TY - JOUR
T1 - Audit of Clinical Care Received by COVID-19 Patients Treated at a Tertiary Care Hospital of Nepal in 2021
AU - Mandal, Shrawan Kumar
AU - Neupane, Jenish
AU - Kumar, Ajay M.V.
AU - Davtyan, Hayk
AU - Thekkur, Pruthu
AU - Jayaram, Anup
AU - Chalise, Bimal Sharma
AU - Rawal, Manisha
AU - Paudel, Manu
AU - Baral, Bishwodip
AU - Shah, Rajesh Kumar
AU - Maharjan, Kijan
AU - Shrestha, Sanjay
AU - Bhandari, Lilanath
AU - Nisha, K. C.
AU - Gautam, Nabaraj
AU - Sunny, Avinash K.
AU - Thakur, Nishant
AU - Subeedee, Koshal Chandra
AU - Mandal, Sushil Kumar
AU - Bastola, Anup
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/11
Y1 - 2022/11
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85146138070
UR - https://www.scopus.com/inward/citedby.url?scp=85146138070&partnerID=8YFLogxK
U2 - 10.3390/tropicalmed7110381
DO - 10.3390/tropicalmed7110381
M3 - Article
AN - SCOPUS:85146138070
SN - 2414-6366
VL - 7
JO - Tropical Medicine and Infectious Disease
JF - Tropical Medicine and Infectious Disease
IS - 11
M1 - 381
ER -
