Abstract
The algorithm for examining patients for SARS-CoV-2 during admission to non-infectious hospitals, a unified route scheme for patients taking into account the potential infectious hazard is not regulated.The aim of the study is to identify the features of the diagnosis of SARS-CoV-2 during planned hospitalization in the field of “traumatology and orthopedics”; to present schemes for examining patients for SARS-CoV-2 during hospitalization and patient routing in the clinic.Materials and methods. The route and procedure of examination to exclude the nosocomial spread of COVID-19 in patients hospitalized for three months is described. 3366 survey results were analyzed.Results. Positive PCR tests for COVID-19 before hospitalization were obtained in 4.5 % of patients. High titers of IgM are found in 7.8 % of cases. At the level of the Pass Office, 10.5 % of arrivals were denied hospitalization. The CT scan of the chest organs, which was then carried out, revealed among the examined 9.1 % of asymptomatic pneumonia, of which 93.5 % – with radiological signs of COVID-19, 2/3 of “covid” pneumonia – with a CT-0 degree. Another part of hospitalizations was postponed due to somatic contraindications during clinical examination. After all the selection stages, 73.2 % of planned hospitalizations ended up. In the hospital, 12 cases of COVID-19 were detected in the postoperative period, more often on the 4th day after the operation. A total of 2,328 patients were discharged during the study period – 69.2 % of planned hospitalizations, a third of patients received a medical withdrawal from hospitalization due to COVID-19.Conclusions. The peculiarities of admitting patients to planned hospitalization in the traumatology and orthopedics profile is the difficulty of reliably detecting COVID-19 in a limited time. In some cases of asymptomatic course, the disease is detected only with the help of CT diagnostics. In 0.5 % of cases, COVID-19 is detected in the postoperative period. The described patient routing scheme, multistage diagnostics to exclude COVID-19 are able to ensure maximum infectious safety of patients and staff in the clinic.
Highlights
COVID-19 оказал разрушительное воздействие на системы здравоохранения во всем мире, отменив плановые медицинские услуги, в том числе ортопедические операции, нарушив повседневную жизнь [1, 2]
The aim of the study is to identify the features of the diagnosis of SARS-CoV-2 during planned hospitalization in the field of “traumatology and orthopedics”; to present schemes for examining patients for SARS-CoV-2 during hospitalization and patient routing in the clinic
The route and procedure of examination to exclude the nosocomial spread of COVID-19 in patients hospitalized for three months is described. 3366 survey results were analyzed
Summary
Аннотация Алгоритм обследования пациентов на SARS-CoV-2 при госпитализации в неинфекционные стационары, унифицированная схема маршрута пациентов с учетом потенциальной инфекционной опасности не регламентированы. Описан маршрут и порядок обследования для исключения внутрибольничного распространения COVID-19 пациентов, госпитализированных в течение трех месяцев. В стационаре выявлено 12 случаев COVID-19 в послеоперационном периоде, чаще – на 4-й день после операции. Итого за исследуемый период выписано 2328 пациентов – 69,2 % от запланированных госпитализаций, треть пациентов получила медицинский отвод от госпитализации в связи с COVID-19. В 0,5 % случаев COVID-19 выявляется в послеоперационном периоде. Многоступенчатая диагностика для исключения COVID-19 способны обеспечить максимальную инфекционную безопасность пациентов и персонала в клинике. Ключевые слова: коронавирусная инфекция; COVID-19; SARS-COV-2; травматология и ортопедия; госпитализация Для цитирования: Николаев Н.С., Белова Н.В., Преображенская Е.В., Малюченко Ю.А., Добровольская Н.Ю., Андронников Е.А. Особенности госпитализации пациентов в травматолого-ортопедический центр в условиях второй волны пандемии COVID-19.
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