Role: Clinical Assistant Professor
                In Byung Kim: Role: Clinical Professor
                Hyoun Jong Moon: Role: Director
                Wang Jun Lee: Role: Chief Executive Officer and Chairman
                Journal
                Journal ID (nlm-ta): J Hosp Infect
                Journal ID (iso-abbrev): J. Hosp. Infect
                Title: The Journal of Hospital Infection
                Publisher: Published by Elsevier Ltd on behalf of The Healthcare Infection Society.
                ISSN (Print): 0195-6701
                ISSN (Electronic): 1532-2939
                Publication date PMC-release: 1 October 2020
                Publication date (Electronic): 1 October 2020
                Affiliations
                [a ]Department of Infectious Diseases, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
                [b ]Department of Physical Medicine and Rehabilitation, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
                [c ]Department of Laboratory Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
                [d ]Department of Emergency Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
                [e ]New Horizon Cancer Institute, Myongji Hospital, Goyang, Korea
                [f ]Department of General Surgery, Myongji Hospital, Goyang, Korea
                Author notes
                [∗ ]Corresponding author. Wang Jun Lee, MD Chief Executive Officer and Chairman, Department of General Surgery, Myongji Hospital, Goyang, Korea Myongji Hospital, 55 Hwasu-ro 14-beon-gil, Deogyang-gu, Goyang 10475, Republic of Korea. Tel.: +82 31-810-5114; fax: +82 31-810-7329
                Article
                Publisher Item ID: S0195-6701(20)30456-4
                DOI: 10.1016/j.jhin.2020.09.031
                PMC ID: 7528870
                PubMed ID: 33011308
                SO-VID: e77264df-c60f-4939-a16f-32174c987b7d
                Copyright © © 2020 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 13 July 2020
                Date revision received : 14 September 2020
                Date accepted : 26 September 2020
                Categories
                Subject: Short Report

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: covid-19,non-covid-19 patients,hospital infection,hospital visiting,essential clinical care,acute care hospital,acute myocardial infarctions,strokes,acute appendicitis,quality of care,south korea,time-sensitive therapy,chemotherapy,radiation therapy,hemodialysis,pediatrics,vaccination,health system reform,national response
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: covid-19, non-covid-19 patients, hospital infection, hospital visiting, essential clinical care, acute care hospital, acute myocardial infarctions, strokes, acute appendicitis, quality of care, south korea, time-sensitive therapy, chemotherapy, radiation therapy, hemodialysis, pediatrics, vaccination, health system reform, national response

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