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. 2020 Dec;74(12):e13630.
doi: 10.1111/ijcp.13630. Epub 2020 Aug 11.

Internal medicine patients admitted without COVID-19 during the outbreak

Joseph Mendlovic  1 , Gali Weiss  1 , Nael Da'as  2 , Amos Yinnon  2   3 , David E Katz  2   3
Affiliations

Internal medicine patients admitted without COVID-19 during the outbreak

Joseph Mendlovic et al. Int J Clin Pract. 2020 Dec.

Abstract

Background: The first case of COVID-19 in Israel was reported on February 21, 2020. Shaare Zedek (SZ), a 1000-bed tertiary care medical centre in Jerusalem, Israel, cared for a significant number of these patients. While attention focused on COVID-19 patients, uninfected patients were admitted to decreasing numbers of available internal medicine (IM) beds as IM departments were converted to COVID-19 isolation wards. As a result of the increase in COVID-19 patients, closure of IM wards, re-assignment of staff and dynamic changes in available community placement options, we investigated the impact of the outbreak on IM patient not admitted for COVID-19.

Methods: We reviewed IM admissions during March 15-April 30, 2020 for patients without COVID-19. Characteristics assessed included number of admissions, age, length of stay, mortality rate, number of discharges, number discharged home and functional status of the patients. Data were compared with the previous 3 years (2017-2019) during the same time period.

Results: During March 15-April 30, 2020 there were 409 patients admitted to IM compared with a mean of 557 over the previous 3 years. Fewer patients were admitted to the ED and the IM wards during the outbreak. There was no significant difference between the two groups with regards to gender, in-hospital mortality rate, number discharged, number discharged home and patient functional level. Patients admitted during the outbreak to IM were younger (74.85 vs 76.86 years) and had a mean shorter hospital length of stay (5.12 vs 7.63 days) compared with the previous 3 years.

Conclusion: While the characteristics of patients admitted to IM during the outbreak were similar, hospital length of stay was significantly shorter. Internal management processes, as well as patient preferences may have contributed to this observation. An infectious disease outbreak may have a significant effect on uninfected admitted patients.

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Conflict of interest statement

We confirm that all authors of this paper have fulfilled the conditions of the IJCP regarding contribution to the concept, design and drafting of the manuscript. In addition, all authors have passed final approval on the manuscript that is currently being submitted. We declare that the manuscript has not been submitted or accepted for publication elsewhere, and we are not aware of any manuscripts that are related to the one we submit. No conflicts of interests were declared by any of the authors regarding the content of this report.

Figures

FIGURE 1
FIGURE 1
New cases of COVID‐19 by date of positive test in 2020. Black arrows indicate the closure of a single Internal Medicine department. Source for Israel and global data, https://www.worldometers.info/coronavirus/
FIGURE 2
FIGURE 2
Emergency room admissions to Shaare Zedek by Year, January—April
FIGURE 3
FIGURE 3
Distribution and number of IM patients during a peak day of the outbreak (A), and the same day a year prior (B). IM, internal medicine ward; Isolation, rapidly built COVID‐19 patient isolation ward; ICU, COVID‐19 intensive care unit; Satellite, satellite IM ward
See this image and copyright information in PMC

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