Audit of Clinical Care Received by COVID-19 Patients Treated at a Tertiary Care Hospital of Nepal in 2021
Authors:
- Shrawan Kumar MandalShrawan Kumar Mandal
- Jenish NeupaneJenish Neupane
- Ajay M. V. KumarAjay M. V. Kumar
- Hayk DavtyanHayk Davtyan
- Pruthu ThekkurPruthu Thekkur
- Anup JayaramAnup Jayaram
- Bimal Sharma ChaliseBimal Sharma Chalise
- Manisha RawalManisha Rawal
- Manu PaudelManu Paudel
- Bishwodip BaralBishwodip Baral
- Rajesh Kumar ShahRajesh Kumar Shah
- Kijan MaharjanKijan Maharjan
Open Access
- 16 November 2022
- journal article
- research article
- Published by MDPI AG in Tropical Medicine and Infectious Disease
- Vol. 7 (11) , 381
Abstract
Like the world over, Nepal was also hard hit by the second wave of COVID-19. We audited the clinical care provided to COVID-19 patients admitted from April to June 2021 in a tertiary care hospital of Nepal. This was a cohort study using routinely collected hospital data. There were 620 patients, and most (458, 74%) had severe illness. The majority (600, 97%) of the patients were eligible for admission as per national guidelines. Laboratory tests helping to predict the outcome of COVID-19, such as D-dimer and C-reactive protein, were missing in about 25% of patients. Nearly all (>95%) patients with severe disease received corticosteroids, anticoagulants and oxygen. The use of remdesivir was low (22%). About 70% of the patients received antibiotics. Hospital exit outcomes of most (>95%) patients with mild and moderate illness were favorable (alive and discharged). Among patients with severe illness, about 25% died and 4% were critically ill, needing further referral. This is the first study from Nepal to audit and document COVID-19 clinical care provision in a tertiary care hospital, thus filling the evidence gap in this area from resource-limited settings. Adherence to admission guidelines was excellent. Laboratory testing, access to essential drugs and data management needs to be improved.Keywords
Funding Information
- WHO/SEARO
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