Remote risk-stratification of dyspnoea in acute respiratory disorders: a systematic review of the literature

Abstract

Background: Telephone and video-based triage of dyspnoea has become commonplace and clinicians are faced with a new challenge in risk stratification of patients with dyspnoea due to suspected COVID-19. This review aimed to identify existing remote assessment modalities for acute dyspnoea which can be applied during pandemics.

Methods: We conducted a systematic search of Medline, Embase, the Cochrane Library and medRxiv for studies of remote assessment of dyspnoea [PROSPERO ID: CRD42020202292]. A total of 3014 abstracts were screened independently by two reviewers and 32 studies were progressed to full text screening.

Results: Five studies met the inclusion criteria. Commonly assessed clinical features included respiratory rate, work of breathing, counting time and mental status. All studies found remote triage modalities to be appropriate for detecting severe respiratory distress or the need for emergency level care.

Conclusion: Evidence-based tools to remotely assess dyspnoea will reduce resource strain during current and future pandemics.

Keywords: COVID-19; dyspnoea; mhealth; remote assessment; telehealth; triage.