Monitoring of COVID-19 patients via telemedicine with telemonitoring

To asses if telemedicine with telemonitoring is a clinically useful and safe tool for monitoring patients with COVID-19. A prospective observational study of patients with COVID-19 diagnosed via a positive PCR test who were considered high-risk and who were monitored with telemedicine and telemonito...

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Published in:	Revista clínica espanõla (English edition) Vol. 220; no. 8; pp. 472 - 479
Main Authors:	Martínez-García, M., Bal-Alvarado, M., Santos Guerra, F., Ares-Rico, R., Suárez-Gil, R., Rodríguez-Álvarez, A., Pérez-López, A., Casariego-Vales, E., Fernández Rial, Álvaro, Rabuñal Rey, Ramón, Rodríguez Álvarez, Ana, Pérez López, Antía, Golpe Gómez, Rafael, Gil Mouce, Cristina, Suárez Ramírez, Nicolás, Almuiña Simón, Carmen, José Cereijo Quinteiro, María, Daporta Rodríguez, Luis, Fernández Valdivieso, Elvira, Vázquez Fernández, Andrés, Barcia Losada, Andrea, García Martínez, Arantza, Portero Vázquez, Amparo, Trillo Dono, Natalia, Revilla Villegas, Concepción, Fernández Rodríguez, Raquel, García Armesto, Isabel, Giadas Piñeiro, Rocío, Rosa Rodríguez Macía, Ana, Carballada González, Francisco, Núñez Orjales, Ramón, Martin Lázaro, Joaquín, Alfredo González Guzmán, Luis, Mar Abad García, María, Gloria Álvarez Silveiro, María, Carmen Coria Abel, María, Díaz Sánchez, Javier, Jesús Freire Regueiro, María, María Casanova Quiñoá, Ana, José Dobao Feijoo, María, Luisa Fernández Rodríguez, María, Rey Ponce, Ángela, Monte Secades, Rafael, Jesús Pérez Taboada, María, Sánchez Fernández, Rafael, Pérez Peña, Juan, Pereira, Manuel, Conde Freire, Jesús
Format:	Journal Article
Language:	English
Published:	Elsevier España, S.L.U 01-11-2020 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)
Subjects:	Case management COVID-19 COVID-19 management Gestión caso Gestión COVID-19 Original Telemedicina Telemedicine COVID-19 Telemedicina Telemedicine Case management COVID-19 management Gestión caso Gestión COVID-19
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Summary:	To asses if telemedicine with telemonitoring is a clinically useful and safe tool for monitoring patients with COVID-19. A prospective observational study of patients with COVID-19 diagnosed via a positive PCR test who were considered high-risk and who were monitored with telemedicine and telemonitoring in the Lugo Healthcare Area between March 17th and April 17th, 2020, was conducted. Two groups of patients were included: those in outpatient monitoring from the beginning and those in outpatient monitoring following hospital discharge. Every patient completed a clinical questionnaire with his or her temperature once per day and oxygen saturation levels three times per day. Proactive monitoring was done by getting in touch with every patient at least once a day. A total of 313 patients (52.4% female) with a mean age of 60.9 (SD 15.9) years were included. Two patients refused to participate in the program. Finally, 224 were monitored from the beginning and 89 patients were monitored after discharged. In the first group, 38 (16.90%) were referred to the Emergency department on 43 occasions; 18 (8.03%) were hospitalized, and two died. There were no deaths or lifethreatening at home. Including the patients monitored after hospitalization, monitoring was performed in 304 cases. One patient was readmited (0.32%) and another left the program (0.32%). The mean time of monitoring was 11.64 (SD 3.58) days and 224 (73.68%) patients were discharged during the 30 days the study lasted. Our data suggest that telemedicine with at-home telemonitoring, when used proactively, allows for clinically useful and safe monitoring of high-risk patients with COVID-19. Evaluar si la telemedicina con telemonitorización es una herramienta clínicamente útil y segura para el seguimiento de pacientes con COVID-19. Estudio observacional prospectivo de los pacientes con diagnóstico de COVID-19 por PCR positiva y considerados de alto riesgo que se siguieron con telemedicina y telemonitorización en el Área Sanitaria de Lugo entre el 17 de marzo y el 17 de abril del 2020. Se incluyeron 2 grupos de pacientes: seguimiento ambulatorio desde el inicio y tras el alta hospitalaria. Cada paciente remitió un cuestionario clínico al día con su temperatura y saturación de oxígeno 3 veces al día. El seguimiento fue proactivo, contactando con todos los pacientes al menos una vez al día. Se incluyó a 313 pacientes (52,4% mujeres) con edad media 60,9 (DE 15,9) años. Otros 2 pacientes rehusaron entrar en el programa. Desde el inicio, se siguió ambulatoriamente a 224 pacientes y a 89 pacientes tras su alta hospitalaria. Entre los primeros, 38 (16,90%) se remitieron a Urgencias en 43 ocasiones con 18 (8,03%) ingresos y 2 fallecidos. En los domicilios no hubo fallecimientos ni urgencias vitales. Incluyendo a los pacientes tras hospitalización, el seguimiento se realizó en 304 casos. Un paciente reingresó (0,32%) y otro abandonó (0,32%). El tiempo medio de seguimiento fue 11,64 (DE 3,58) días y en los 30 días del estudio 224 (73,68%) pacientes fueron dados de alta. Nuestros datos sugieren que la telemedicina con telemonitorización domiciliaria, utilizada de forma proactiva, permite un seguimiento clínicamente útil y seguro en pacientes con COVID-19 de alto riesgo.
Bibliography:	The TELEA-COVID-19 Joint Monitoring Team members are listed in Annex 1.
ISSN:	2254-8874 2254-8874
DOI:	10.1016/j.rceng.2020.07.001