Delayed treatment of bacteremia during the COVID-19 pandemic
Delayed treatment of bacteremia during the COVID-19 pandemic
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DOI：
10.1515/dx-2020-0114
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发表时间：
2021-08-01
期刊：
影响因子：
3.5
通讯作者：
Naito, Toshio
中科院分区：
文献类型：
--
作者：
Miyagami, Taiju;Uehara, Yuki;Naito, Toshio
目的：冠状病毒病（COVID-19）失明，即在诊断中过度考虑疾病，据报道已导致某些疾病的诊断延迟。我们比较了在COVID-19大流行的两个月内因菌血症入院的患者与2019年同期入院的患者之间的几项临床指标。我们假设大流行导致了菌血症治疗的延迟。方法：这项回顾性观察性研究比较了针对2020年3月1日至5月31日期间在两家医院急诊室就诊且血培养结果呈阳性的患者采取的几项措施。菌血症与2019年同期治疗的相应患者。主要措施是从咨询到血培养/抗菌药物的时间。结果：我们纳入了2020年的29名合格患者和2019年的26名患者。2020年，从咨询到抗菌药物给药的时间明显长于2019年（平均值[范围]，222 [145-309]分钟vs. 139 [102-179]分钟，p=0.002）。2020年，胸部计算机断层扫描（CT）的频率显著较高（96.6% vs. 73.1%，p=0.021）。两个时期的血培养时间或血培养前胸部CT检查时间无显著差异。结论：我们的研究结果表明，由于COVID-19流行/大流行，专注于使用CT扫描排除其感染导致菌血症的诊断和治疗总体延迟。医疗服务提供者必须意识到COVID-19失明，并根据合理的标准客观地评估患者并采取适当的行动。
Objectives: Coronavirus disease (COVID-19) blindness, that is, the excessive consideration of the disease in diagnosis, has reportedly led to delayed diagnosis of some diseases. We compared several clinical measures between patients admitted for bacteremia during the two months of the COVID-19 pandemic and those admitted during the same period in 2019. We hypothesized that the pandemic has led to delayed treatment of bacteremia.Methods: This retrospective observational study compared several measures undertaken for patients who visited the emergency unit in two hospitals between March 1 and May 31, 2020, during the COVID-19 pandemic and whose blood cultures tested positive for bacteremia with those for corresponding patients treated during the same period in 2019. The primary measure was time from consultation to blood culture/antimicrobials.Results: We included 29 eligible patients from 2020 and 26 from 2019. In 2020, the time from consultation to antimicrobial administration was significantly longer than in 2019 (mean [range], 222 [145-309] min vs. 139 [102-179] min, p=0.002). The frequency of chest computed tomography (CT) was significantly higher in 2020 (96.6 vs. 73.1%, p=0.021). Significant differences were not observed in the time to blood culture or chest CT preceding the blood culture between the two periods.Conclusions: Our findings suggested that due to the COVID-19 epidemic/pandemic, focusing on the exclusion of its infection using CT scans leads to an overall delay in the diagnosis and treatment of bacteremia. Medical providers must be aware of COVID-19 blindness and evaluate patients objectively based on rational criteria and take appropriate action.