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Coronavirus disease (COVID-19): observations and lessons from primary medical care at a German community hospital

The pandemic outbreak of COVID-19 challenges medical care systems all around the world. We here describe our experiences during the treatment of COVID-19 patients (n = 42) treated from 2 March 2020 to 16 April 2020 at a German district hospital. Forty-two COVID-19 patients were hospitalized and five...

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Autores principales: Schiller, Martin, Fisahn, Juergen, Huebner, Ute, Hofmann, Patrick, Walther, Joerg, Riess, Susann, Grimm, Christiane, Schwab, Hansjörg, Kick, Wolfgang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425615/
https://www.ncbi.nlm.nih.gov/pubmed/32850041
http://dx.doi.org/10.1080/20009666.2020.1763079
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author Schiller, Martin
Fisahn, Juergen
Huebner, Ute
Hofmann, Patrick
Walther, Joerg
Riess, Susann
Grimm, Christiane
Schwab, Hansjörg
Kick, Wolfgang
author_facet Schiller, Martin
Fisahn, Juergen
Huebner, Ute
Hofmann, Patrick
Walther, Joerg
Riess, Susann
Grimm, Christiane
Schwab, Hansjörg
Kick, Wolfgang
author_sort Schiller, Martin
collection PubMed
description The pandemic outbreak of COVID-19 challenges medical care systems all around the world. We here describe our experiences during the treatment of COVID-19 patients (n = 42) treated from 2 March 2020 to 16 April 2020 at a German district hospital. Forty-two COVID-19 patients were hospitalized and five patients developed a severe disease, requiring intensive care. Overall, 11 out of 42 hospitalized patients died. COVID-19 caused lymphocytopenia, as well as increased d-dimer, c-reactive protein and creatine kinase, and lactate dehydrogenase levels. These changes were mostly pronounced in patients that developed a severe disease course. Radiologic findings included ground-glass opacity, bilateral/multilobular involvement, consolidation, and posterior involvement. We compared COVID-19 patients to an average population of ‘non-COVID’ patients. Interestingly, no laboratory or radiologic finding was specific for COVID-19 when standing alone, as comorbidities of ‘non-COVID’ patients certainly can mimic similar results. In common praxis, the diagnosis of COVID-19 is based on a positive PCR result. However, a false-negative result causes problems for the workflow of an entire hospital. In our clinic, the consequences of a false assumption of SARS-CoV-2 negativity in four cases had dramatic consequences, as contact persons had to be quarantined. To avoid this, a comprehensive view of lab-results, radiology, clinical symptoms and comorbidities is necessary for the correct diagnosis or exclusion of COVID-19.
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spelling pubmed-74256152020-08-25 Coronavirus disease (COVID-19): observations and lessons from primary medical care at a German community hospital Schiller, Martin Fisahn, Juergen Huebner, Ute Hofmann, Patrick Walther, Joerg Riess, Susann Grimm, Christiane Schwab, Hansjörg Kick, Wolfgang J Community Hosp Intern Med Perspect Research Article The pandemic outbreak of COVID-19 challenges medical care systems all around the world. We here describe our experiences during the treatment of COVID-19 patients (n = 42) treated from 2 March 2020 to 16 April 2020 at a German district hospital. Forty-two COVID-19 patients were hospitalized and five patients developed a severe disease, requiring intensive care. Overall, 11 out of 42 hospitalized patients died. COVID-19 caused lymphocytopenia, as well as increased d-dimer, c-reactive protein and creatine kinase, and lactate dehydrogenase levels. These changes were mostly pronounced in patients that developed a severe disease course. Radiologic findings included ground-glass opacity, bilateral/multilobular involvement, consolidation, and posterior involvement. We compared COVID-19 patients to an average population of ‘non-COVID’ patients. Interestingly, no laboratory or radiologic finding was specific for COVID-19 when standing alone, as comorbidities of ‘non-COVID’ patients certainly can mimic similar results. In common praxis, the diagnosis of COVID-19 is based on a positive PCR result. However, a false-negative result causes problems for the workflow of an entire hospital. In our clinic, the consequences of a false assumption of SARS-CoV-2 negativity in four cases had dramatic consequences, as contact persons had to be quarantined. To avoid this, a comprehensive view of lab-results, radiology, clinical symptoms and comorbidities is necessary for the correct diagnosis or exclusion of COVID-19. Taylor & Francis 2020-05-21 /pmc/articles/PMC7425615/ /pubmed/32850041 http://dx.doi.org/10.1080/20009666.2020.1763079 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Schiller, Martin
Fisahn, Juergen
Huebner, Ute
Hofmann, Patrick
Walther, Joerg
Riess, Susann
Grimm, Christiane
Schwab, Hansjörg
Kick, Wolfgang
Coronavirus disease (COVID-19): observations and lessons from primary medical care at a German community hospital
title Coronavirus disease (COVID-19): observations and lessons from primary medical care at a German community hospital
title_full Coronavirus disease (COVID-19): observations and lessons from primary medical care at a German community hospital
title_fullStr Coronavirus disease (COVID-19): observations and lessons from primary medical care at a German community hospital
title_full_unstemmed Coronavirus disease (COVID-19): observations and lessons from primary medical care at a German community hospital
title_short Coronavirus disease (COVID-19): observations and lessons from primary medical care at a German community hospital
title_sort coronavirus disease (covid-19): observations and lessons from primary medical care at a german community hospital
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425615/
https://www.ncbi.nlm.nih.gov/pubmed/32850041
http://dx.doi.org/10.1080/20009666.2020.1763079
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