Analysis of an ambulatory care pathway for patients with COVID-19 utilising remote pulse oximetry

Abstract

comorbidities. Hypertension was more common in the cohort of patients who required reassessment, which supports previous studies showing that cardiovascular comorbidities are associated with increased mortality in COVID-19. 2 Pulmonary infiltrates on chest X-ray were more common in the cohort of patients who required reassessment, mirroring the importance of radiological findings in the outcomes of COVID-19 patients. 3 ConclusionsHome pulse oximetry with telephone follow-up was used to prevent hospital admission in a considerable proportion of patients who would have otherwise been admitted in the absence of this pathway. Telephone follow-up effectively identified patients who required further clinical assessment.This study demonstrates the potential for safe ambulation of a subgroup of patients with COVID-19, while identifying practical inclusion criteria that could be replicated in ambulatory units across the UK. Future research should focus on the inclusion of various prognostic markers, due to their potential power in determining disease trajectory. n Conflicts of interestNone declared.

Effectiveness and safety of pulse oximetry in remote patient monitoring of patients with COVID-19: a systematic review

“…Of these 35 records, 13 were conference abstracts with little available information and were excluded. 11 , 12 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 The RPM models in eight studies did not include pulse oximetry as a monitoring tool for all participants but only for specific subgroups, and these studies were excluded. 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 One study was excluded owing to reporting irrelevant outcomes, focusing on therapeutic options with less emphasis on the RPM model.…”

BJS commission on surgery and perioperative care post-COVID-19

“…Given that bed and staff shortages are major factors that reduce a hospital's capacity to perform tests and operations, healthcare facilities have needed to limit the use of medical resources by patients with mild cases of COVID-19 as much as possible, for example by asking these patients to recover at home or seek treatment in the community rather than in an acute hospital setting 49 . Although patients undergoing elective surgery may be eligible for this approach, those in need of emergency surgical intervention may not withstand waiting for the results of the test, which may take as long as 24 h. The sensitivity of RT-PCR on nasopharyngeal swab is not absolute and false-negative tests are quite possible 29 , which may lead to dealing with an infected patient as COVID-19-negative, and the false sense of security may subsequently increase the transmission of infection.…”

Starting Home Telemonitoring and Oxygen Therapy Directly after Emergency Department Assessment Appears to Be Safe in COVID-19 Patients

“…Home telemonitoring is now implemented in several hospitals as a standard of care and is considered a safe strategy for monitoring COVID-19 patients after hospital discharge [ 7 , 8 , 9 , 10 ]. Published studies on the safety of home telemonitoring started directly after an assessment at the Emergency Department (ED) [ 11 , 12 , 13 , 14 ] or on the safety of home telemonitoring and oxygen therapy [ 15 , 16 ] are sparse. As far as we know, there are only four studies describing the results of home telemonitoring and oxygen therapy started directly after ED assessment; one was performed in Guadeloupe [ 17 ] and three in the United States of America [ 18 , 19 , 20 ].…”