Original article

Home management of COVID-19 symptomatic patients: a safety study on COVID committed home medical teams
Venturini Sergio, Orso Daniele, Cugini Francesco, Martin Francesco, Boccato Cecilia, De Santi Laura, Pontoni Elisa, Tomasella Silvia, Nicotra Fabrizio, Grembiale Alessandro, Tonizzo Maurizio, Grazioli Silvia, Fossati Sara, Callegari Astrid, del Fabro Giovanni, Massimo
To reduce the overburden in the hospital, during the COVID-19 pandemic, some "COVID Committed Home Medical Teams" (CCHTs) were created in Italy. These units consist of a small pool of general practitioners who aim to evaluate all patients with COVID-19 who require a medical examination directly at home. After the first visit (which can end with patient hospitalisation or home management), CCHTs periodically monitor the patients' clinical conditions and vital signs (usually a revaluation every 24-48 hours, except for a sudden worsening). However, this strategy - which reduces the pressure on hospitals - has never been evaluated for patient safety. Our study aims to determine whether a home-based monitoring and treatment strategy for non-severe COVID-19 patients was safe as direct hospital admission by the emergency department. We conducted a retrospective observational study about 1,182 patients admitted to the hospital for COVID-19 between September 2020 and April 2021, confronting in-hospital and 30-day mortality in both CCHT-referred (n=275) and directly admitted by emergency department (n=907). Patients assessed by the CCHT had lower in-hospital and 30-day mortality (18% vs 28%, p = 0.001; and 20% vs 30%, p = 0.002); but, in the propensity score matching comparison, there was no characteristic between the two groups turned out significantly different. CCHT did not correlate with in-hospital or 30-day mortality. CCHT is a safe strategy to reduce hospital overburden for COVID-19 during pandemic surges.

Page 412-417 - Vol.30 N. 3 - 2022