Page 18 - Delaware Medical Journal - July/August 2020

COVID-19 in a Community Hospital: The First 100 Patients
Mark J. Boytim, MD; William Chasanov, DO, MBA; Ngozi Azuogu, MSN, RN; Rebecca Marcinak, PharmD; Diane Taylor; Haley Winward
Since the initial presentation of novel coronavirus (2019-nCoV) or COVID-19 pneumonia occurred in Wuhan, China this winter, the disease has spread rapidly throughout the world.1,2 The United States and the State of Delaware have not been excluded from the pandemic.3 This analysis serves to report on the first 100 cases of COVID-19 patients that were admitted to Beebe Healthcare since the first case on March 20, 2020. Patients who were male, elderly, institutionalized, and those with co-morbidities fared worse in comparison to other patients.
PURPOSE
This report, produced by the Population Health Team at Beebe Healthcare, serves to explain to the Delaware medical community the demographics and patient journey
of the first 100 patients seen in our community hospital. It also helps Population Health personnel determine the direction additional data modeling and studies should take to support future management of patients with COVID-19.
BACKGROUND
COVID-19, previously known as the 2019 novel coronavirus (2019-
nCoV), is now known as Severe Acute Respiratory Syndrome Coronavirus
2 (SARS-COV2). SARS-COV2 is a single-stranded betacoronavirus in the family Coronaviridae. This virus is spread primarily via droplets, which is similar to many other respiratory viruses, including influenza.4,5,6,7
Patients with COVID-19 can be asymptomatic but can also have varied symptoms that can cause critical illness and even lead to death. Symptoms include fever, cough, shortness of breath, fatigue, muscle aches, anosmia, ageusia, sore throat, congestion, nausea, vomiting, and/or diarrhea. The incubation period from viral exposure to the development of symptoms is approximately two to 14 days, with the
average time for those who become symptomatic occurring between days four to six.4
Initial studies reported that more severe disease may occur in those
with risk factors — including hypertension, chronic heart disease, chronic lung disease, chronic kidney disease, diabetes mellitus — and those immunocompromised due to cancer or autoimmune diseases.1,2 Further studies suggested that SARS-COV2 may cause a “cytokine storm,” wherein large concentrations of pro-inflammatory mediators, including IL-6, are released, causing the progression to severe disease and potentially death.8,9,10,11
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Abstract