Care, screening, and follow-up of COVID-19 patients at a dedicated outpatient center, Val-de-Marne, April–June 2020

Due to the COVID-19 crisis, the difficulty of managing patients suspected of being infected with SARS-CoV-2 in private practices under hygienic conditions that are satisfactory for both doctors and patients, and in the absence of a dedicated facility, a specialized outpatient center was urgently established by a group of general practitioners. The objectives of this article are to describe the general organization of the COVID-19 outpatient center and to present the epidemiological and clinical characteristics of patients suspected of having COVID-19 who were tested for SARS-CoV-2 and of confirmed patients who were seen between April 7 and May 15, 2020. It took ten days for the center, housed in a gymnasium, to provide comprehensive medical care (consultation, diagnostic RT-PCR testing, follow-up) under appropriate hygiene conditions (one-way patient and staff flow, dedicated rooms, hygiene supplies, waste management). From April 1 to June 12, 2020, 824 consultations were conducted, and 11 patients were urgently transferred to the hospital. Patients were referred by their primary care physicians (58%), hospital physicians, or the Samu-Centre 15 emergency dispatch center (17%). 70% of consultations were initial visits and 30% were follow-up consultations, particularly following hospitalization. The proportion of patients tested for SARS-CoV-2 increased over time (from 39% in week 15 to 66% in week 20), and the positivity rate of samples decreased (from 28% to 0%). The patients most frequently tested were those with comorbidities, severe symptoms, healthcare professionals, those in contact with vulnerable individuals, and those who consulted between weeks 18 and 20. The patients most frequently testing positive for SARS-CoV-2 were women, those aged 60 and older, healthcare professionals, those meeting criteria for severe illness, those with ageusia, and those who sought care between weeks 15 and 17. No cases of COVID-19 were reported among healthcare professionals due to activities at the center. Positioned at the interface between community and hospital care, the COVID-19 center made it possible to respond urgently to the challenges of an epidemic of unprecedented scale caused by a contagious infectious agent, while ensuring the safe operation of private medical practices and laboratories. Such an organizational model deserves to be supported by professionalized structures with budgets that can be mobilized in emergencies.

Author(s): Vaux Sophie, Fischer Elise, Sainte-Rose Sandra, Bialot Gilles, Scheiff Christian, Ehrstein Florent, Delmas Gilles, Rainier Steven, Settbon Dove, Settbon Noham, Bideux Fabrice, Munroop Cindy, Mallet Estelle, Toussaint Alexandre, Fischer Claude, Nguyen Patrick, Tan Soline

Publishing year: 2020

Pages: 502-509

Weekly Epidemiological Bulletin, 2020, n° 25, p. 502-509

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