Isolation precautions cause minor delays in diagnostics and treatment of non-COVID patients.

BACKGROUND: Isolation precautions are essential prevent spread of COVID-19 infection but may have a negative impact on inpatient care. The impact of these measures on non-COVID-19 patients remains largely unexplored. AIM: This study aimed to investigate diagnostic and treatment delays related to isolation precautions, the associated patient outcome, and the predisposing risk factors for delays. METHODS: This observational study was conducted in seven Helsinki region hospitals during the first wave of the COVID-19 pandemic in Finland. The study used data on all non-COVID-19 inpatients, who were initially isolated due to suspected COVID-19, to estimate whether isolation precautions resulted in diagnostic or treatment delays. RESULTS: Out of 683 non-COVID-19 patients, 33 (4.8%) had delays related to isolation precautions. Clinical condition deteriorated non-fatally in seven (1.0%) patients. The following events were associated with an increased risk of treatment or a diagnostic delay: more than three ward transfers (P = 0.025); referral to an incorrect speciality in the emergency department (P = 0.004); more than three SARS-CoV-2 RT-PCR tests performed (P = 0.022); and where cancer was the final diagnosis (P = 0.018). In contrast, lower respiratory tract symptoms (P = 0.013) decreased the risk. CONCLUSIONS: The use of isolation precautions for patients who did not have COVID-19 had minor negative effects on patient outcomes. The present study underlines the importance of targeting diagnostic efforts to patients with unspecified symptoms and to those with a negative SARS-CoV-2 test result. Thorough investigations to achieve an accurate diagnosis improves the prognosis of patients and facilitates appropriate targeting of hospital resources.

Auditory cortex activation associated with octave illusion.

Most right-handers perceive an octave illusion when they are presented with a 400 Hz tone to one ear and with a 800 Hz tone to the other ear simultaneously, and when the tones continuously reverse between the ears: instead of the correct sound sequence, the subjects typically report a high tone in the right ear alternating with a low tone in the left. To study the neural basis of the illusion, we recorded neuromagnetic responses to binaural 400 and 800 Hz tones in different combinations. In the auditory cortex of each hemisphere, the 100 ms response (N100m) was stronger to pairs where the 800 Hz tone was presented to the contralateral ear and the 400 Hz tone to the ipsilateral ear than vice versa. The sustained fields tended to behave in an opposite manner. We suggest that the perceived locations of the sounds in the octave illusion follow the N100m lateralization, and the percept is contributed by streaming by the ear.