Abstract
Aim: The effects of COVID-19 disease are more severe in older adult patients. As a result of observations and analyzes, it has been previously reported that the mortality rate is higher in older adults. In reducing mortality and morbidity in elderly patients staying in nursing homes, it is vital to detect the patient in need of hospitalization early and deliver them to health services on time as well as early diagnosis. We planned our study to determine what can be done to provide optimal detection and treatment of COVID-19 infection in the older adult or dependent population in the out-of-hospital care home in Karaman. We aimed to share our experience of on-site examination of patients living in nursing homes without hospital admission, together with the data we analyzed retrospectively as a result of the analyzes made.
Material and Methods: Our study is a single-center, retrospective, observational study. This study was conducted with the data of 55 patients previously diagnosed with COVID-19 by reverse-transcriptase-polymerase chain reaction (rRT-PCR) in Yollarbaşı Nursing Home. Age, gender, comorbid diseases, complaints, examination, and vital signs of all patients were recorded. Blood samples were taken from all patients.
Results: 27 (49.1 %) of the patients were male, and 28 (50.9%) were female. The mean age of the group was 47.91 years. The most common symptom was cough (%25,5), followed by fever (14.5 %). The lowest oxygen saturation was found to be 52%. The mean lymphocyte value was 1590 µl (microliter). All three patients we referred to the hospital were hospitalized, and a 100% correct referral was made. In addition, only 3 of the 52 patients we left in the nursing home at the first visit needed hospitalization afterward.
Conclusion: We wanted to share our experience; an on-site examination to reduce transmission and detect critical patients early will reduce the burden of emergency services in hospitals and the risk of infection in this particular population with minor environmental change.
Keywords
References
- 1. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239-1242.
- 2. WHO announces COVID-19outbreak a pandemic. Europe: World Health Organization, 2020 [cited 2020 Apr 18]. Available from: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who-announces-covid-19-outbreak-a-pandemic (Erişim tarihi:15.12.2021)
- 3. Bianchetti A, Bellelli G, Guerini F, et al. Improving the care of older patients during the COVID-19 pandemic. Aging Clinical and Experimental Research 2020 Jul 32:1883–1888.
- 4. Boccardi V, Ruggiero C, Mecocci P. COVID-19: A Geriatric Emergency. Geriatrics. 2020 Apr 26;5(2):24.
- 5. Grabowski D, Mor V. Nursing Home Care in Crisis in the Wake of COVID-19. JAMA. 2020 Jul 7;324(1):23-24.
- 6. Abrams RH, Loomer L, Gandhi A et al. Characteristics of U.S. Nursing Homes with COVID‐19 Cases. Journal of the American Geriatrics Society. 2020 Aug;68(8):1653-1656.
- 7. T.C. Sağlık Bakanlığı COVID-19 (SARS-CoV-2) Rehberi . https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_ Rehberi.pdf . 2020.( Erişim tarihi: 15.12.2021)
- 8. Ciminelli G, Mandicó SG. COVID-19 in Italy: An Analysis of Death Registry Dat. Journal of Public Health. 2020 Nov 23;42(4):723-730.
- 9. Bianchetti A, Rozzini R, Guerini F et al. Clinical presentation of COVID-19 in dementia patients. J Nutr Health Aging. 2020; 24(6):560-562.
- 10. Golinelli, D., Boetto, E., Carullo, G., et al. How the COVID-19 pandemic is favoring the adoption of digital technologies in healthcare: a rapid literature review. medRxiv. 2020 https://doi.org/10.1101/2020.04.26.20080341
- 11. Kadir, M. A. Role of telemedicine in healthcare during COVID-19 pandemic in developing countries. Telehealth and Medicine Today, 2020, 5(2). https://doi.org/10.30953/tmt.v5.187
Abstract
Amaç: COVID-19 hastalığının etkileri yaşlı hastalarda daha ağır seyretmektedir. Yapılan gözlemler ve analizler sonucunda yaşlı hastalarda daha ölümcül seyredebileceği daha önce bildirilmiştir. Bakımevlerinde kalan yaşlı hastalarda mortalite ve morbiditenin azaltılmasında, erken tanı koymak kadar, hastane yatış ihtiyacı olan hastayı da erken saptayıp sağlık hizmetine uygun zamanda ulaştırmak önem arz etmektedir. Karaman ilinde ileri yaş ve bakıma muhtaç popülasyonda, COVID-19 enfeksiyonunun hastane dışı bakımevinde optimal tespit ve tedavisinin sağlanması açısından yapılabilecekleri belirlemek amacıyla çalışmamızı planladık. Yapılan analizler sonucunda retrospektif olarak incelediğimiz verilerle beraber, bakımevinde kalan hastaların hastane başvurusu olmadan yerinde muayene deneyimimizi paylaşmayı amaçladık.
Gereç ve Yöntemler: Çalışmamız tek merkezli, retrospektif, gözlemsel bir çalışmadır. Bu çalışma, Yollarbaşı Bakımevinde daha önce ters-transkriptaz-polimeraz zincir reaksiyonu (rRT-PCR) ile COVID-19 tanısı konmuş 55 tane hastanın verileri ile yapılmıştır. Bütün hastaların yaşı, cinsiyeti, komorbid hastalıkları, şikâyeti, muayene ve vital bulguları kaydedildi. Hastaların hepsinin kan numuneleri alındı.
Bulgular: Hastaların 27’si erkek (%49,1), 28’i (%50,9) kadındı. Grubun yaş ortalaması 47,91 saptandı. En sık saptanan semptom öksürük (%25,5) ve onu takiben ateşti (%14,5). En düşük oksijen saturasyonu %52 saptandı. Ortalama lenfosit değeri 1590 µl (mikrolitre) olarak tespit edildi. Hastaneye sevk ettiğimiz 3 hastanın da yatışı olmuştur ve %100 oranında doğru sevk yapılmıştır. Ayrıca ilk bakıda bakımevinde bıraktığımız 52 hastadan sadece 3 tanesine sonradan yatış ihtiyacı olmuştur.
Sonuç: Bulaşı azaltmak ve kritik hastaları erken saptamak amaçlı yerinde muayene edilmesinin hem hastanelerin acil servis yükünü azaltacağı hem de bu özel popülasyonun daha az ortam değişikliği ile enfekte olma riskinin azalacağı kanaatine vararak bu konudaki deneyimimizi paylaşmak istedik.
Keywords
References
- 1. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239-1242.
- 2. WHO announces COVID-19outbreak a pandemic. Europe: World Health Organization, 2020 [cited 2020 Apr 18]. Available from: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who-announces-covid-19-outbreak-a-pandemic (Erişim tarihi:15.12.2021)
- 3. Bianchetti A, Bellelli G, Guerini F, et al. Improving the care of older patients during the COVID-19 pandemic. Aging Clinical and Experimental Research 2020 Jul 32:1883–1888.
- 4. Boccardi V, Ruggiero C, Mecocci P. COVID-19: A Geriatric Emergency. Geriatrics. 2020 Apr 26;5(2):24.
- 5. Grabowski D, Mor V. Nursing Home Care in Crisis in the Wake of COVID-19. JAMA. 2020 Jul 7;324(1):23-24.
- 6. Abrams RH, Loomer L, Gandhi A et al. Characteristics of U.S. Nursing Homes with COVID‐19 Cases. Journal of the American Geriatrics Society. 2020 Aug;68(8):1653-1656.
- 7. T.C. Sağlık Bakanlığı COVID-19 (SARS-CoV-2) Rehberi . https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_ Rehberi.pdf . 2020.( Erişim tarihi: 15.12.2021)
- 8. Ciminelli G, Mandicó SG. COVID-19 in Italy: An Analysis of Death Registry Dat. Journal of Public Health. 2020 Nov 23;42(4):723-730.
- 9. Bianchetti A, Rozzini R, Guerini F et al. Clinical presentation of COVID-19 in dementia patients. J Nutr Health Aging. 2020; 24(6):560-562.
- 10. Golinelli, D., Boetto, E., Carullo, G., et al. How the COVID-19 pandemic is favoring the adoption of digital technologies in healthcare: a rapid literature review. medRxiv. 2020 https://doi.org/10.1101/2020.04.26.20080341
- 11. Kadir, M. A. Role of telemedicine in healthcare during COVID-19 pandemic in developing countries. Telehealth and Medicine Today, 2020, 5(2). https://doi.org/10.30953/tmt.v5.187
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Original Research |
| Authors | |
| Publication Date | April 30, 2022 |
| Submission Date | December 19, 2021 |
| Acceptance Date | March 13, 2022 |
| Published in Issue | Year 2022 Volume: 5 Issue: 1 |
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Articles published in this journal are licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Journal of Geriatric Science is indexed in Turkey Citation Index, Turkish MEDLINE, Asos Indeks, Scilit, EuroPub, and Index Copernicus International - Journals Master List since September 2022.
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