How has telemedicine assisted COVID-19 patients?

By Dr. Priyom Bose, Ph.D.Feb 14 2022Reviewed by Benedette Cuffari, M.Sc.

The ongoing coronavirus disease 2019 (COVID-19) pandemic has been caused by the spread of a contagious virus known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the commencement of COVID-19 vaccination around the world, the emergence of new SARS-CoV-2 variants has led to a rapid increase in the number of COVID-19 cases, which has also increased COVID-19-related hospitalization and mortality rates.

Study: The Utility of Telemedicine In Managing Patients After COVID-19. Image Credit: Cryptographer / Shutterstock.com

This news article was a review of a preliminary scientific report that had not undergone peer-review at the time of publication. Since its initial publication, the scientific report has now been peer reviewed and accepted for publication in a Scientific Journal. Links to the preliminary and peer-reviewed reports are available in the Sources section at the bottom of this article. View Sources

An introduction to telemedicine

Due to the vast amount of pressure put on hospitals, particularly that which was witnessed during the COVID-19 pandemic, many hospitals were forced to release stable and treated patients to make space for severe cases. Some of the patients who are discharged under this type of pressure could require extended oxygen treatment; therefore, this approach is not ideal.

Both healthcare professionals and policymakers have recognized that telemedicine could be an effective tool for the remote treatment of stable patients. Telemedicine is defined as the utilization of electronic information and communications technology to support the health care system.

Previous studies have demonstrated that the implementation of telehealth measures has effectively helped patients who live in remote regions. Furthermore, research has shown that practicing telemedicine not only reduces mortality but also decreases the days lost due to unplanned cardiovascular hospitalizations.

Similarly, during the Ebola outbreak, mobile applications helped trace and monitor confirmed cases. In Taiwan, online communication with healthcare providers through online video calls increased the availability of medical consultants during the SARS-CoV-1 outbreak.

In the current COVID-19 pandemic, telemedicine has played an important role in treating chronically ill patients during the lockdown. Although many available studies cover different aspects of the COVID-19 pandemic, none have addressed the time when COVID-19 patients could be safely released from the hospital.

About the study

In acknowledging the urgent need for managing outpatients, especially after hospital discharge, scientists have conducted a pilot telemonitoring program. The data collected from this program has been published in a recent Research Square* study while it is being considered for publication in BMC One Health Outlook.

In this study, patients were recruited either during the time of being discharged from Barlicki Memorial Hospital in Lodz, or after completing their first outpatient visit six weeks after discharge from another center.

Participants were recruited between December 2020 and May 2021 and were provided with equipment to record daily saturation and heart rate measurement, as well as a tablet for remote data transmission. The researchers also obtained daily reports of cough, dyspnea, and fatigue from the study participants.

Study findings

The researchers monitored thirty patients for at least forty-five days and a minimum of two weeks after spontaneous saturation normalization. The mean age of the study participants was 55 years.

The researchers divided the groups in accordance with their clinical improvement. For example, patients with greater than 10% improvement in their functional vital capacity (FVC)  or greater than 15% increase in their lung transfer for carbon monoxide (T_L,CO) were considered to be clinically improved patients. Comparatively, patients who exhibited at-rest saturation measurements lower than 94% indicated a lack of clinical improvement.

The non-improvement group exhibited lower than 94% SpO₂ with higher variations in saturation measurements up to day 22. These patients also did not show significantly improved pulmonary function tests two-three months post-hospital discharge. Importantly, the researchers emphasized the lack of data to guide the use of home pulse oximetry or validate it in disease progression.

The researchers observed that participants who missed two or more measurements during the observation period were more inclined to be categorized into the clinically improved group. Furthermore, daily heart rate measurements did not differ between the study groups.

In the clinically improved study cohort, only one patient returned to the hospital because of diarrhea as a post-hospitalization and post-antibiotic consequence. Between both groups, the data on dyspnea and cough intensity were not statistically significant.

Conclusions

The findings from the current study demonstrate that telemedicine allows for the management of COVID-19 patients in a controlled manner.

One of the limitations of this study is the lack of randomization; however, the key strengths of this study are its longer observation time and the computation of the correlation between patient's pulmonary function tests and pulse oximetry results. This study emphasizes that home oxygen saturation telemonitoring could help predict the trajectory of the disease course.

This news article was a review of a preliminary scientific report that had not undergone peer-review at the time of publication. Since its initial publication, the scientific report has now been peer reviewed and accepted for publication in a Scientific Journal. Links to the preliminary and peer-reviewed reports are available in the Sources section at the bottom of this article. View Sources