Continuous Remote Monitoring in Moderate and Severe COVID-19 Patients

Avinash H Rajanna; Vaibhav S Bellary; Sohani Kashi Puranic; Nayana C; Jatin Raaghava Nagaraj; Eshanye D A; Preethi K

doi:10.7759/cureus.44528

Continuous Remote Monitoring in Moderate and Severe COVID-19 Patients

Cureus. 2023 Sep 1;15(9):e44528. doi: 10.7759/cureus.44528. eCollection 2023 Sep.

Authors

Avinash H Rajanna¹, Vaibhav S Bellary¹, Sohani Kashi Puranic¹, Nayana C¹, Jatin Raaghava Nagaraj¹, Eshanye D A¹, Preethi K¹

Affiliation

¹ General Medicine, Employees' State Insurance Corporation and Medical College (ESIC-MC) and Post Graduate Institute of Medical Science and Research (PGIMSR) Model Hospital, Rajajinagar, Bangalore, IND.

Abstract

Background COVID-19 steadily built up the pressure on healthcare systems worldwide, creating the need for novel methods to alleviate the burden. Continuous remote monitoring of vital parameters reduces morbidity and mortality in hospitals by providing real-time disease data that can be analyzed through web portals. It enables healthcare workers to identify which patients require prompt administration of healthcare. Patients remain under the purview of their doctors and can be notified early if there are any deteriorations in the parameters being monitored. Aims To evaluate the use of remote monitoring in moderate and severe COVID-19 patients and to correlate the Dozee Early Warning Score (DEWS) with severity and outcome in moderate and severe COVID-19 patients. Materials and methods We conducted a prospective study on adult (>18 years old) moderate and severe COVID-19 patients during the second wave of COVID-19. The vitals of the subjects were continuously monitored using Dozee, a contactless remote patient monitoring system enabled with DEWS that reflects the overall patient condition based on respiratory rate (RR), heart rate (HR), and oxygen saturation (SpO₂). We assessed the correlation of DEWS with patients' clinical outcomes: deteriorated or recovered. Results Thirty-nine COVID-19 patients were recruited for the study, of whom 29 were discharged after recovery and 10 deteriorated and died. Respiratory rate trend, respiratory rate DEWS, SpO₂ DEWS, and total DEWS showed a significant reduction in recovered patients, while the same parameters showed a significant increase followed by consistently high scores in patients who deteriorated and died due to the disease. Total DEWS was proportional to the risk of mortality in a patient. Conclusion We concluded that continuous vitals monitoring and the resulting DEWS in moderate and severe COVID-19 patients were indicators of their improvement or deterioration. DEWS uses continuous remote monitoring of routinely collected vitals (HR, RR, and SpO₂) to serve as a predictor of patient outcome.

Keywords: clinical deterioration; contactless; continuous monitoring; covid-19; early warning score; remote monitoring.