Home » News » Hospitalized “because of” or “with” COVID-19: should we make the distinction? | Coronavirus

Hospitalized “because of” or “with” COVID-19: should we make the distinction? | Coronavirus

According to Dr. Caroline Quach-Thanh, yes, this distinction is worth making. COVID-19","text":"On veut savoir qui est hospitalisé à cause du virus; sinon, on peut surévaluer la morbidité et la virulence du virus. On veut un meilleur portrait des complications liées à la COVID-19"}}">We want to know who is hospitalized because of the virus; otherwise, the morbidity and virulence of the virus may be overestimated. We want a better picture of the complications related to COVID-19, says the pediatrician, microbiologist-infectious disease specialist at the Sainte-Justine University Hospital Center (CHU).

Dr. Quach-Thanh adds that the high rate of people hospitalized with COVID-19 – therefore with a main diagnosis other than COVID-19 – is a sign that community transmission is still very high.

The Omicron variant, which is dominant at the moment, is 50% less virulent than the others, as Caroline Quach-Thanh reminds us. The doctor also points to a South African study which estimates that in previous waves, 1 to 2% of cases were asymptomatic; with Omicron, it is more of the order of 30%.

According to Dr. Gilbert Boucher, president of the Association of Quebec Emergency Medicine Specialists and emergency physician at the Montreal Heart Institute, this statistic is also partly good news: COVID-19 ont peu de symptômes","text":"ça montre que la double vaccination fonctionne. Les personnes [vaccinées] qui ont la COVID-19 ont peu de symptômes"}}">it shows that the double vaccination works. The people [vaccinées] who have COVID-19 have few symptoms. And the vast majority of those who are vaccinated and present to the emergency room with symptoms of COVID-19 are not admitted.

On the other hand, if Benoit Mâsse, professor of social and preventive medicine at the School of Public Health of the University of Montreal, knows full well that there is a proportion of people admitted to the hospital with COVID-19, he wonders why the figure mentioned, 50%, is so high. COVID-19 soit infectée [et asymptomatique]. C’est une proportion disproportionnée avec ce que l’on voit dans la population. Ça voudrait dire que le Québec presque en entier serait infecté…","text":"C'est surprenant qu’une personne sur deux qui est hospitalisée pour une autre raison que la COVID-19 soit infectée [et asymptomatique]. C’est une proportion disproportionnée avec ce que l’on voit dans la population. Ça voudrait dire que le Québec presque en entier serait infecté…"}}">It’s surprising that one in two people who are hospitalized for some other reason than COVID-19 are infected [et asymptomatique]. This is a disproportionate proportion with what we see in the population. That would mean that almost all of Quebec would be infected …, he said.

Same story for Dr. Alain Vadeboncœur, emergency physician at the Montreal Heart Institute. I wonder about the very nature of the data, how it is calculated, he says.

He specifies that it is sometimes difficult to decide whether or not the reason for the hospitalization is related to COVID-19. COVID-19 cause des complications dans plein de systèmes. Par exemple, une personne âgée tombe, se fracture une jambe et est hospitalisée; on apprend qu’elle a la COVID-19 à son admission. Mais est-ce qu’elle est tombée à cause d’un étourdissement causé par la COVID-19? On ne le sait pas. Les médecins font un jugement","text":"On sait que la COVID-19 cause des complications dans plein de systèmes. Par exemple, une personne âgée tombe, se fracture une jambe et est hospitalisée; on apprend qu’elle a la COVID-19 à son admission. Mais est-ce qu’elle est tombée à cause d’un étourdissement causé par la COVID-19? On ne le sait pas. Les médecins font un jugement"}}">We know that COVID-19 causes complications in many systems. For example, an elderly person falls, breaks a leg and is hospitalized; we learn that she has COVID-19 upon admission. But did she fall due to dizziness caused by COVID-19? We do not know. Doctors make a judgment.

Benoit Mâsse and Dr Alain Vadeboncœur add that more data is needed to fully understand the situation.

For example, people admitted with COVID-19 Later Develop Symptoms That Require Longer Hospitalization? When was the person tested? Could she have caught the virus in the hospital? If it is later discovered that a patient’s symptoms are indeed caused by COVID-19, is the person considered hospitalized? due of COVID-19?

It should be noted, moreover, that this phenomenon is not however new: during the last waves, there were also hospitalized patients. with COVID-19, as Benoît Mâsse reminds us.

More difficult moments future

So why talk about it now?

Maybe it’s to tell people it’s not that bad [la situation dans les hôpitaux] and that we can relax the measures. But we can’t do this again, underlines Dr. Vadeboncœur, who adds that hospitals will experience difficult times for a few more weeks.

During a recent press briefing, the Minister of Health, Christian Dubé, did not offer an explanation for the methodology and the reasons which push the government to present the data related to hospitalizations differently. He stressed, however, that if the government chooses to make this distinction, the presence of people hospitalized with COVID-19 remains a problem for the health system.

: it’s not2000 is 2000case minus 40%. But even if these people returned for another reason, these people, we have to treat them differently. We cannot give birth to a pregnant woman who has COVID next to a woman who does not have COVID. “,” Text “:” It would be easy for us to say: this is not pas2000 is 2000cas minus 40%. But even if these people returned for another reason, these people, we have to treat them differently. You cannot give birth to a pregnant woman who has COVID next to a woman who does not have COVID. “}}”>It would be easy for us to say: it’s not 2000, it’s 2000 cases minus 40%. But even if these people returned for another reason, these people, we have to treat them differently. You cannot give birth to a pregnant woman who has COVID next to a woman who does not have COVID.

Still a significant impact on the health system

Omicron being so contagious, the absolute number of patients hospitalized due to COVID-19 is still high, as Dr. Caroline Quach-Thanh recalls.

So, it doesn’t matter if people are hospitalized Due to Where with COVID-19, the very high number of people infected in hospitals, greatly complicates the situation, which is already critical. They are still occupied beds, points out Mr. Mâsse.

It still puts pressure on the hospital, staff, equipment, even if it is an asymptomatic case., adds Dr Vadeboncœur.

« You cannot allow an infected person to be placed next to another patient who is not infected. So what does it change, at the end of the day [qu’on parle de personnes infectées « avec » la COVID-19]? »

A quote from Dr Alain Vadeboncœur, emergency physician

In addition, the protocols for infected patients are much more complex to apply. We must protect the patients, the workers; you have to disinfect everything, wear protective equipment …, explains Dr Boucher.

Due to the lack of staff, everything takes longer, which can also have an impact on the length of stay.

Benoit Mâsse explains that these protocols are very important to avoid nosocomial infections, infections caught during a hospital stay.

Dr. Gilbert Boucher adds that many surgeries must be canceled when the patient is discovered to have COVID-19. These patients, even if they are asymptomatic, may experience a greater number of complications after surgery from the virus. Knowing this, Dr. Boucher indicates that several patients take enormous precautions. We see a lot of people who stay home for three weeks before their surgery because they are afraid of catching it, he said.

Dr. Boucher believes that the hospital model must adapt to cope with the many patients admitted “with” COVID-19. He says some hospitals have started to no longer systematically isolate people hospitalized “with” the virus in a dedicated COVID-19 unit: if you have symptoms, you are placed in a COVID unit, if not, it is better to be on the specialized units to have appropriate care.

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