The outcomes of COVID-19 measures in a hyperbaric oxygen therapy centre during the pandemic
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Abstract
Background: A hyperbaric oxygen (HBO) treatment session carries a high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission since patients stay in a closed area for 2 hours. The primary aim of this study was to evaluate the effects of the preventive measures taken in the HBO centre.
Materials and methods: This study evaluated the measures taken during the coronavirus disease 2019 (COVID-19) pandemic for multiplace hyperbaric chamber operated in department (Health Sciences University-Gulhane Research and Training Hospital, Ankara, Turkey) between March 16th, 2020 and December 31st, 2020. The medical records of patients who underwent HBO treatment during this period were evaluated retrospectively. Their demographic attributes, the presence of risk factors, HBO indications, HBO session data, and COVID-19 inquiry forms were analysed.
Results: A total of 122 patients underwent HBO treatment, and 150 people were subjected to pressure tolerance test (PTT). No COVID-19 case was treated with HBO in our department. The hyperbaric chamber was operated 608 times in total. Of these, 9.7% (n = 59) procedures were carried out under emergency conditions, and 10% (n = 61) were PTTs. Accordingly, 59.8% (n = 73) of the HBO-treated patients were considered at risk for a severe clinical presentation of SARS-CoV-2. SARS-CoV-2 was detected in 5.7% (n = 7) of the HBO-treated patients during the HBO treatment period. Besides, two inside attendants (14.3%) were diagnosed with COVID-19. There were only two concurrent cases in the same session among SARS-CoV-2 positive cases. The records revealed that these patients were sitting three seats away from each other. Another patient was sitting in between the two infected patients but was not diagnosed with SARS-CoV-2.
Conclusions: There is no clear evidence that these two patients infected each other; on the contrary, since no other patient was infected with SARS-CoV-2 in the same session, we may suspect that the infections were coincidental. The measures taken in our department seem to suffice in preventing in-session transmission of COVID-19 and similar infectious diseases in an HBO centre.
Keywords: hyperbaric oxygenCOVID-19SARS-CoV-2transmissionmeasures
References
- Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579(7798): 270–273.
- Wu F, Zhao Su, Yu B, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020; 579(7798): 265–269.
- Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020; 382(8): 727–733.
- Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020; 5(4): 536–544.
- Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497–506.
- Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020; 8(4): 420–422.
- Vetter P, Vu DL, L'Huillier AG, et al. Clinical features of covid-19. BMJ. 2020; 369(m1470).
- Kim GU, Kim MJ, Ra SH, et al. Clinical characteristics of asymptomatic and symptomatic patients with mild COVID-19. Clin Microbiol Infect. 2020; 26(7): 948.e1–948.e3.
- Meyerowitz EA, Richterman A, Gandhi RT, et al. Transmission of SARS-CoV-2: A Review of Viral, Host, and Environmental Factors. Ann Intern Med. 2021; 174(1): 69–79.
- Morawska L, Milton DK. It is time to address airborne transmission of coronavirus disease 2019 (COVID-19). Clin Infect Dis. 2020; 71(9): 2311–2313.
- World Health Organization Web Site [homepage on the Internet]. Publications: Transmission of SARS-CoV-2: implications for infection prevention precautions. https://www.who.int/publications/i/item/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations (cited 2021 May 09).
- Klompas M, Baker MA, Rhee C, et al. Airborne Transmission of SARS-CoV-2: Theoretical Considerations and Available Evidence. JAMA. 2020 [Epub ahead of print]; 324(5): 441–442.
- Chagla Z, Hota S, Khan S, et al. International Hospital and Community Epidemiology Group. Airborne Transmission of COVID-19. Clin Infect Dis. 2020 [Epub ahead of print].
- Lu J, Gu J, Li K, et al. COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020. Emerg Infect Dis. 2020; 26(7): 1628–1631.
- Hamner L, Dubbel P, Capron I, et al. High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice - Skagit County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(19): 606–610.
- Shen Ye, Li C, Dong H, et al. Community Outbreak Investigation of SARS-CoV-2 Transmission Among Bus Riders in Eastern China. JAMA Intern Med. 2020; 180(12): 1665–1671.
- Undersea and Hyperbaric Medical Society Web site. [homepage on the Internet]. “Guidelines for infection control, patient treatment, and staff safety considerations related to Hyperbaric Oxygen Therapy in monoplace and multiplace hyperbaric chambers during the novel coronavirus disease (COVID-19) outbreak”. Created March 2020. https://www.uhms.org/images/MiscDocs/UHMS_Guidelines_-_COVID-19_V4.pdf (cited 2021 May 25).
- European Committee for Hyperbaric Medicine (ECHM) Web Site. [homepage on the Internet].“EUBS & ECHM position statement on the use of Hyperbaric Oxygen Therapy (HBOT) for the treatment of COVID-19 patients (30th April 2020). http://www.echm.org/documents/English-ECHM-EUBS-position-on-the-use-of-HBOT-for-COVID-19-1st-May-2020.pdf (cited 2021 May 25).
- Cascella M, Rajnik M, Aleem A, et al. Features, Evaluation, and Treatment of Coronavirus (COVID-19) [Updated 2021 Apr 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.
- 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(13): 1239–1242.
- Borges LP, Martins AF, de Melo MS, et al. Seroprevalence of SARS-CoV-2 IgM and IgG antibodies in an asymptomatic population in Sergipe, Brazil. Rev Panam Salud Publica. 2020; 44: e108.
- Pollán M, Pérez-Gómez B, Pastor-Barriuso R, et al. ENE-COVID Study Group. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. Lancet. 2020; 396(10250): 535–544.
- Stringhini S, Wisniak A, Piumatti G, et al. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): a population-based study. Lancet. 2020; 396(10247): 313–319.
- Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(24): 759–765.
- Wikipedia Web site. [homepage on the Internet]. “Türkiye’de COVID-19 pandemisi zaman çizelgesi”. https://tr.wikipedia.org/wiki/Türkiye%27de_COVID-19_pandemisi_zaman_çizelgesi#Mart_2020 (cited 2021 May 25).
