Being the first in Spain, Léon Hospital implements suPAR in clinical routine in time to facing the COVID-19 outbreak

By: Julio Ajenjo García, ViroGates

suPAR News Vol. 3, p.16-17, June 2020

Complejo Asistencial Universitario de León (León Hospital) is a 1056-bed university hospital placed in the Castilla y León region in Spain.

In Mid-April, and as the first in Spain, León Hospital decided to implement suPAR in clinical routine in its Emergency Department (ED) for triaging of acute medical patients. A key objective is to using suPAR to identify patients who can be discharged. This way the hospital can avoid unnecessary admissions and reduce the costs associated herewith.

Facing the COVID-19 outbreak and to optimize the prioritizations needed to allocate resources, it was also immediately decided to use suPAR for triaging of patients suspected for having this infection.

Now, some three weeks later after the implementation of suPAR, León Hospital is still heavily engaged dealing with COVID-19 patients. And, in fact, many more than normally of those who arrive at the ED are seriously ill. They have simply been waiting for too long at home in the hope the COVID-19 crisis would soon pass.

We have had the pleasure to ask Head of ED Dr. Saúl Escudero Alvarez and Head of Core Lab Dra. Isabel Fernández Natal to give us a first-hand account on the impact COVID-19 has on a Spanish hospital. Since both Dr. Escudero Alvarez and Dra. Fernández Natal were instrumental in implementing suPAR as a routine marker we have, of course, also asked how it is to be the first hospital in the country to use suPAR.

suPAR News: What happened at León Hospital in the days after the COVID-19 outbreak and how do you handle the situation today?

Drs. Escudero Alvarez and Fernández Natal: Given the increase in suspected cases of COVID-19, we changed the structure and operation of both the ED and the rest of the hospital. We had to adapt to the new situation. There were days where more than 95% of the patients who consulted the ED showed symptoms suggesting a COVID-19 infection. Now we are trying to return to a more normal working day similar to those we had in the past, however, without letting our guards down in case of new spikes in COVID-19 cases.

suPAR News: How is your staff doing? Do your departments have the resources to meet all clinical needs in these demanding times?

Drs. Escudero Alvarez and Fernández Natal: The emergency personnel is well. We have the strength to continue fighting against the COVID-19 disease, although physical and, above all, emotional exhaustion has left a mark in all of us. Some of our employees have become sick, but fortunately none have been seriously ill. The clinical needs of the patients, whether or not infected with COVID-19, have been met, despite the difficulties.

suPAR News: How do you classify patients suspected of having a COVID-19 infection?

Drs. Escudero Alvarez and Fernández Natal: Currently the classification is purely clinical. It is based on the vital signs and symptoms of the patient and processed using computerized triage (SET).

suPAR News: It is probably still too early to ask whether suPAR has had an impact on your triage of patients suspected of having a COVID-19 infection; but how do you plan to use this biomarker going forward and what are your expectations?

Drs. Escudero Alvarez and Fernández Natal: We are still in the data collection phase. However, we believe that suPAR may help us decide whether to admit or discharge our acute care patients, with all that this entail for both the patients and their families.