477. Implementing a Follow-up Call Program for Ambulatory patients with COVID-19 in a Tertiary Center in Mexico City

Pinto, Yamile G Serrano; Crabtree-Ramírez, Brenda; Ortiz, Cristian E Espejo; Hernández-Alemon, Aldo; Iruegas-Núñez, David A; Hernández-Martínez, Ingrid V; Gómez-Islas, Valeria E; Oropeza-Viveros, Dulce M; Castro Gómez, Sandra Erika; Esquinca-González, Alexia; García-Fong, Kevin R; Gómez-Vázquez, Eduardo; Arias-Delgado, Karen A; Guerrero-Torres, Lorena; Lopez Iñiguez, Alvaro

BACKGROUND: The Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán is a teaching hospital which was converted into a Coronavirus disease 2019 (COVID-19) designated hospital on mid-March 2020. In Mexico City, the COVID-19 peak started in mid-April 2020. A considerable proportion of those diagnosed with SARS-CoV-2 infection were treated by ambulatory care. We aimed to describe the clinical characteristics at diagnosis of ambulatory patients diagnosed with COVID-19, their willingness to donate plasma and their clinical outcomes at one month of the follow-up call program implementation. METHODS: A call strategy follow-up program (FUP) was established on April 19, 2020. All ambulatory patients received at least 3 calls every 48–72 hours, followed by 2 weekly calls. A team of voluntary medical students, general practitioners, fellows, and medical specialists was assembled for this purpose. Signs of alarm (fever >72 hours, shortness of breath, respiratory insufficiency) and other clinical signs were collected on every call. Willingness to donate plasma and possibility of a correct home isolation were also addressed. RESULTS: From April 19 to May 18, 2020, a total of 360 patients tested positive for SARS-CoV2, of whom 350 were followed. Their median age was 44 years (33–51), and 55% were female. 145 (41%) had completed all FUP calls and 194 (55%) referred to be asymptomatic in their last call. We identified 8 patients with signs of alarm during the calls, and 2 of them required hospitalization. During the FUP, 66% referred fatigue that limited their activities, 56% anosmia or dysgeusia, 32% headache, and 22% diarrhea. 90% were capable to properly isolate in their homes. Willingness to donate plasma was assessed in 89 patients, of whom, 75 (84%) manifested their willingness to donate. CONCLUSION: Ambulatory follow-up is feasible and effective to identify those in need of hospitalization. Remarkably, half of the ambulatory patients had no comorbidities and presented anosmia/dysgeusia as the most frequent symptoms during follow-up. Willingness to donate plasma was high in this cohort. DISCLOSURES: All Authors: No reported disclosures