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. 2021 May:79:100828.
doi: 10.1016/j.resmer.2021.100828. Epub 2021 May 7.

Daily multidisciplinary COVID-19 meeting: Experiences from a French university hospital

C Rolland-Debord  1 , A Canellas  2 , P Choinier  2 , A Milon  3 , I Debrix  4 , E Blin  2 , N Belaube  5 , S Mattioni  6 , F Millet  2 , M Nadal  5 , C Petit-Hoang  7 , P Rigaud  2 , J S Rech  6 , M Siguier  5 , D Sroussi  2 , M Denis  5 , C Amiel  8 , M Fartoukh  9 , S Georgin-Lavialle  6 , L Lassel  5 , A Parrot  2 , J Cadranel  10
Affiliations

Daily multidisciplinary COVID-19 meeting: Experiences from a French university hospital

C Rolland-Debord et al. Respir Med Res. 2021 May.

Abstract

Objectives: In March 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) a pandemic. In absence of official recommendations, implementing daily multidisciplinary team (MDT) COVID-19 meetings was urgently needed. Our aim was to describe our initial institutional standard operating procedures for implementing these meetings, and their impact on daily practice.

Methods: All consecutive patients who were hospitalized in our institution due to COVID 19, from March 31 to April 15, 2020, were included. Criteria to be presented at MDT meetings were defined as a proven COVID-19 by PCR or strongly suspected on CT scan, requiring hospitalization and treatment not included in the standard of care. Three investigators identified the patients who met the predefined criteria and compared the treatment and outcomes of patients with predefined criteria that were presented during MDT meeting with those not presented during MDT meeting. COVID-19 MDT meeting implementation and adhesion were also assessed by a hospital medical staff survey.

Results: In all, 318 patients with confirmed or suspected COVID-19 were examined in our hospital. Of these, 230 (87%) were hospitalized in a COVID-19 unit, 91 (40%) of whom met predefined MDT meeting criteria. Fifty (55%) patients were presented at a MDT meeting versus 41 (45%) were not. Complementary exploration and inclusion in the CorImmuno cohort were higher in MDT meeting group (respectively 35 vs. 15%, P=0.03 and 80 versus 49%, P=0.0007). Prescription of hydrocortisone hemisuccinate was higher in group of patients not presented during MDT meeting (24 vs. 51%, P=0.007). Almost half of the patients fulfilling the inclusion criteria were not presented at MDT meeting, which can be partly explained by technical software issues.

Conclusions: Multidisciplinary COVID-19 meetings helped implementing a single standard of care, avoided using treatments that were untested or currently being tested, and facilitated the inclusion of patients in prospective cohorts and therapeutic trials.

Keywords: COVID-19; Multidisciplinary meetings; Prospective cohorts; Standard of care; Therapeutic trials.

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Figures

Fig. 1
Fig. 1
Local standardised recommendations of the COVID-19 multidisciplinary meeting. COVID-19: coronavirus disease 19; MDT: multidisciplinary team; SaO2: arterial oxygen saturation; BMI: body mass index.
Fig. 2
Fig. 2
Flow chart of COVID-19 patients between March 31 and April 15, 2020. MDT+: Patients fulfilling the MDT meeting criteria that were presented in MDT meeting. MDT-: Patients fulfilling the MDT meeting criteria that were not presented in MDT meeting. COVID-19+: Positive SARS-CoV-2 PCR and/or compatible thoracic CT-scan; COVID-19: coronavirus disease 19; MDT: multidisciplinary team; ICU: intensive care unit.
See this image and copyright information in PMC

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