Background Among the many medical challenges presented by the COVID-19 pandemic, management of the majority of patients in community outpatient settings is crucial. The aim of this study was to describe the characteristics and outcomes among confirmed COVID-19 cases who were managed at three settings: two outpatient settings and one inpatient. Methods A retrospective database cohort study was conducted in a large Israeli Health Maintenance Organization. All COVID-19 cases diagnosed between 28 February 2020 and 20 July 2020 were included. Cases in the community settings were managed through a nationwide remote monitoring center, using preliminary telehealth triage and 24/7 virtual care. Outcome parameters included hospital admission, disease severity, need for respiratory support and mortality. Results About 5448 cases, aged range 0–97 years, were enrolled; 88.7% were initially managed as outpatient either at home or in designated hotels, 3.1 and 2.1% of them, respectively, later required hospitalization. The main reason for hospitalization was dyspnea; 12 were diagnosed with severe disease; 56 patients (1.3%) died, five (0.1%) of whom were initially allocated to the outpatient settings. Conclusions Care for appropriately selected COVID-19 patients in the community provides a safe and effective option. This can contribute to reducing the hospitalization burden, with no evidence of increased morbidity or mortality.

中文翻译：

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以色列的 COVID-19 社区护理——来自一家大型健康维护组织的全国性队列研究

背景 在 COVID-19 大流行带来的众多医疗挑战中，社区门诊环境中大多数患者的管理至关重要。本研究的目的是描述在三种情况下管理的确诊 COVID-19 病例的特征和结果：两种门诊设置和一名住院患者。方法 在一家大型以色列健康维护组织中进行了一项回顾性数据库队列研究。包括 2020 年 2 月 28 日至 2020 年 7 月 20 日期间诊断出的所有 COVID-19 病例。社区环境中的病例通过全国远程监控中心进行管理，使用初步远程医疗分诊和 24/7 虚拟护理。结果参数包括住院、疾病严重程度、呼吸支持需求和死亡率。结果 约 5448 例，年龄范围 0-97 岁，被录取；88.7% 的患者最初在家中或指定酒店进行门诊管理，其中分别有 3.1% 和 2.1% 的患者后来需要住院治疗。住院的主要原因是呼吸困难；12人被诊断出患有严重疾病；56 名患者 (1.3%) 死亡，其中 5 名 (0.1%) 最初被分配到门诊。Conclusions Care for appropriately selected COVID-19 patients in the community provides a safe and effective option. 这有助于减少住院负担，没有证据表明发病率或死亡率增加。其中五人（0.1%）最初被分配到门诊。Conclusions Care for appropriately selected COVID-19 patients in the community provides a safe and effective option. 这有助于减少住院负担，没有证据表明发病率或死亡率增加。其中五人（0.1%）最初被分配到门诊。Conclusions Care for appropriately selected COVID-19 patients in the community provides a safe and effective option. 这有助于减少住院负担，没有证据表明发病率或死亡率增加。