Active surveillance for suspected COVID-19 cases in inpatients with information technology

  • Author Footnotes
    † Joint first authors, contributed equally.
    C-Y. Lin
    Footnotes
    † Joint first authors, contributed equally.
    Affiliations
    Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Infectious Control Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • Author Footnotes
    † Joint first authors, contributed equally.
    C-H. Cheng
    Footnotes
    † Joint first authors, contributed equally.
    Affiliations
    Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • P-L. Lu
    Affiliations
    Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • D-C. Shih
    Affiliations
    Department of Medical Information, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • C-T. Hung
    Affiliations
    Infectious Control Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • H-H. Lo
    Affiliations
    Department of Medical Information, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • M-J. Tsai
    Correspondence
    Corresponding author. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tz-You 1 st Road, 807, Kaohsiung, Taiwan:
    Affiliations
    College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    Search for articles by this author
  • J-Y. Hung
    Affiliations
    College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    Search for articles by this author
  • Author Footnotes
    † Joint first authors, contributed equally.
Published:March 31, 2020DOI:https://doi.org/10.1016/j.jhin.2020.03.027
      As coronavirus disease 2019 (COVID-19) struck many countries worldwide in early 2020, the Taiwan government responded rapidly to minimize imported cases and community spread in Taiwan [
      • Wang C.J.
      • Ng C.Y.
      • Brook R.H.
      Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing.
      ]. Many hospitals took proactive measures, including quarantine strategies at the entrances [
      • Lee I.K.
      • Wang C.C.
      • Lin M.C.
      • Kung C.T.
      • Lan K.C.
      • Lee C.T.
      Effective strategies to prevent coronavirus disease-2019 (COVID-19) outbreak in hospital.
      ]. However, as shown by several reports, SARS-CoV-2 might be transmitted by asymptomatic carriers [
      • Rothe C.
      • Schunk M.
      • Sothmann P.
      • Bretzel G.
      • Froeschl G.
      • Wallrauch C.
      • et al.
      Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany.
      ,
      • Bai Y.
      • Yao L.
      • Wei T.
      • Tian F.
      • Jin D.Y.
      • Chen L.
      • et al.
      Presumed Asymptomatic Carrier Transmission of COVID-19.
      ]; also symptomatic individuals may evade hospital entrance quarantine measures. On 19th February 2020 the Central Epidemic Command Center (CECC) reported a Taiwanese case who was admitted for pneumonia, with a diagnosis of COVID-19 made three weeks after her admission [
      • Taiwan Centers for Disease Control
      Taiwan confirms one more confirmed cases; CECC continues to undertake contact tracing and investigation before illness onset.
      ]. Many medical staff who had cared for the case were consequently quarantined. This case highlights the need to maintain a high level of suspicion for COVID-19, particularly in patients whose pneumonia does not respond to antibiotic treatment.
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