Hospitalization Indications for Confirmed COVID-19 Patients: Ministry of Health

The primary health care institutions, upon detecting a suspected case of COVID-19, organize sampling and referral for testing in accordance with the guidelines approved by the Ministry of Health of the Republic of Armenia on January 31, 2020, Number N 336-A.

Following this, the primary health care physician contacts the confirmed COVID-19 patient, clarifies the complaints, and assesses any accompanying diseases. Based on the patient's complaints, a decision is made regarding a home visit to assess the severity of the patient's condition on-site, which also considers the necessity of hospitalization.

In cases of mild clinical course, the clinical signs and symptoms of COVID-19 patients may worsen during the second week of the disease due to lower respiratory tract involvement. What are the indications for hospitalization of COVID-19 patients?

1. Mild course of COVID-19 and age over 60,
2. COVID-19 in pregnancy with the presence of symptoms,
3. Mild course of COVID-19 with chronic cardiovascular disease, hypertension, diabetes, chronic obstructive pulmonary disease, immunodeficiency conditions, cancer, obesity, chronic renal failure,
4. Moderate course (pneumonia without hypoxia) characterized by:
   1. High fever, typically above 38 °C,
   2. Respiratory symptoms,
   3. Pneumonia pattern as per radiological data,
5. Severe pneumonia, which in addition to high fever and respiratory symptoms, shows the presence of ≥1 of the following signs:
   1. Respiratory rate ≥30/minute (adults),
   2. Oxygen saturation SpO2 ≤93%,
   3. Infiltrates covering >50% of the lung field within 24-48 hours,
6. Critical conditions (respiratory failure, septic shock, and/or multiple organ failure).

It should be noted that a confirmed COVID-19 patient is hospitalized if the oxygen saturation is SpO2 ≤93% and/or the respiratory rate is >22/minute.