Wuhan hospital program helps high-risk patients avoid COVID-19

Empty hospital bed
None of the 318 patients reported concerning respiratory symptoms and none tested positive for COVID-19 by 30 March, despite 29 having tests due to possible symptoms. Image: Martha Dominguez de Gouveia/Unsplash

A hospital that used strict measures to prevent high-risk Wuhan inflammatory bowel disease (IBD) patients from contracting coronavirus (COVID-19) could provide a model for health services globally, new research shows.

Led by Wuhan University and University of Melbourne researchers, the study outlines a model to prevent COVID-19 in IBD patients and possibly those with other high-risk conditions. It is published in The Lancet Gastroenterology and Hepatology.

University of Melbourne researcher and gastroenterologist at St Vincent’s Hospital, Melbourne, Dr Nik (John) Ding worked on the project with Wuhan University academics and several departments of Wuhan University’s Renmin Hospital.

Of the 318 Renmin Hospital patients with IBD, 204 had ulcerative colitis and 114 had Crohn’s disease. More than two-thirds lived and worked near Huanan Seafood Supermarket, where COVID-19 is believed to have originated.

In January, patients were asked to withhold their immunosuppressive therapies due to the potential high risk of COVID-19 infection, in accordance with the national Chinese Society of Gastroenterology guidelines.

A range of prevention measures were introduced, and regular information and instructional alerts sent to the patients’ online IBD groupsvia the Chinese social media platform WeChat.

The measures included single hospital rooms, advice to stay at home if possible, encouraging use of N95 masks for those who had recent treatment with biologics and immunosuppressants, and keeping in contact with the IBD team every day.

Patients were also informed about self-prevention actions such as avoiding public places and self-isolating and improving their personal protective health-care practices (hand hygiene, mask wearing, and storage).

While some health authorities are already doing great work, Dr Ding said this project at the COVID-19 epicentre could help them do even better. He said the model could translate anywhere, particularly in densely populated cities.

“This hospital has taken it to the next level by communicating directly through popular social media channels,” Dr Ding said. “They also protected the patients by asking their loved ones to follow the same advice. Taking extra precautions definitely can help.”

The patients were sent questionnaires on 10 February about coronavirus exposure, risk factors and prevention measures.

Most had heeded the advice. None of the 318 patients reported concerning respiratory symptoms and none tested positive for COVID-19 by 30 March, despite 29 having tests due to possible symptoms. Some had required hospital treatment for IBD complications.

The study’s researchers believe the experiences reported could provide a model of care to prevent COVID-19 in patients with IBD.

“It is critical for IBD treatment teams to emphasise infection risk assessment, prevention strategies, patient education, and effective therapies,” Dr Ding said.

“But to achieve effective infection management plans, mass awareness of important prevention and protection strategies is paramount and may go beyond what is currently recommended in some guidelines.

“It is also crucial to have a method of communication between patients and their IBD teams that allows patient’s concerns to be addressed in a timely fashion.”