Abstract
The majority of available US-published reports present populations with community spread in urban areas. The objective of this report is to describe a rural healthcare system's utilisation of therapeutic options available to treat Coronavirus Disease 2019 (COVID-19) and subsequent patient outcomes. A total of 150 patients were treated for COVID-19 at three hospitals in the Dakotas from 21 March 2020 to 30 April 2020. The most common pharmacological treatment regimens administered were zinc, hydroxychloroquine plus azithromycin and convalescent plasma. Adjunctive treatments included therapeutic anticoagulation, tocilizumab and corticosteroids. As of 1 June 2020, 127 patients have survived to hospital discharge, 12 patients remain hospitalised and 11 patients have expired. The efficacy of hydroxychloroquine and azithromycin use has yet to be determined but was not without risks of corrected QT interval prolongation and arrhythmias in our cohort. We did not appreciate any adverse effects that appeared related to tocilizumab or convalescent plasma administration in those patient subsets. These findings may provide insight into disease severity and treatment options in the rural setting with limited resources to participate in clinical trials and encourage larger comparative studies evaluating treatment efficacy.
Highlights
In our study, patients with confirmed SARS-CoV-2 infection by positive nasopharyngeal polymerase chain reaction test seen in the emergency department or admitted to one of three Sanford Health hospitals between 21 March 2020 and 30 April 2020 were included
We describe the characteristics, pharmacologic treatment and preliminary outcomes of 150 acute care patients with COVID-19 within three hospitals of Sanford Health, an integrated healthcare system in the upper Midwest
Patients with confirmed SARS-CoV-2 infection by positive nasopharyngeal polymerase chain reaction test seen in the emergency department or admitted to one of three Sanford Health hospitals between 21 March 2020 and 30 April 2020 were included
Summary
The objective of this report is to describe a rural healthcare system’s utilisation of therapeutic options available to treat Coronavirus Disease 2019 (COVID-19) and subsequent patient outcomes. We describe the characteristics, pharmacologic treatment and preliminary outcomes of 150 acute care patients with COVID-19 within three hospitals of Sanford Health, an integrated healthcare system in the upper Midwest.
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