Assessment of the impact and reorganization of interventional pulmonology services at a tertiary care centre during nationwide lockdown for COVID-19 pandemic

https://doi.org/10.4081/monaldi.2021.1615

Authors

  • Rahul Tyagi Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
  • Saurabh Mittal | saurabh_kgmu@yahoo.co.in Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India. https://orcid.org/0000-0002-7979-6405
  • Karan Madan Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India. https://orcid.org/0000-0002-5330-6391
  • Anant Mohan Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
  • Vijay Hadda Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
  • Pawan Tiwari Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
  • Randeep Guleria Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India.

Abstract

COVID 19 pandemic has brought about a sea change in health care practices across the globe. All specialities have changed their way of working during the pandemic. In this study, we evaluated the impact of COVID-19 on the practice of interventional pulmonology at our centre. All interventional pulmonology procedures done during the three months after implementation of lockdown were evaluated retrospectively for patient demographics, clinical diagnosis, indication for procedure and diagnostic accuracy. The changes in practices, additional human resources requirement, the additional cost per procedure and impact on resident training were also assessed. Procedures done during the month of January 2020 were used as controls for comparison. Twenty-two flexible bronchoscopies (75.8%), four semirigid thoracoscopies (13.7%) and three EBUS-TBNAs (10.3%) were carried out during three month lockdown period as compared to 174 during January 2020. Twenty-three of the procedures were for the diagnostic indication (79%), and six were therapeutic (20.6%). The diagnostic yield in suspected neoplasm was 100% while for suspected infections was 58.3%. The percentage of independent procedures being done by residents reduced from 45.4% to 0%. The workforce required per procedure increased from 0.75 to 4-8, and the additional cost per procedure came out to be 135 USD. To conclude, COVID 19 has impacted the interventional pulmonology services in various ways and brought about a need to reorganize the services, while also thinking of innovative ideas to reduce cost without compromising patient safety.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

Hussain A, Yadav S, Hadda V, et al. Covid-19: A Comprehensive review of a formidable foe and the road ahead. Expert Rev Respir Med 2020;14:869-79.

Sommerstein R, Fux CA, Vuichard-Gysin D, et al. Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19. Antimicrob Resist Infect Control 2020;9:100.

COVIDIndia.org [Internet]. COVID-19 tracker updates for India for state wise & district wise data. Accessed: 12 September 2020. Available from: https://covidindia.org/

Madan M, Pahuja S, Mohan A, et al. TB infection and BCG vaccination: are we protected from COVID-19? Public Health 2020;185:91-2.

Mohan A, Tiwari P, Bhatnagar S, et al. Clinico-demographic profile & hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India. Indian J Med Res 2020;152:61/9.

Wu Z, McGoogan JM. Characteristics of and Important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323:1239-42.

Wong SCY, Kwong RT-S, Wu TC, et al. Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect 2020;105 119-27.

Wahidi MM, Shojaee S, Lamb CR, et al. The use of bronchoscopy during the coronavirus disease 2019 pandemic: CHEST/AABIP Guideline and Expert Panel Report. Chest 2020;158:1268-81.

Porpiglia F, Enrco Checcucci E, Amparore D, et al. Slowdown of urology residents’ learning curve during the COVID-19 emergency. BJU Int 2020;125:e15-7.

Raymond E, Thieblemont C, Alran S, et al. Impact of the COVID-19 outbreak on the management of patients with cancer. Targ Oncol 2020; 15: 249–259.

Esperto F, Papalia R, Autrán-Gómez AM, et al. COVID-19’s impact on Italian urology. Int Braz J Urol 2020;46 26-33.

Amparore D, Claps F, Cacciamani GE, et al. Impact of the COVID-19 pandemic on urology residency training in Italy. Minerva Urol Nefrol 2020;72:505-9.

Kogan M, Klein SE, Hannon CP, et al. Orthopaedic education during the COVID-19 pandemic. J Am Acad Orthop Surg 2020;28:e456.

Quesada PR, Solis SN, Diaz RC, Kraft SM. Otolaryngology residency application during the SARS-CoV-2 (COVID-19) pandemic. Otolaryngol Head Neck Surg 2020;163:89-90.

Downloads

Published
2021-01-25
Info
Issue
Section
COVID-19 - Collection of articles on the Coronavirus outbreak
Keywords:
bronchoscopy, COVID-19, SARS CoV-2, EBUS_TBNA
Statistics
  • Abstract views: 473

  • PDF: 168
How to Cite
Tyagi, Rahul, Saurabh Mittal, Karan Madan, Anant Mohan, Vijay Hadda, Pawan Tiwari, and Randeep Guleria. 2021. “Assessment of the Impact and Reorganization of Interventional Pulmonology Services at a Tertiary Care Centre During Nationwide Lockdown for COVID-19 Pandemic”. Monaldi Archives for Chest Disease 91 (1). https://doi.org/10.4081/monaldi.2021.1615.