IntroductionSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or COVID-19, constitutes a public health emergency of international concern. The virus has spread globally through aerosol and contact transmission since the discovery of the SARS-CoV-2 in December 2019 in Wuhan, China. 1 As of 8 October 2020, 36,002,827 cases of COVID-19 have been reported worldwide, including 1,049,810 deaths. 2 The majority of early reported cases had the common symptoms of fever, dry cough and dyspnoea, as well as less common symptoms of headache, myalgia and sputum production. Computerised tomography (CT) scans showed bilateral lung opacities in almost all patients. 3 A meta-analysis of risk factors of critical COVID-19 patients showed that patients with dyspnoea were more likely to deteriorate into a critical condition than those who presented with fever only. There was an increased risk among the elderly (especially males over 65 years) and patients with comorbidities, such as diabetes, hypertension, cardiovascular and respiratory disease. 4 The assessment of dyspnoea is therefore an essential part of managing patients presenting with suspected COVID-19.The pandemic has placed increasing strain on scarce healthcare resources such as hospital beds and clinician time. This has been due to both increased demand and the need for stringent infection control procedures. As a result, many countries have relied on primary care systems to reduce the fl ow of patients through hospital emergency departments.A large amount of community-based diagnosis and triage of COVID-19 is currently being performed by video and telephone consultation. This has presented clinicians with a new challenge in risk-stratifying patients with shortness of breath. Dyspnoea is a diverse symptom and can be present in those who are critically ill but also in the worried well. Objective modes of assessment are required to differentiate these patient groups.The transformation of primary care from face-to-face to remote consultations has been aided by technology such as
Background Due to the highly infectious nature of the disease, a large amount of community-based triage of COVID-19 is performed by video/telephone consultation, especially in primary care. This presented clinicians with a new challenge in risk stratification of patients with dyspnoea due to suspected COVID19. This review searched existing literature to identify existing modalities to remotely assess patients with acute respiratory distress, which can be adapted for the COVID-19 pandemic and in future similar situations. Methods We conducted a systematic search of Medline, Embase and Medrxiv for studies of the remote assessment of dyspnoea in acute respiratory disorders in adults/children. The study was registered on PROSPERO (ID: CRD42020202292): 3014 abstracts were screened independently by two reviewers and 32 studies were progressed to full text screening. Results Five studies were selected for review, including 1317 patients. Two studies assessed video consultation, two assessed telephone related triage tools, and one study assessed an online triage tool for dyspnoea. In one study, video consultation was found to have 83% sensitivity for diagnosing ‘severe’ respiratory distress in comparison to face-to-face assessment. The online triage tool was found to have 87.5% sensitivity for detecting dyspnoea requiring emergency level care. Conclusion A range of successful remote risk stratification tools and clinical features were identified for assessing dyspnoea severity which can be adapted to COVID-19 and future pandemics to assess respiratory distress via telemedicine. These findings will influence development of comprehensive evidence-based tools to assess dyspnoea which will reduce resource strain during current/future pandemics. References Loinaz C, Marcacuzco A, Fernández-Ruiz M, Caso O, Cambra F, San Juan R, et al. Varied clinical presentation and outcome of SARS-CoV-2 infection in liver transplant recipients: Initial experience at a single center in Madrid, Spain. Transpl Infect Dis Off J Transplant Soc. 2020 Jun 20;e13372.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.