Health System Dynamic & Resource Requirement in a South African COVID-19 Field Hospital

Health System Dynamic & Resource Requirement in a South African COVID-19 Field

The aim of this study is to describe the patient clinical profile, resource requirements, and health system dynamics in a field hospital during the second wave of the Coronavirus (COVID-19) pandemic, leading to the outbreak of viral severe acute respiratory syndrome (SARS-CoV-2 virus), in South Africa. By describing the field hospital in this unique setting, the investigators hope to provide an efficient guide to similar settings across low- and middle-income countries.

This was a retrospective, single-center study. A total of 596 patients with confirmed COVID-19 were admitted to Mitchells Plain Hospital of Hope (MPHOH), Cape Town, South Africa, between January 1st and February 28th, 2021. Patient clinical characteristics, outcome, and resource allocation was collected. Daily hospital dynamics, including admissions, discharges, deaths and oxygen use was analyzed and compared to the local and national COVID-19 incidence rates.

Study Overview

• Status: Completed
• Conditions: COVID-19 Pandemic; Low-Income Population; Global Health; Health Resources; Field Hospitals; Health Systems

Detailed Description

The aim of the study is to amplify what is known about field hospitals in resource-constrained setting, so as to guide meaningfully the future COVID-19 public health response. Understanding not only the patient profile, but clinical resource requirements, and health system dynamic in a South African field hospital during the second wave of the COVID-19 pandemic can help in preparation for a future infection surge. This will shed light on the extent and timing of excess demand for intermediate care facilities for COVID-19 during peak infection periods in this region. Furthermore, lessons learnt here can guide efforts in similar settings across low-and middle-income countries.

Data was collected on all patients admitted to MPHOH between January 1st and February 28th 2021 using notes from patient folders' and an electronic hospital records systems. Patient demographics, clinical profile, resource utilization; as well as the hospital dynamics were collected. COVID-19 incidence rates were collected from the National Institute for Infectious Diseases, South Africa

A descriptive data analysis was performed to report the number, mean, median, and range of all relevant values. Hospital level data were summarized into weekly intervals, described and compared to COVID-19 incidence rates. Statistical data analysis was performed using R Statistical Computing program and Microsoft Excel.

• Study Type: Observational
• Enrollment (Actual): 596

Contacts and Locations

Study Locations

• South Africa
  • Western Province
    • Cape Town, Western Province, South Africa, 7785
      • Mitchells Plain Hospital of Hope Covid-19 Field Hospital, Lentegeur Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The study population is from an underserved community utilizing public health services. The population in based in Mitchells Plain, Cape Town South Africa.

Description

Inclusion Criteria:

• All patients admitted to the Mitchells Plain Hospital of Hope COVID-19 field hospital between 1st January 2021 and 29th February 2021. Patients admitted to the hospital must have been: over 18years of age, diagnosed with COVID-19 via polymerase chain reaction (PCR) test, transferred from a referring facility.

Exclusion Criteria:

• No patients were excluded.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
COVID-19 Patients; Completed Sample of all patients admitted to the Mitchells Plain Hospital of Hope COVID-19 Field Hospital between January 1st and February 29th 2021. All patients were diagnosed with COVID-19 prior to admission to the hospital and were transferred directly from a referring hospital.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient Demographics	Patient age (in numbers)	January 1st to February 29th 2021
Patient Demographics	Patient sex (male or female)	January 1st to February 29th 2021
Patient Clinical Condition	Patient medical comorbidities on admission (categorical)	January 1st to February 29th 2021
Patient Clinical Condition	If patient diabetic, type of diabetic treatment received in hospital (oral vs insulin therapy)	January 1st to February 29th 2021
Patient Clinical Condition	If patient diabetic, glycated haemoglobin (HBA1C) level during admission (in numbers)	January 1st to February 29th 2021
Patient Clinical Condition	Patient clinical complications during hospital admission (categorical)	January 1st to February 29th 2021
Patient Clinical Condition	If patient received antibiotic treatment during admission, name of infection treated (categorical)	January 1st to February 29th 2021
Patient Clinical condition	Patient ICU priority triage score on admission (in numbers)	January 1st to February 29th 2021
Hospital Human Resources Utilized	Number of patients who utilized palliative care services (in numbers)	January 1st to February 29th 2021
Hospital Human Resources Utilized	Number of patients who utilized dietician services (in numbers)	January 1st to February 29th 2021
Hospital Human Resources Utilized	Number of patients who utilized physiotherapy services (in numbers)	January 1st to February 29th 2021
Hospital Physical Resources Utilized	Number of patients requiring oxygen therapy during admission (in numbers)	January 1st to February 29th 2021
Hospital Physical Resources Utilized	Type of oxygen therapy utilized by each patient (Categorical: nasal prong oxygen; face mask oxygen; or high flow oxygen)	January 1st to February 29th 2021
Hospital Physical Resources Utilized	Duration of oxygen therapy for each patient (in days)	January 1st to February 29th 2021
Hospital Physical Resources Utilized	Number of patients requiring antibiotic treatment (in numbers)	January 1st to February 29th 2021
Hospital Physical Resources Utilized	If patient required antibiotic therapy, name of antibiotic given (categorical)	January 1st to February 29th 2021
Hospital Physical resources Utilized	Patient duration of hospital stay (in days)	January 1st to February 29th 2021
Health System Dynamics	Daily number of patients admitted to hospital (in numbers/day)	January 1st to February 29th 2021
Health System Dynamics	Daily number of inpatients at hospital (in numbers/day)	January 1st to February 29th 2021
Health System Dynamics	Daily number of patients discharged from hospital (in numbers/day)	January 1st to February 29th 2021
Health System Dynamics	Daily number of patient deaths (in numbers/day)	January 1st to February 29th 2021
Health System Dynamics	Daily number of patients transferred out of hospital to another medical facility (in numbers/day)	January 1st to February 29th 2021
Health System Dynamics	Daily hospital bed capacity (in numbers/day)	January 1st to February 29th 2021
Health System Dynamics	Daily hospital oxygen consumption (in kg/day)	January 1st to February 29th 2021
Health System Dynamics	Name of hospital from which each patient was referred from (categorical)	January 1st to February 29th 2021
Local Incidence rates of COVID-19 infections	South African National COVID-19 incidence rates per week (in numbers/week)	December 1st 2020 to February 29th 2021
Local Incidence rates of COVID-19 infections	Western Cape Provincial COVID-19 incidence rates per week (in numbers/week)	December 1st 2020 to February 29th 2021

Collaborators and Investigators

• Sponsor: University of Cape Town

Study record dates

Study Major Dates

• Study Start (Actual): February 11, 2021
• Primary Completion (Actual): March 31, 2021
• Study Completion (Actual): March 31, 2021

Study Registration Dates

• First Submitted: November 3, 2021
• First Submitted That Met QC Criteria: November 7, 2021
• First Posted (Actual): November 9, 2021

Study Record Updates

• Last Update Posted (Actual): November 9, 2021
• Last Update Submitted That Met QC Criteria: November 7, 2021
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; COVID-19
• Other Study ID Numbers: African Covid19 Field Hospital

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data and hospital level data will be available to the public on completion of the research

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No