Hospital in times of Covid-19: reaction and adaptation

Aim: Describe the patient's features and the hospital changes during the first weeks of the COVID-19 pandemic alarm in a General Hospital. Method: Observational study that asses all the admissions in the hospital departments between March 1st and April 30th of 2017, 2018, 2019 and 2020 in a General Hospital. The information was obtained from the basic data set of the Center. We consider 00.00 on March 14th of 2020 as the beginning of the alarm state and as cut-off point between two periods: before the state of alert (March 1st-13th) and the state of alert (March 14th- April 30th) Results: After the state of alarm the number of admissions decreased (p< 0,0001) in all kind of admissions (p<0,001) and in the ten medical and surgical services of adults between 3,5% and 55,9% comparing with the main of 3 previous years. At the same time main stay decreased ( p<0,001) and rate of admitted from urban areas increased (p<0,01). Although total mortality did not change, deaths during the first 24 hours after admissions were increased (p<0,008). Conclusions: This study describes surge and adaptation mechanisms of a hospital during state of alert by COVID-19 pandemic. Our results could help other Centers with designing and measuring their preparations.