procedure and participants
As shown in Figure 1, a total of 5,866 persons were treated in the outpatient obstetrics and gynecology department at Wuhan Union Hospital from March 12, 2020, to April 26, 2020. A total of 1,054 persons received “online” telemedicine services, and 4,812 persons received “offline” outpatient services. All “offline” outpatients were required to test their temperature and collect a medical history before their visit. Those who had the following were transferred to designated outpatient clinics: body temperature greater than 37.3℃, respiratory symptoms, and a COVID-19 or exposure history. Eligible patients entered the waiting area and signed a notification confirming that they had no symptoms of or exposure history to COVID-19. If any of the outpatients need inpatient treatment or outpatient surgery, such as diagnostic scraping, cervical biopsy, etc., a series of COVID-19-associated tests were carried out, including SARS-CoV-2 NAT of throat swabs, chest CT scan and a SARS-CoV-2-specific serological test. Others volunteered to undergo these tests to be able to get back to work or escort hospitalized family members. All outpatients who were tested were included in the study. If the test results had a positive finding, the patients were sent to the designated outpatient clinics, and an infection card was reported for the first time. Patients with negative test results were admitted to the hospital or outpatient clinics for follow-up treatment. Emergency patients were placed in segregated wards or underwent emergency surgery under protective measures in cases that were too critical to wait for the results of the COVID-19 tests. If the tests were negative, the emergency patients were then transferred to a regular ward. All enrolled patients were followed up until discharge from the hospital or May 8, 2020 (for patients had not been discharged or admitted). The requirement for informed consent was waived due to the retrospective data collection and the urgency to collect data on the emerging SARS-CoV-2. This study was approved by the Ethics Committee of Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology [approval No.2020(0218)].