Gestión integral de COVID 19 en un hospital regional en el noroeste de España./ COVID 19 comprehensive management in a regional hospital of Northwestern Spain.

espanolIntroduccion: La pandemia de COVID-19 provoco un cambio de paradigma en la atencion medica. Objetivo: Evaluar una estrategia para abordar integralmente la pandemia en un distrito de salud que comprende 42 000 personas. Metodo: Entre el 10 de marzo y 15 de mayo de 2020 se creo la Unidad COVID en un hospital regional correspondiente al distrito y se establecio un circuito independiente para el diagnostico y manejo de pacientes con sospecha o confirmacion de COVID-19; los centros de salud social fueron monitoreados mediante PCR. Resultados: Ingresaron 18 pacientes positivos a COVID-19 (edad de 72.9 ± 13.2 anos), 66 % eran hombres; todos presentaron neumonia, 67 % desarrollo sindrome de dificultad respiratoria y ninguno requirio ventilacion mecanica. La estancia hospitalaria fue de 9.4 ± 5.3 dias y la mortalidad, de 11 %. Se realizaron pruebas de PCR a todos los residentes (n = 827) y trabajadores (n = 519) del hospital, se realizaron 1044 llamadas telefonicas y se evitaron 36 hospitalizaciones. Solo 50 pacientes necesitaron seguimiento cercano, cuatro (0.48 %) positivos a COVID-19. Conclusion: El monitoreo clinico en el hospital y centros de salud social mostro que el perfil de los pacientes fue similar al documentado en la literatura y que la incidencia de COVID-19 fue baja en los centros sociales de salud. EnglishIntroduction: The COVID-19 pandemic has brought about a paradigm shift in healthcare. Objective: To evaluate the utility of a strategy to comprehensively address the pandemic in a health area that covers 42,000 people. Method: Between March 10 and May 15, 2020, the COVID Unit was created in the corresponding regional hospital, and an independent circuit was established for the diagnosis and management of patients with suspected or confirmed COVID-19; social health centers were monitored with PCR testing. Results: Eighteen COVID-19-positive patients (age 72.9 ± 13.2 years) were admitted, out of which 66% were males. All these patients had pneumonia and 67% had respiratory distress syndrome; no one required mechanical ventilation. Mean hospital stay was 9.4 ± 5.3 days, and mortality, 11%. PCR tests were applied to all hospital residents (n = 827) and workers (n = 519), 1,044 phone calls were made and 36 hospital admissions were avoided. Only 50 patients required close follow-up, out of which four (0.48%) were positive for COVID-19. Conclusion: Clinical monitoring at the hospital and social health centers showed that patient profile was like that documented in the literature and that the incidence of COVID-19 was low in social health centers.