View Score: An early warning score to detect possible complications among COVID-19 patients

Meenakshi Bhakare; Rajkumar Nikalje; Reshma Patil; Urvi Shukla; Rupesh Bokade; Gajanan Sakhare; Shardul Joshi; Aditi Pais

doi:10.4103/jfmpc.jfmpc_221_23

View Score: An early warning score to detect possible complications among COVID-19 patients

J Family Med Prim Care. 2023 Dec;12(12):3160-3166. doi: 10.4103/jfmpc.jfmpc_221_23. Epub 2023 Dec 21.

Authors

Meenakshi Bhakare¹, Rajkumar Nikalje², Reshma Patil³, Urvi Shukla⁴, Rupesh Bokade⁵, Gajanan Sakhare⁶, Shardul Joshi⁶, Aditi Pais⁶

Affiliations

¹ Department of Respiratory Medicine, Symbiosis Medical College for Women and Symbiosis University Hospital and Research Centre, Symbiosis International (Deemed University), Pune, Maharashtra, India.
² Symbiosis University Hospital and Research Centre, Symbiosis International (Deemed University), Pune, Maharashtra, India.
³ Department of Community Medicine, Symbiosis Medical College for Women, Symbiosis International (Deemed University), Pune, Maharashtra, India.
⁴ Intensive Care Unit, Symbiosis University Hospital And Research Centre, Symbiosis International (Deemed University), Pune, Maharashtra, India.
⁵ Department of Emergency Medicine, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India.
⁶ BRIOTA Technologies Private Limited Pune, Maharashtra, India.

Abstract

Introduction: Understanding pulmonary function at various phases after coronavirus disease 2019 (COVID-19) infection is critical for determining the exact pathophysiological mechanism of COVID-19.

Research question: What is the correlation between spirometry indices and clinical indicators in COVID-19 patients over a 6-week follow-up?

Objectives: 1) To assess deterioration or improvement in spirometry parameters including forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and ratio FEV₁/FVC in COVID-19 patients. 2) To study the correlation between FVC, FEV₁, and FEV₁/FVC with oxygen saturation and clinical findings.

Materials and methods: A prospective observational study was conducted for a 6-week period among 25, COVID-19 patients who were either asymptomatic or mildly symptomatic. Each patient received a home-use-connected spirometer-SpiroPRO^®, a pulse oximeter, and a thermometer from Briota Technologies Pvt Ltd. (BRIOTA). Patients and healthcare professionals were given training for performing spirometry twice a day as well as access to mobile apps was provided. Spirometry indices, patient symptoms, and vital statistics were used to calculate the VIEW™ score using machine learning algorithms.

Result: The Bland-Altman plots showed that FEV₁ reduced slightly up to 21-28 days and comes back to normal around 42 days. VIEW™ score increased up to day 21 and then decreased toward day 42. An increase in VIEW™ score increases the risk of COVID-19 complications. VIEW™ score and FEV₁ showed a significant correlation.

Conclusion: Home-based spirometry acts as an effective tool for COVID-19 patients to predict lung complications and also promote self-monitoring thereby reducing the burden on the health system.

Keywords: COVID-19; VIEW™ score; daily spirometry.