Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients

The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became on...

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Bibliographic Details
Published in:PloS one 2021-05, Vol.16 (5), p.e0251295-e0251295
Main Authors: Garzon-Chavez, Daniel, Romero-Alvarez, Daniel, Bonifaz, Marco, Gaviria, Juan, Mero, Daniel, Gunsha, Narcisa, Perez, Asiris, Garcia, María, Espejo, Hugo, Espinosa, Franklin, Ligña, Edison, Espinel, Mauricio, Quentin, Emmanuelle, Teran, Enrique, Mora, Francisco, Reyes, Jorge
Format: Article
Language:English
Subjects:
Administration
Artificial intelligence
Biology and Life Sciences
Care and treatment
Chest
Computed tomography
Coronaviruses
COVID-19
Diagnosis
Disease transmission
Hospitals
Laboratories
Lesions
Medical imaging
Medical personnel
Medicine and Health Sciences
Nosocomial infections
Pandemics
Patients
People and places
Polymerase chain reaction
Public health
Research and Analysis Methods
Schedules
Severe acute respiratory syndrome coronavirus 2
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Summary:The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became one of the most affected in Latin America on 24 April 2020. The Hospital General del Sur de Quito (HGSQ) had to transition from a general to a specific COVID-19 health center in a short period of time to fulfill the health demand from patients with respiratory afflictions. Here, we summarized the implementations applied in the HGSQ to become a COVID-19 exclusive hospital, including the rearrangement of hospital rooms and a triage strategy based on a severity score calculated through an artificial intelligence (AI)-assisted chest computed tomography (CT). Moreover, we present clinical, epidemiological, and laboratory data from 75 laboratory tested COVID-19 patients, which represent the first outbreak of Quito city. The majority of patients were male with a median age of 50 years. We found differences in laboratory parameters between intensive care unit (ICU) and non-ICU cases considering C-reactive protein, lactate dehydrogenase, and lymphocytes. Sensitivity and specificity of the AI-assisted chest CT were 21.4% and 66.7%, respectively, when considering a score >70%; regardless, this system became a cornerstone of hospital triage due to the lack of RT-PCR testing and timely results. If health workers act as vectors of SARS-CoV-2 at their domiciles, they can seed outbreaks that might put 1,879,047 people at risk of infection within 15 km around the hospital. Despite our limited sample size, the information presented can be used as a local example that might aid future responses in low and middle-income countries facing respiratory transmitted epidemics.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0251295