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Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients

The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became on...

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Autores principales: Garzon-Chavez, Daniel, Romero-Alvarez, Daniel, Bonifaz, Marco, Gaviria, Juan, Mero, Daniel, Gunsha, Narcisa, Perez, Asiris, Garcia, María, Espejo, Hugo, Espinosa, Franklin, Ligña, Edison, Espinel, Mauricio, Quentin, Emmanuelle, Teran, Enrique, Mora, Francisco, Reyes, Jorge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128267/
https://www.ncbi.nlm.nih.gov/pubmed/33999930
http://dx.doi.org/10.1371/journal.pone.0251295
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author Garzon-Chavez, Daniel
Romero-Alvarez, Daniel
Bonifaz, Marco
Gaviria, Juan
Mero, Daniel
Gunsha, Narcisa
Perez, Asiris
Garcia, María
Espejo, Hugo
Espinosa, Franklin
Ligña, Edison
Espinel, Mauricio
Quentin, Emmanuelle
Teran, Enrique
Mora, Francisco
Reyes, Jorge
author_facet Garzon-Chavez, Daniel
Romero-Alvarez, Daniel
Bonifaz, Marco
Gaviria, Juan
Mero, Daniel
Gunsha, Narcisa
Perez, Asiris
Garcia, María
Espejo, Hugo
Espinosa, Franklin
Ligña, Edison
Espinel, Mauricio
Quentin, Emmanuelle
Teran, Enrique
Mora, Francisco
Reyes, Jorge
author_sort Garzon-Chavez, Daniel
collection PubMed
description The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became one of the most affected in Latin America on 24 April 2020. The Hospital General del Sur de Quito (HGSQ) had to transition from a general to a specific COVID-19 health center in a short period of time to fulfill the health demand from patients with respiratory afflictions. Here, we summarized the implementations applied in the HGSQ to become a COVID-19 exclusive hospital, including the rearrangement of hospital rooms and a triage strategy based on a severity score calculated through an artificial intelligence (AI)-assisted chest computed tomography (CT). Moreover, we present clinical, epidemiological, and laboratory data from 75 laboratory tested COVID-19 patients, which represent the first outbreak of Quito city. The majority of patients were male with a median age of 50 years. We found differences in laboratory parameters between intensive care unit (ICU) and non-ICU cases considering C-reactive protein, lactate dehydrogenase, and lymphocytes. Sensitivity and specificity of the AI-assisted chest CT were 21.4% and 66.7%, respectively, when considering a score >70%; regardless, this system became a cornerstone of hospital triage due to the lack of RT-PCR testing and timely results. If health workers act as vectors of SARS-CoV-2 at their domiciles, they can seed outbreaks that might put 1,879,047 people at risk of infection within 15 km around the hospital. Despite our limited sample size, the information presented can be used as a local example that might aid future responses in low and middle-income countries facing respiratory transmitted epidemics.
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spelling pubmed-81282672021-05-27 Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients Garzon-Chavez, Daniel Romero-Alvarez, Daniel Bonifaz, Marco Gaviria, Juan Mero, Daniel Gunsha, Narcisa Perez, Asiris Garcia, María Espejo, Hugo Espinosa, Franklin Ligña, Edison Espinel, Mauricio Quentin, Emmanuelle Teran, Enrique Mora, Francisco Reyes, Jorge PLoS One Research Article The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became one of the most affected in Latin America on 24 April 2020. The Hospital General del Sur de Quito (HGSQ) had to transition from a general to a specific COVID-19 health center in a short period of time to fulfill the health demand from patients with respiratory afflictions. Here, we summarized the implementations applied in the HGSQ to become a COVID-19 exclusive hospital, including the rearrangement of hospital rooms and a triage strategy based on a severity score calculated through an artificial intelligence (AI)-assisted chest computed tomography (CT). Moreover, we present clinical, epidemiological, and laboratory data from 75 laboratory tested COVID-19 patients, which represent the first outbreak of Quito city. The majority of patients were male with a median age of 50 years. We found differences in laboratory parameters between intensive care unit (ICU) and non-ICU cases considering C-reactive protein, lactate dehydrogenase, and lymphocytes. Sensitivity and specificity of the AI-assisted chest CT were 21.4% and 66.7%, respectively, when considering a score >70%; regardless, this system became a cornerstone of hospital triage due to the lack of RT-PCR testing and timely results. If health workers act as vectors of SARS-CoV-2 at their domiciles, they can seed outbreaks that might put 1,879,047 people at risk of infection within 15 km around the hospital. Despite our limited sample size, the information presented can be used as a local example that might aid future responses in low and middle-income countries facing respiratory transmitted epidemics. Public Library of Science 2021-05-17 /pmc/articles/PMC8128267/ /pubmed/33999930 http://dx.doi.org/10.1371/journal.pone.0251295 Text en © 2021 Garzon-Chavez et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Garzon-Chavez, Daniel
Romero-Alvarez, Daniel
Bonifaz, Marco
Gaviria, Juan
Mero, Daniel
Gunsha, Narcisa
Perez, Asiris
Garcia, María
Espejo, Hugo
Espinosa, Franklin
Ligña, Edison
Espinel, Mauricio
Quentin, Emmanuelle
Teran, Enrique
Mora, Francisco
Reyes, Jorge
Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients
title Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients
title_full Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients
title_fullStr Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients
title_full_unstemmed Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients
title_short Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients
title_sort adapting for the covid-19 pandemic in ecuador, a characterization of hospital strategies and patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128267/
https://www.ncbi.nlm.nih.gov/pubmed/33999930
http://dx.doi.org/10.1371/journal.pone.0251295
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