Hospital at Home treatment with Remdesivir for patients with COVID-19: Real life experience.

Background : Access and appropriateness of therapeutics for COVID-19 vary due to access or regulatory barriers, severity of disease, and for some therapies, stage of the pandemic and circulating variants. Remdesivir has shown benefits in clinical recovery and is the treatment of choice for selected patients, both hospitalized and non-hospitalized, in main international guidelines. The use of Remdesivir in alternatives to conventional hospitalization such as Hospital at Home units remain incompletely explored. In this work, we aim to describe the real-life experience of outpatient remdesivir infusion for COVID-19 in a Hospital at Home unit. Methods : We selected all the consecutive patients receiving remdesivir from a prospective cohort of 507 COVID-19 patients admitted at a Hospital at Home unit. Admission criteria included COVID-19 with FiO2 requirement under 0.35 and respiratory rate under 22 rpm. Patients were daily assessed in-person by a nurse and a physician. Results : Two-hundred thirty-six patients admitted in HaH received remdesivir, from whom 172 were treated at home. Only 2% presented any adverse event related to the infusion, all of them mild. HaH saved 1416 day-beds, with only 5% of the patients requiring transfer back to hospital. Conclusions : Remdesivir infusion in Hospital at Home units seems to be a safe and efficient alternative to conventional hospitalization for treating non-severe COVID-19 patients

Medicalized Hotel as an Alternative to Hospital Care for Management of Noncritical COVID-19

Background: Since the first wave of COVID-19, alternatives to conventional hospitalization have been proposed for the provision of different levels of care, ranging from shelter during quarantine to hospital-level medical care. Objective: To describe the adaptation of a hotel by a hospital-at-home team to provide hospital-level care to patients with COVID-19 during the first wave of the pandemic in Barcelona, Spain. Methods: Hospital Clínic de Barcelona (HCB) is a 750-bed, public, tertiary teaching hospital serving 560 000 persons in the metropolitan area of Barcelona, Spain. In March 2020, the hospital-at-home unit was instructed to medicalize a hotel ('health hotel' [HH]) in downtown Barcelona. The aim of this initiative was to help decongest hospitals in the area by admitting patients with low dependency (Barthel Index score >60) and mild to severe COVID-19 from emergency departments or COVID-19 hospital wards, according to Centers for Disease Control and Prevention clinical guideline

A Prospective Cohort of SARS-CoV-2-Infected Health Care Workers: Clinical Characteristics, Outcomes, and Follow-up Strategy

Background. During the coronavirus disease 2019 (COVID-19) outbreaks, health care workers (HCWs) are at a high risk of infection. Strategies to reduce in-hospital transmission between HCWs and to safely manage infected HCWs are lacking. Our aim was to describe an active strategy for the management of COVID-19 in severe acute respiratory syndrome coronavirus 2 (SARSCoV-2)-infected HCWs and investigate its outcomes. Methods. A prospective cohort study of SARS-CoV-2-infected health care workers in a tertiary teaching hospital in Barcelona, Spain, was performed. An active strategy of weekly polymerase chain reaction screening of HCWs for SARS-CoV-2 was established by the Occupational Health department. Every positive HCW was admitted to the Hospital at Home Unit with daily assessment online and in-person discretionary visits. Clinical and epidemiological data were recorded. Results. Of the 590 HCWs included in the cohort, 134 (22%) were asymptomatic at diagnosis, and 15% (89 patients) remained asymptomatic during follow-up. A third of positive cases were detected during routine screening. The most frequent symptoms were cough (68%), hyposmia/anosmia (49%), and fever (41%). Ten percent of the patients required specific treatment at home, while only 4% of the patients developed pneumonia. Seventeen patients required a visit to the outpatient clinic for further evaluation, and 6 of these (1%) required hospital admission. None of the HCWs included in this cohort required intensive care unit admission or died. Conclusions. Active screening for SARS-CoV-2 among HCWs for early diagnosis and stopping in-hospital transmission chains proved efficacious in our institution, particularly due to the high percentage of asymptomatic HCWs. Follow-up of HCWs in Hospital at Home units is safe and effective, with low rates of severe infection and readmission. Keywords. coronavirus; COVID-19; health care workers; Hospital at Home; SARS-CoV-2

Hospital at home treatment with remdesivir for patients with COVID-19: real-life experience

Objectives: Access and appropriateness of therapeutics for COVID-19 vary because of access or regulatory barriers, the severity of the disease, and for some therapies, the stage of the pandemic and circulating variants. Remdesivir has shown benefits in clinical recovery and is the treatment of choice for selected patients, both hospitalized and nonhospitalized, in main international guidelines. The use of remdesivir in alternatives to conventional hospitalization such as hospital at home (HaH) units remains incompletely explored. In this study, we aim to describe the real-life experience of outpatient remdesivir infusion for COVID-19 in a HaH unit. Methods: We selected all the consecutive patients receiving remdesivir from a prospective cohort of 507 COVID-19 patients admitted at a HaH unit. Admission criteria included COVID-19 with a fraction of inspired oxygen requirement under 0.35 and respiratory rate under 22 rpm. Patients were daily assessed in person by a nurse and a physician. Results: A total of 236 patients admitted at the HaH unit received remdesivir, 172 of whom were treated at home. Only 2% presented any adverse event related to the infusion, all of them mild. HaH saved 1416 day-beds, with only 5% of the patients requiring transfer back to the hospital. Conclusion: Remdesivir infusion in HaH units seems to be a safe and efficient alternative to conventional hospitalization for treating patients with nonsevere COVID-19

Métodos de innovación docente aplicados a los estudios de Ciencias de la Comunicación

Se analiza el fenómeno de la implantación del Espacio Europeo de Educación Superior (EEES) a los estudios de Ciencias de la Comunicación, desde el punto de vista del profesorado. En este sentido se analizan experiencias educativas como: cuadernos de visionado para la iniciación de los alumnos en el comentario fílmico; la utilización didáctica de recursos audiovisuales; el uso de películas como herramientas en la educación de estudiantes; el uso de la televisión informativa; y la aplicación de técnicas de aprendizaje colaborativo entre otras propuestas. Asimismo, se estudia el estado de implantación del EEES en España y se describen propuestas de aplicación del mismo a diferentes áreas de los estudios de Ciencias de la Comunicación. También se dedican estudios a la descripción de nuevas estrategias docentes en el marco del EEES y se proponen fórmulas de evaluación de los aprendizajes. Por último se presta atención a la aplicación de las Tecnologías de la Información y la Comunicación a los citados estudios y se definen nuevas herramientas para apoyar a los estudiantes en su labor.MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]