Remote Patient Monitoring for Home Management of Coronavirus Disease 2019 in New York: A Cross-Sectional Observational Study

Abstract

Background: Coronavirus disease 2019 (COVID-19) poses a global public health emergency, overwhelming health systems worldwide and forcing rapid adoption of telemedicine strategies. Introduction: The COVID-19 Precision Recovery Program (PRP) is a remote patient monitoring (RPM) clinical program that was deployed by a New York health system to perform physiologic and symptomatic monitoring for patients with confirmed or suspected COVID-19 diagnoses. Methods: The present cross-sectional descriptive study reports retrospective data collected from the PRP during the COVID-19 crisis in New York. Results: One hundred twelve patients were included; mean (standard deviation) age was 49 (17.6) years and 60.7% were female. Most prevalent reported comorbidities were hypertension (36.3%), hypercholesterolemia (26.5%), and diabetes (17.7%). Less than half (44.6%) had a positive polymerase chain reaction COVID test (PCR-test), 33% had an unknown COVID status, and 17.9% had a negative test result. The most commonly reported symptoms included dyspnea (55.4%) and anxiety (55.4%). Anxiety was ranked as the most severe symptom (9.8%), followed by difficulty concentrating (4.5%). Symptom presentation did not significantly differ based on PCR-test status. Discussion: RPM can be a valuable tool for delivering care to patients with confirmed or suspected COVID-19 diagnoses. Considering similarities in symptom presentation between PCR-test statuses, access to COVID-related clinical care should not be based on PCR-test results. Conclusions: RPM has strong potential to assist in the effective management of suspected COVID-19 patients.

Post-acute COVID-19 syndrome negatively impacts health and wellbeing despite less severe acute infection

“…The prevalence of these symptoms in previously healthy, relatively young adults, identifies long-term sequelae that are associated with even less severe cases of COVID-19 infection. Although the proportion of positive PCR and/or antibody tests was 39%, this reflects concerns raised regarding the accuracy and potentially high rate of false-negatives seen in testing [14, 15, 16], the limited access to testing earlier in the pandemic, and participants possibly delaying seeking PCR tests during acute infection. The diagnosis of probable COVID-19 infection is supported by the similarity in persistent symptom presentation shared with those who received positive COVID-19 tests.…”

Telehealth follow up in emergency department patients discharged with COVID-like illness and exertional hypoxia

“…We monitored these patients with a combination of post-ED telemedicine (virtual) follow up (VF) and remote patient monitoring (RPM) with home pulse oximetry. During the Covid-19 pandemic, telemedicine and RPM models have been described to monitor pulse oximetry (SpO 2 ) in patients discharged from both inpatient and ED care, including escalation protocols as intervention for clinical deterioration [ [3] , [4] , [5] , [6] ]. Our objective is to describe the crisis pathway we employed and assess the available outcomes.…”

Remote patient monitoring for ED discharges in the COVID-19 pandemic

“… 14 The COVID-19 precision recovery programme in New York has a similar model to ours but has only reported patient demographics to date. 15 The data generated by these programmes in their various formats may help clarify the natural history of COVID-19, enabling evidence-based identification of patients who may benefit from early intervention or escalation to inperson care. Importantly, RPM programmes consistently receive positive reception among healthcare workers and patients, as without their engagement, these programmes would not be possible.…”