[Roles of multidisciplinary team in diagnosis and treatment of suspected cases of COVID-19]

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):209-214. doi: 10.3785/j.issn.1008-9292.2020.03.15.
[Article in Chinese]

Abstract

Objective: To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of coronavirus disease 2019 (COVID-19).

Methods: The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Municipal Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed.

Results: In the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged. There was no cross-infection occurred in suspected patients during the hospitalization. There were no deaths and no medical staff infections.

Conclusions: The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved with MDT, particularly for complicated cases.

目的: 分析多学科协作诊疗(MDT)在2019冠状病毒病(COVID-19)疑似病例诊治中的参与情况及处置结果,总结MDT在COVID-19诊治中的作用。

方法: 回顾性分析2020年1月21日至3月20日就诊于金华市中心医院的48例COVID-19疑似患者的临床资料及诊治经过,进一步分析MDT在患者处置流程和诊断中的作用。

结果: 18例确诊COVID-19,30例排除COVID-19。确诊患者经MDT讨论2~12次,平均每例患者讨论(4.7±3.2)次;非COVID-19患者多学科讨论2~4次,平均每例患者讨论(2.3±0.6)次。MDT对COVID-19疑似患者诊疗流程及诊断标准进行了讨论及调整。在MDT主导下,1例危重型患者积极治疗后转省级定点医院治疗,1例COVID-19合并急性胆囊炎患者行胆囊穿刺置管引流术手术,1例高度疑似患者行肺泡灌洗液检查排除COVID-19。除1例COVID-19危重型患者转省级医院治疗外,17例COVID-19患者均治愈出院,未发现院内及疑似患者交叉感染,无死亡病例,无医务人员感染发生,非COVID-19患者及时转到相应专科治疗。

结论: 在COVID-19疑似患者诊治过程中,MDT的参与提高了诊治效率,尤其对疑难复杂病例诊治有重要作用。

MeSH terms

  • Betacoronavirus* / isolation & purification
  • COVID-19
  • China
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / therapy
  • Humans
  • Interdisciplinary Communication*
  • Pandemics*
  • Patient Care Team* / standards
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / therapy
  • Retrospective Studies
  • SARS-CoV-2
  • Treatment Outcome