Audit of Clinical Care Received by COVID-19 Patients Treated at a Tertiary Care Hospital of Nepal in 2021.

Autor:	Mandal SK; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Neupane J; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Kumar AMV; International Union Against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France.; International Union Against Tuberculosis and Lung Disease, South-East Asia Office, C-6 Qutub Institutional Area, New Delhi 110016, The National Capital Territory of Delhi, India.; Yenepoya Medical College, Yenepoya (Deemed to be University), University Road, Deralakatte, Mangaluru 575018, Karnataka, India., Davtyan H; Tuberculosis Research and Prevention Center, NGO, Yerevan 0014, Armenia., Thekkur P; International Union Against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France.; International Union Against Tuberculosis and Lung Disease, South-East Asia Office, C-6 Qutub Institutional Area, New Delhi 110016, The National Capital Territory of Delhi, India., Jayaram A; Manipal Institute of Virology, Manipal, Academy of Higher Education, Manipal, Udupi 576104, Karnataka, India., Chalise BS; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Rawal M; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Paudel M; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Baral B; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Shah RK; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Maharjan K; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Shrestha S; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Bhandari L; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., K C N; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Gautam N; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal., Sunny AK; WHO Country Office, Kathmandu 44600, Nepal., Thakur N; Epidemiology and Disease Control Division, Kathmandu 44600, Nepal., Subeedee KC; Epidemiology and Disease Control Division, Kathmandu 44600, Nepal., Mandal SK; Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu 44600, Nepal., Bastola A; Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal.
Jazyk:	angličtina
Zdroj:	Tropical medicine and infectious disease [Trop Med Infect Dis] 2022 Nov 16; Vol. 7 (11). Date of Electronic Publication: 2022 Nov 16.
DOI:	10.3390/tropicalmed7110381
Abstrakt:	Like the world over, Nepal was also hard hit by the second wave of COVID-19. We audited the clinical care provided to COVID-19 patients admitted from April to June 2021 in a tertiary care hospital of Nepal. This was a cohort study using routinely collected hospital data. There were 620 patients, and most (458, 74%) had severe illness. The majority (600, 97%) of the patients were eligible for admission as per national guidelines. Laboratory tests helping to predict the outcome of COVID-19, such as D-dimer and C-reactive protein, were missing in about 25% of patients. Nearly all (>95%) patients with severe disease received corticosteroids, anticoagulants and oxygen. The use of remdesivir was low (22%). About 70% of the patients received antibiotics. Hospital exit outcomes of most (>95%) patients with mild and moderate illness were favorable (alive and discharged). Among patients with severe illness, about 25% died and 4% were critically ill, needing further referral. This is the first study from Nepal to audit and document COVID-19 clinical care provision in a tertiary care hospital, thus filling the evidence gap in this area from resource-limited settings. Adherence to admission guidelines was excellent. Laboratory testing, access to essential drugs and data management needs to be improved.
Databáze:	MEDLINE
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