Abstract
Background: The first case of COVID-19 in Israel was reported on
February 21, 2020. Shaare Zedek (SZ), a 1000-bed tertiary care medical
center in Jerusalem, Israel, cared for a significant number of these
patients. While attention focused on COVID-19 patients, uninfected
patients were admitted to decreasing numbers of available internal
medicine (IM) beds as IM departments were converted to COVID-19
isolation wards. Due to the increase in COVID-19 patients, closure of IM
wards, re-assignment of staff, and dynamic changes in available
community placement options, we investigated the impact of the outbreak
on IM patient not admitted for COVID-19. Methods: We reviewed IM
admissions during March 15 – April 30, 2020 for patients without
COVID-19. Characteristics assessed included number of admissions, age,
length of stay, mortality rate, number of discharges, number discharged
home, and functional status of the patients. Data was compared to the
previous three years (2017 – 2019) during the same time period.
Results: During March 15 – April 30, 2020 there were 409 patients
admitted to IM compared to a mean of 557 over the previous three years.
Fewer patients were admitted to the ED and the IM wards during the
outbreak. There was no significant difference between the two groups
with regards to gender, in-hospital mortality rate, number discharged,
number discharged home, and patient functional level. Patients admitted
during the outbreak to IM were younger (74.85 vs 76.86 years) and had a
mean shorter hospital length of stay (5.12 vs 7.63 days) compared to the
previous three years. Conclusion: While the characteristics of patients
admitted to IM during the outbreak were similar, hospital length of stay
was significantly shorter. Internal management processes, as well as
patient preferences may have contributed to this observation. An
infectious disease outbreak may have a significant effect on uninfected
admitted patients.