Outcomes of non-hospitalized isolation service during COVID-19 pandemic
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Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or COVID-19 affected more than 500 million patients worldwide and overwhelmed hospital resources. Rapid increase of new cases forced patient isolation to be conduct outside the hospital where many strategies have been implemented. This study aimed to compare outcomes among non-hospitalized isolation service.
Methods
A retrospective cohort study was conducted in asymptomatic and mildly symptomatic adult patients who were allocated to home isolation, community isolation, and hospitel (i.e., hotel isolation) under service of Ramathibodi Hospital and Chakri Naruebodindra Medical Institute. Variables including patients’ characteristics, comorbidities, symptoms, and medication were retrieved for use in inverse-probability-weighted regression adjustment model. Risks and risk differences (RDs) of death, oxygen requirement, and hospitalization were estimated from the model afterward.
Results
A total of 3869 patients were included in the analysis. Mean age was 41.8 ± 16.5 years. Cough was presented in 62.2% of patients, followed by hyposmia (43.7%), runny nose (43.5%), sore throat (42.2%), and fever (38.6%). Among the isolation strategies, hospitel yielded the lowest risks of death (0.3%), oxygen requirement (4.5%), and hospitalization (3.3%). Hospitel had significantly lower oxygen requirements and hospitalization rates compared with home isolation with the RDs (95% CI) of -0.016 (−0.029, -0.002) and -0.025 (−0.038, -0.012), respectively. Death rates did not differ among isolation strategies.
Conclusion
Non-hospitalized isolation is feasible and could ameliorate hospital demands. Given the lowest risks of death, hospitalization, and oxygen requirement, hospitel might be the best isolation strategy.
