Journal of Community Hospital Internal Medicine Perspectives (Mar 2020)

Coronavirus disease (COVID-19): observations and lessons from primary medical care at a German community hospital

  • Martin Schiller,
  • Juergen Fisahn,
  • Ute Huebner,
  • Patrick Hofmann,
  • Joerg Walther,
  • Susann Riess,
  • Christiane Grimm,
  • Hansjörg Schwab,
  • Wolfgang Kick

DOI
https://doi.org/10.1080/20009666.2020.1763079
Journal volume & issue
Vol. 10, no. 2
pp. 81 – 87

Abstract

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The pandemic outbreak of COVID-19 challenges medical care systems all around the world. We here describe our experiences during the treatment of COVID-19 patients (n = 42) treated from 2 March 2020 to 16 April 2020 at a German district hospital. Forty-two COVID-19 patients were hospitalized and five patients developed a severe disease, requiring intensive care. Overall, 11 out of 42 hospitalized patients died. COVID-19 caused lymphocytopenia, as well as increased d-dimer, c-reactive protein and creatine kinase, and lactate dehydrogenase levels. These changes were mostly pronounced in patients that developed a severe disease course. Radiologic findings included ground-glass opacity, bilateral/multilobular involvement, consolidation, and posterior involvement. We compared COVID-19 patients to an average population of ‘non-COVID’ patients. Interestingly, no laboratory or radiologic finding was specific for COVID-19 when standing alone, as comorbidities of ‘non-COVID’ patients certainly can mimic similar results. In common praxis, the diagnosis of COVID-19 is based on a positive PCR result. However, a false-negative result causes problems for the workflow of an entire hospital. In our clinic, the consequences of a false assumption of SARS-CoV-2 negativity in four cases had dramatic consequences, as contact persons had to be quarantined. To avoid this, a comprehensive view of lab-results, radiology, clinical symptoms and comorbidities is necessary for the correct diagnosis or exclusion of COVID-19.

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