Clinical Course and Outcomes among COVID-19 Patients at the Hospitel in Bangkok: A Retrospective Study
Jackrapong Bruminhent, Yosapan Kaewsanga, Werapoj Jiraaumpornpat, Vanlapa Arnuntasupakul, Thitiporn Suwatanapongched, Sasisopin Kiertiburanakul
Tropical Medicine and Infectious Disease, doi:10.3390/tropicalmed7090238
A hospitel is a hotel that has been designated as an extension of the healthcare facilities during the COVID-19 pandemic in resource-limited settings. However, the clinical course and outcomes of patients with COVID-19 admitted to this unique type of facility have never been studied. We retrospectively reviewed the medical records of adult patients with COVID-19 who were admitted to a single hospitel in Bangkok, Thailand. Risk factors with respect to chest X-ray progression and clinical progression were analyzed using a logistic regression. A total of 514 patients were recruited, with a mean (standard deviation) age of 35.6 (13.4) years, and 58.6% were women. Patients were admitted after a median (interquartile range) of 3 (2-6) days of illness and were classified with mild (12.3%), moderate (86.6%), and severe (1.1%) conditions. Favipiravir and corticosteroids were prescribed in 26.3% and 14.9% of patients, respectively. Chest X-ray progression was found in 7.6% of patients, and hospital transfer occurred in 2.9%, with no deaths. Favipiravir use (odds ratio (OR) 3.3, 95% confidence interval (CI) 1.4-7.5, p = 0.005), nausea/vomiting after admission (OR 32.3, 95% CI 1.5-700.8, p = 0.03), and higher oxygen saturation on admission (OR 1.99; 95% CI 1.22-3.23, p = 0.005) were factors associated with chest X-ray progression. Additionally, an oxygen requirement on admission was an independent risk factor for hospital transfer (OR 904, 95% CI 113-7242, p < 0.001). In a setting where the hospitel has been proposed as an extension facility for patients with relatively non-severe COVID-19, most patients could achieve a favorable clinical outcome. However, patients who require oxygen supplementation should be closely monitored for disease progression and promptly transferred to a hospital if necessary.
Supplementary Materials: The following supporting information can be downloaded at: https://www. mdpi.com/article/10.3390/tropicalmed7090238/s1, Table S1 : Rama Co-RADS: A tool used as an assessment scheme for chest X-ray findings to diagnose and monitor patients with COVID-19 pneumonia. Author Contributions: Conceptualization, J.B. and S.K.; methodology, J.B. and S.K.; validation, J.B., Y.K., W.J. and S.K.; formal analysis, S.K.; data curation, Y.K., W.J., V.A. and T.S.; writing-original draft preparation, J.B.; writing-review and editing, J.B. and S.K.; All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding.
Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board of the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (approval number: COA. MURA2021/402).
Informed Consent Statement: Not applicable. Data Availability Statement: All relevant data are presented within the manuscript.
Conflicts of Interest: The authors declare no conflict of interest.
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'abstract': '<jats:p>A hospitel is a hotel that has been designated as an extension of the healthcare '
'facilities during the COVID-19 pandemic in resource-limited settings. However, the clinical '
'course and outcomes of patients with COVID-19 admitted to this unique type of facility have '
'never been studied. We retrospectively reviewed the medical records of adult patients with '
'COVID-19 who were admitted to a single hospitel in Bangkok, Thailand. Risk factors with '
'respect to chest X-ray progression and clinical progression were analyzed using a logistic '
'regression. A total of 514 patients were recruited, with a mean (standard deviation) age of '
'35.6 (13.4) years, and 58.6% were women. Patients were admitted after a median (interquartile '
'range) of 3 (2–6) days of illness and were classified with mild (12.3%), moderate (86.6%), '
'and severe (1.1%) conditions. Favipiravir and corticosteroids were prescribed in 26.3% and '
'14.9% of patients, respectively. Chest X-ray progression was found in 7.6% of patients, and '
'hospital transfer occurred in 2.9%, with no deaths. Favipiravir use (odds ratio (OR) 3.3, 95% '
'confidence interval (CI) 1.4–7.5, p = 0.005), nausea/vomiting after admission (OR 32.3, 95% '
'CI 1.5–700.8, p = 0.03), and higher oxygen saturation on admission (OR 1.99; 95% CI '
'1.22–3.23, p = 0.005) were factors associated with chest X-ray progression. Additionally, an '
'oxygen requirement on admission was an independent risk factor for hospital transfer (OR 904, '
'95% CI 113–7242, p < 0.001). In a setting where the hospitel has been proposed as an '
'extension facility for patients with relatively non-severe COVID-19, most patients could '
'achieve a favorable clinical outcome. However, patients who require oxygen supplementation '
'should be closely monitored for disease progression and promptly transferred to a hospital if '
'necessary.</jats:p>',
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