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. 2020 Nov;220(8):472-479.
doi: 10.1016/j.rce.2020.05.013. Epub 2020 Jun 5.

Monitoring of COVID-19 patients by telemedicine with telemonitoring

[Article in English, Spanish]
M Martínez-García  1 , M Bal-Alvarado  2 , F Santos Guerra  3 , R Ares-Rico  4 , R Suárez-Gil  2 , A Rodríguez-Álvarez  2 , A Pérez-López  2 , E Casariego-Vales  2 ; en nombre del Equipo de Seguimiento Compartido TELEA-COVID Lugo; Equipo TELEA COVID-19 (Lugo)
Collaborators, Affiliations

Monitoring of COVID-19 patients by telemedicine with telemonitoring

[Article in English, Spanish]
M Martínez-García et al. Rev Clin Esp (Barc). 2020 Nov.

Abstract
in English, Spanish

Aim: To asses if telemedicine with telemonitoring is a clinically useful and secure tool in the tracking of patients with COVID-19.

Methods: A prospective observational study of patients with COVID-19 diagnosis by positive PCR considered high-risk tracked with telemedicine and telemonitoring was conducted in the sanitary area of Lugo between March 17th and April 17th, 2020. Two groups of patients were included: Outpatient Tracing from the beginning and after discharge. Every patient sent a daily clinical questionnaire with temperature and oxygen saturation 3 times a day. Proactive monitoring was done by getting in touch with every patient at least 11a day.

Results: 313 patients (52.4% female) with a total average age of 60.9 (DE 15.9) years were included. Additionally, 2 patients refused to join the program. Since the beginning, 224 were traced outpatient and 89 after being discharged. Among the first category, 38 (16.90%) were referred to Emergency department on 43 occasions; 18 were hospitalized (8.03%), and 2 deceased. Neither deaths nor a matter of vital emergency occurred at home. When including patients after admissions monitoring was done in 304 cases. One patient re-entered (0.32%) to the hospital, and another one left the program (0.32%). The average time of monitoring was 11.64 (SD 3.58) days, and 224 (73.68%) patients were discharged during the 30 days of study.

Conclusions: Our study suggests that telemedicine with home telemonitoring, used proactively, allows for monitoring high-risk patients with COVID-19 in a clinically useful and secure way.

Objetivo: Evaluar si la telemedicina con telemonitorización es una herramienta clínicamente útil y segura para el seguimiento de pacientes con COVID-19.

Métodos: 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.

Resultados: 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.

Conclusiones: 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.

Keywords: COVID-19; COVID-19 management; Case management; Gestión COVID-19; Gestión caso; Telemedicina; Telemedicine.

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Figures

Figure 1
Figure 1
Patient monitoring work flow.
Figure 2
Figure 2
Flow chart of COVID-19 positive adult patients who are considered high-risk and in at-home monitoring (March 17 to April 17, 2020).
Figure 3
Figure 3
Monitoring of COVID-19 patients with telemedicine: probability of continuing in the program over time.
See this image and copyright information in PMC

Comment in

  • [Telemedicine for COVID-19].
    Ena J. Ena J. Rev Clin Esp. 2020 Nov;220(8):501-502. doi: 10.1016/j.rce.2020.06.002. Epub 2020 Jun 9. Rev Clin Esp. 2020. PMID: 33994574 Free PMC article. Spanish. No abstract available.

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