Dataset Information

Therapeutic effects of multidisciplinary individualized treatment for COVID-19 patients: the experience of a supporting medical team in Wuhan.

ABSTRACT:

Background

The sudden outbreak of coronavirus disease 2019 (COVID-19) has brought people around the world into an abyss of suffering. At that time, there were no clear and effective means for the treatment of the virus. We prepared a medical team consisted of specialists in critical care, respiratory diseases, infections, gastroenterology, endocrinology, cardiology, cerebrovascular diseases, nephrology, rehabilitation, psychology, and nutrition. This study shared our multidisciplinary treatment experience in treating patients with COVID-19.

Methods

Patients with positive SARS-CoV-2 swab test were divided into three groups: ordinary cases, severe cases and critical cases. Every patient received the multi-disciplinary comprehensive and individualized tailored treatment based on the specific situation of each patient. Patients' medical records, epidemiological, clinical, laboratory, radiological characteristics, Borg dyspnea score, Barthel index, self-rating anxiety scale (SAS) as well as treatment and outcome data were analyzed.

Results

The mean age of the 90 patients was 61.88±15.25 years. Some patients without underlying disease had developed comorbidities such as hyperglycemia (24, 26.67%) and hypertension (9, 10%). With multidisciplinary individualized treatment, the patients' albumin level and Barthel index score increased significantly, while glucose level, blood pressure, and Nutrition Risk Screening 2002 (NRS-2002), Borg scale, and SAS values significantly decreased at discharge. The in-hospital mortality rate was 4.44%. However, there was still a gap in Nutrition Risk Screening, Borg dyspnea score and Barthel index between the critical cases and the ordinary and severe cases at discharge. We observed that the patients with more severe disease had significantly higher age, rates of hypertension, and mortality. The median hospitalization time of discharged patients was 19 days [interquartile range (IQR), 9.0-20.0 days].

Conclusions

Multidisciplinary collaboration and individualized treatment could effectively improve the general status of patients with different severity of COVID-19.

SUBMITTER: Liu J

PROVIDER: S-EPMC10797397 | biostudies-literature | 2023 Dec

REPOSITORIES: biostudies-literature

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Publications

Therapeutic effects of multidisciplinary individualized treatment for COVID-19 patients: the experience of a supporting medical team in Wuhan.

Liu Jianrong J Yuan Xiaofeng X Yang Qing Q Bi Xiaogang X Li Xinhua X Bian Huawei H Sun Ke K Zhang Xianling X Yang Yang Y

Journal of thoracic disease 20231226 12

<h4>Background</h4>The sudden outbreak of coronavirus disease 2019 (COVID-19) has brought people around the world into an abyss of suffering. At that time, there were no clear and effective means for the treatment of the virus. We prepared a medical team consisted of specialists in critical care, respiratory diseases, infections, gastroenterology, endocrinology, cardiology, cerebrovascular diseases, nephrology, rehabilitation, psychology, and nutrition. This study shared our multidisciplinary tr ...[more]

PMID: 38249885

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Project description:BackgroundLike with all cancers, multidisciplinary team (MDT) meetings are the norm in bone and soft tissue tumour (BST) management too. Problem in attendance of specialists due to geographical location is the one of the key barriers to effective functioning of MDTs. To overcome this problem, virtual MDTs involving videoconferencing or telemedicine have been proposed, but however this has been seldom used and tested. The COVID-19 pandemic forced the implementation of virtual MDTs in the Oxford sarcoma service in order to maintain normal service provision. We conducted a survey among the participants to evaluate its efficacy.MethodsAn online questionnaire comprising of 24 questions organised into 4 sections was circulated among all participants of the MDT after completion of 8 virtual MDTs. Opinions were sought comparing virtual MDTs to the conventional face-to-face MDTs on various aspects. A total of 36 responses were received and were evaluated.Results72.8% were satisfied with the depth of discussion in virtual MDTs and 83.3% felt that the decision-making in diagnosis had not changed following the switch from face-to-face MDTs. About 86% reported to have all essential patient data was available to make decisions and 88.9% were satisfied with the time for discussion of patient issues over virtual platform. Three-fourths of the participants were satisfied (36.1% - highly satisfied; 38.9% - moderately satisfied) with virtual MDTs and 55.6% of them were happy to attend MDTs only by the virtual platform in the future. Regarding future, 77.8% of the participants opined that virtual MDTs would be the future of cancer care and an overwhelming majority (91.7%) felt that the present exercise would serve as a precursor to global MDTs involving specialists from abroad in the future.ConclusionOur study shows that the forced switch to virtual MDTs in sarcoma care following the unprecedented COVID-19 pandemic to be a viable and effective alternative to conventional face-to-face MDTs. With effective and efficient software in place, virtual MDTs would also facilitate in forming extended MDTs in seeking opinions on complex cases from specialists abroad and can expand cancer care globally.

Project description:ObjectivesIn December 2019, a novel coronavirus disease (COVID-19) emerged in Wuhan city, China, which has subsequently led to a global pandemic. At the time of writing, COVID-19 in Wuhan appears to be in the final phase and under control. However, many other countries, especially the US, Italy and Spain, are still in the early phases and dealing with increasing cases every day. Therefore, this article aims to summarise and share the experience of controlling the spread of COVID-19 in Wuhan and provide effective suggestions to enable other countries to save lives.Study designData from the National Health Commission of China are used to investigate the evolution trajectory of COVID-19 in Wuhan and discuss the impacts of the intervention strategies.MethodsA four-stage modified Susceptible-Exposed-Infectious-Removed (SEIR) model is presented. This model considers many influencing factors, including chunyun (the Spring festival), sealing off the city and constructing the Fangcang shelter hospitals. In addition, a novel method is proposed to address the abnormal data on 12-13 February as a result of changing diagnostic criteria. Four different scenarios are considered to capture different intervention measures in practice. The exposed population in Wuhan who moved out before sealing off the city have also been identified, and an analysis on where they had gone was performed using the Baidu Migration Index.ResultsThe results demonstrate that the four-stage model was effective in forecasting the peak, size and duration of COVID-19. We found that the combined intervention measures are the only effective way to control the spread and not a single one of them can be omitted. We estimate that England will be another epicentre owing to its incorrect response at the initial stages of COVID-19. Fortunately, big data technology can help provide early warnings to new areas of the pandemic.ConclusionsThe four-stage SEIR model was effective in capturing the evolution trajectory of COVID-19. Based on the model analysis, several effective suggestions are proposed to prevent and control the pandemic for countries that are still in the initial phases.

Project description:BackgroundThe contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions.DesignObservations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed.ResultsIn the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available.LimitationsThe design of the study made it difficult to draw definite cause-and-effect conclusions.ConclusionThe Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients' attributes and the medical decisions made at these meetings show that these attributes should be taken into account in order to understand how medical decisions are reached in difficult situations of this kind.

Dataset Information

Therapeutic effects of multidisciplinary individualized treatment for COVID-19 patients: the experience of a supporting medical team in Wuhan.

Background

Methods

Results

Conclusions

Publications

Therapeutic effects of multidisciplinary individualized treatment for COVID-19 patients: the experience of a supporting medical team in Wuhan.

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