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An Unprecedented Challenge: The North Italian Gastroenterologist Response to COVID-19

Background: COVID-19 pandemic has profoundly changed the activities and daily clinical scenarios, subverting organizational requirements of our Gastroenterology Units. AIM: to evaluate the clinical needs and outcomes of the gastroenterological ward metamorphosis during the COVID-19 outbreaks in a hi...

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Autores principales: Tontini, Gian Eugenio, Aldinio, Giovanni, Nandi, Nicoletta, Rimondi, Alessandro, Consonni, Dario, Iavarone, Massimo, Cantù, Paolo, Sangiovanni, Angelo, Lampertico, Pietro, Vecchi, Maurizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745083/
https://www.ncbi.nlm.nih.gov/pubmed/35011850
http://dx.doi.org/10.3390/jcm11010109
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author Tontini, Gian Eugenio
Aldinio, Giovanni
Nandi, Nicoletta
Rimondi, Alessandro
Consonni, Dario
Iavarone, Massimo
Cantù, Paolo
Sangiovanni, Angelo
Lampertico, Pietro
Vecchi, Maurizio
author_facet Tontini, Gian Eugenio
Aldinio, Giovanni
Nandi, Nicoletta
Rimondi, Alessandro
Consonni, Dario
Iavarone, Massimo
Cantù, Paolo
Sangiovanni, Angelo
Lampertico, Pietro
Vecchi, Maurizio
author_sort Tontini, Gian Eugenio
collection PubMed
description Background: COVID-19 pandemic has profoundly changed the activities and daily clinical scenarios, subverting organizational requirements of our Gastroenterology Units. AIM: to evaluate the clinical needs and outcomes of the gastroenterological ward metamorphosis during the COVID-19 outbreaks in a high incidence scenario. Methods: we compared the pertinence of gastroenterological hospitalization, modality of access, mortality rate, days of hospitalization, diagnostic and interventional procedures, age, Charlson comorbidity index, and frequency of SARS-CoV-2 infections in patients and healthcare personnel across the first and the second COVID-19 outbreaks in a COVID-free gastroenterological ward in the metropolitan area of Milan, that was hit first and hardest during the first COVID-19 outbreak since March 2020. Results: pertinence of gastroenterological hospitalization decreased both during the first and, to a lesser degree, the second SARS-CoV2 waves as compared to the pre-COVID era (43.6, 85.4, and 96.2%, respectively), as occurred to the admissions from domicile, while age, comorbidities, length of stay and mortality increased. Endoscopic and interventional radiology procedures declined only during the first wave. Hospitalized patients resulted positive to a SARS-CoV-2 nasopharyngeal swab in 10.2% of cases during the first COVID-19 outbreak after a median of 7 days since admission (range 1–15 days) and only 1 out of 318 patients during the second wave (6 days after admission). During the first wave, 19.5% of healthcare workers tested positive for SARS-CoV-2. Conclusions: a sudden metamorphosis of the gastroenterological ward was observed during the first COVID-19 outbreak with a marked reduction in the gastroenterological pertinence at the admission, together with an increase in patients’ age and multidisciplinary complexity, hospital stays, and mortality, and a substantial risk of developing a SARS-CoV-2 test positivity. This lesson paved the way for the efficiency of hospital safety protocols and admission management, which contributed to the improved outcomes recorded during the second COVID-19 wave.
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spelling pubmed-87450832022-01-11 An Unprecedented Challenge: The North Italian Gastroenterologist Response to COVID-19 Tontini, Gian Eugenio Aldinio, Giovanni Nandi, Nicoletta Rimondi, Alessandro Consonni, Dario Iavarone, Massimo Cantù, Paolo Sangiovanni, Angelo Lampertico, Pietro Vecchi, Maurizio J Clin Med Article Background: COVID-19 pandemic has profoundly changed the activities and daily clinical scenarios, subverting organizational requirements of our Gastroenterology Units. AIM: to evaluate the clinical needs and outcomes of the gastroenterological ward metamorphosis during the COVID-19 outbreaks in a high incidence scenario. Methods: we compared the pertinence of gastroenterological hospitalization, modality of access, mortality rate, days of hospitalization, diagnostic and interventional procedures, age, Charlson comorbidity index, and frequency of SARS-CoV-2 infections in patients and healthcare personnel across the first and the second COVID-19 outbreaks in a COVID-free gastroenterological ward in the metropolitan area of Milan, that was hit first and hardest during the first COVID-19 outbreak since March 2020. Results: pertinence of gastroenterological hospitalization decreased both during the first and, to a lesser degree, the second SARS-CoV2 waves as compared to the pre-COVID era (43.6, 85.4, and 96.2%, respectively), as occurred to the admissions from domicile, while age, comorbidities, length of stay and mortality increased. Endoscopic and interventional radiology procedures declined only during the first wave. Hospitalized patients resulted positive to a SARS-CoV-2 nasopharyngeal swab in 10.2% of cases during the first COVID-19 outbreak after a median of 7 days since admission (range 1–15 days) and only 1 out of 318 patients during the second wave (6 days after admission). During the first wave, 19.5% of healthcare workers tested positive for SARS-CoV-2. Conclusions: a sudden metamorphosis of the gastroenterological ward was observed during the first COVID-19 outbreak with a marked reduction in the gastroenterological pertinence at the admission, together with an increase in patients’ age and multidisciplinary complexity, hospital stays, and mortality, and a substantial risk of developing a SARS-CoV-2 test positivity. This lesson paved the way for the efficiency of hospital safety protocols and admission management, which contributed to the improved outcomes recorded during the second COVID-19 wave. MDPI 2021-12-25 /pmc/articles/PMC8745083/ /pubmed/35011850 http://dx.doi.org/10.3390/jcm11010109 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tontini, Gian Eugenio
Aldinio, Giovanni
Nandi, Nicoletta
Rimondi, Alessandro
Consonni, Dario
Iavarone, Massimo
Cantù, Paolo
Sangiovanni, Angelo
Lampertico, Pietro
Vecchi, Maurizio
An Unprecedented Challenge: The North Italian Gastroenterologist Response to COVID-19
title An Unprecedented Challenge: The North Italian Gastroenterologist Response to COVID-19
title_full An Unprecedented Challenge: The North Italian Gastroenterologist Response to COVID-19
title_fullStr An Unprecedented Challenge: The North Italian Gastroenterologist Response to COVID-19
title_full_unstemmed An Unprecedented Challenge: The North Italian Gastroenterologist Response to COVID-19
title_short An Unprecedented Challenge: The North Italian Gastroenterologist Response to COVID-19
title_sort unprecedented challenge: the north italian gastroenterologist response to covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745083/
https://www.ncbi.nlm.nih.gov/pubmed/35011850
http://dx.doi.org/10.3390/jcm11010109
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