Therapeutic effects of multidisciplinary individualized treatment for COVID-19 patients: the experience of a supporting medical team in Wuhan

Jianrong Liu; Xiaofeng Yuan; Qing Yang; Xiaogang Bi; Xinhua Li; Huawei Bian; Ke Sun; Xianling Zhang; Yang Yang

doi:10.21037/jtd-23-1428

Therapeutic effects of multidisciplinary individualized treatment for COVID-19 patients: the experience of a supporting medical team in Wuhan

J Thorac Dis. 2023 Dec 30;15(12):6813-6820. doi: 10.21037/jtd-23-1428. Epub 2023 Dec 26.

Authors

Jianrong Liu^#¹, Xiaofeng Yuan^#², Qing Yang^#^{3

4}, Xiaogang Bi², Xinhua Li⁵, Huawei Bian⁶, Ke Sun⁷, Xianling Zhang⁸, Yang Yang^{3

4}

Affiliations

¹ Surgical and Transplant Intensive Care Unit, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
² Department of General ICU, the Third Affiliated Hospital of Sun Yat-sen University Lingnan Hospital, Guangzhou, China.
³ Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁴ Organ Transplantation Research Center of Guangdong Province, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁵ Department of Liver Disease & Infection Diseases, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁶ Department of Clinical Nutriology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁷ Department of Obstetrics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁸ Nursing Department, Lingnan Hospital of the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

^# Contributed equally.

Abstract

Background: The sudden outbreak of coronavirus disease 2019 (COVID-19) has brought people around the world into an abyss of suffering. At that time, there were no clear and effective means for the treatment of the virus. We prepared a medical team consisted of specialists in critical care, respiratory diseases, infections, gastroenterology, endocrinology, cardiology, cerebrovascular diseases, nephrology, rehabilitation, psychology, and nutrition. This study shared our multidisciplinary treatment experience in treating patients with COVID-19.

Methods: Patients with positive SARS-CoV-2 swab test were divided into three groups: ordinary cases, severe cases and critical cases. Every patient received the multi-disciplinary comprehensive and individualized tailored treatment based on the specific situation of each patient. Patients' medical records, epidemiological, clinical, laboratory, radiological characteristics, Borg dyspnea score, Barthel index, self-rating anxiety scale (SAS) as well as treatment and outcome data were analyzed.

Results: The mean age of the 90 patients was 61.88±15.25 years. Some patients without underlying disease had developed comorbidities such as hyperglycemia (24, 26.67%) and hypertension (9, 10%). With multidisciplinary individualized treatment, the patients' albumin level and Barthel index score increased significantly, while glucose level, blood pressure, and Nutrition Risk Screening 2002 (NRS-2002), Borg scale, and SAS values significantly decreased at discharge. The in-hospital mortality rate was 4.44%. However, there was still a gap in Nutrition Risk Screening, Borg dyspnea score and Barthel index between the critical cases and the ordinary and severe cases at discharge. We observed that the patients with more severe disease had significantly higher age, rates of hypertension, and mortality. The median hospitalization time of discharged patients was 19 days [interquartile range (IQR), 9.0-20.0 days].

Conclusions: Multidisciplinary collaboration and individualized treatment could effectively improve the general status of patients with different severity of COVID-19.

Keywords: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); coronavirus disease 2019 (COVID-19); multidisciplinary treatment; severely ill patient.