S57 The development and implementation of a virtual discharge ward for patients with COVID-19 pneumonia: data on the first 300 patients

Abstract

<h3>Introduction</h3> There is little described in the current COVID-19 literature about the outcomes of patients discharged from hospital following COVID-19 pneumonia. We describe the rapid establishment of a ‘virtual ward’ (VW) for follow-up of patients with a suspected or confirmed diagnosis of COVID-19 pneumonia or pneumonitis upon hospital discharge, characteristics and outcomes for the first 300 patient referrals. <h3>Methods</h3> Admitted patients with a confirmed/suspected diagnosis of COVID-19 pneumonia/pneumonitis were referred electronically to the VW on discharge. Pulse oximeters were provided if oxygen saturations were &lt;92%. The ‘tracking board’ was reviewed daily and phone calls carried out to assess patients for symptom improvement, stability or deterioration. If cause for concern was raised, same-day review for the patient at home was arranged via predetermined community pathways or patients were transferred urgently to hospital. <h3>Results</h3> The M:F ratio was 2:1 and 25% of patients were of black and minority ethnic origin. 71% of patients had at least 1 co-morbidity. 31% of patients were SARS-CoV-2 PCR negative on respiratory tract samples but had high clinical suspicion of COVID-19. 70% of patients had radiological changes on CXR/CT formally reported as being consistent with COVID-19. Median Length of stay (LOS) on the VW was 3.5 days [range 0–19], 85% of patients had a LOS ≤7 days. Around half (158, 53%) of patients had required oxygen during admission. Pulse oximeters were provided to 31 (10%) of patients. Outcomes are shown in figure 1. Thirty-eight (13%) patients re-attended the Emergency Department; 28 were readmitted; of these, 3 were ventilated for respiratory failure, 5 had increasing oxygen requirements and 8 had confirmed pulmonary embolism. 12 had other reasons for admission. 2 patients readmitted by the VW died, both had underlying terminal diagnoses. <h3>Conclusions</h3> To our knowledge, this is the first description of the characteristics of patients discharged from UK hospitals with COVID-19. We have demonstrated that a virtual COVID-19 ward allowed early discharge of patients, offering a safety net and reassurance for patients and clinicians at the time of discharge. Use of pulse oximeters allowed for early identification of clinical deterioration, enabling prompt readmission when required.