Dedicated team to ambulatory care for patients with COVID-19 requiring oxygen: Low rate of hospital readmission.

OBJECTIVES: We aimed to determine the impact of a dedicated medical team (DMT) on ambulatory care for patients requiring oxygen. METHODS: The DMT selected patients requiring oxygen for less than 5 l/min in the emergency department (ED). The rate of ED readmission was compared in patients managed by the DMT and those managed by the ED physicians (EDPs). Consensual treatment for COVID-19 pneumonia with oxygen requirement was steroids + preventive anticoagulation. RESULTS: A total of 1397 patients with COVID-19 came to our ED from the first to the 31st of August, 2021, among whom 580 (41%) had ambulatory care. A total of 82 (14.1%) patients were managed by the DMT, with a rate of ED readmission of 4.8% (4/82), compared with 13.6% (68/498) for those managed by EDPs (P <0.001). Focusing on the 45/498 (9.0%) patients requiring oxygen and managed by EDPs, the rate of ED readmission was 20%, P = 0.017. Prescription of the consensual treatment concerned 96% versus 40% for those patients requiring oxygen for the DMT and the EDP, respectively (P <0.001). CONCLUSION: A DMT for ambulatory care of patients with COVID-19 requiring oxygen was associated with less return to the ED than usual practices.

Real-world effectiveness of casirivimab plus indevimab in a dedicated ambulatory unit created for patients with early COVID-19 during a massive delta variant wave.

Only limited real-life data are available on the effects of neutralizing monoclonal antibodies in high-risk patients who have early COVID-19 and do not require supplemental oxygen. We prospectively studied 217 patients infected by the delta variant who received casirivimab plus indevimab in a dedicated ambulatory unit created during our 4th COVID wave. Mean age was 64 years, 94% had at least one comorbidity, and mean duration of symptoms was 2.9 days. Oxygen requirement, hospitalization, and mortality rates were 10, 6, and 2.8%, respectively. These results suggest benefits of early administration of neutralizing antibodies in high-risk patients infected with the delta variant.

Impact of an SMS reminder service on outpatient clinic attendance rates by patients with HIV followed-up at Pointe-à-Pitre University Hospital.

OBJECTIVE: By the end of 2014, 23% of people living with HIV (PWHIV) who had had a scheduled appointment at our outpatient clinic had not attended. We implemented an SMS reminder service and assessed its impact on medical consultation-attendance rate. METHODS: The intervention was directed at all PWHIV with a scheduled appointment between March and April 2015 at our infectious diseases department. Two days before the scheduled visit, an appointment reminder SMS was sent to every other patient at random. On the visit day, a questionnaire was used to determine patient perceptions regarding the SMS. RESULTS: A total of 224 patients (126 males, 98 females, mean age 52 years, 94% taking anti-retroviral therapy) were selected to take part in the study. The medical consultation-attendance rate was 76% in the SMS reminder read group (87 patients) and 72% in the SMS reminder not sent or not read group (137 patients, P=0.6). Among the 66 SMS reminder read patients who attended their consultation and answered the questionnaire, 51% reported that the SMS had contributed to their attendance. CONCLUSION: Sending an SMS reminder had no significant impact on clinic attendance rates. This may have been due in part to the sociocultural characteristics of our patients. Further research should investigate other tools to improve attendance rates.