COD19 and COD20: An Italian Experience of Active Home Surveillance in COVID-19 Patients

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic found Italy unprepared to cope with the large concentrated numbers of patients infected with coronavirus disease 2019 (COVID-19) who often required hospital admission and in many cases intensive care. This pandemic very quickly overwhelmed the Italian Healthcare System. This paper describes the Active Home Surveillance System (Operations Center for Discharged Patients; COD19) and the Home Hospital Care System (COD20) and presents the clinical data collected and the level of user satisfaction with the service. The Operations Center for Discharged Patients (COD19) is an active surveillance service for home-care patients which involves: (1) monitoring critical clinical conditions; (2) recognizing social and health issues; (3) and providing necessary clinical services in the form of a telemedicine service. COD20 is a patient-specialist video consultation service that allows to perform an assessment of clinical conditions and any need to visit; defining the priority of access to specialist outpatient visits in the presence or manageable with the new video consultation model. This service was immediately necessary during the COD19 monitoring. COD19 and COD20 are based on the Amazon Web Services Serverless certified platform. The COD19 and COD20 platform can be intrinsically utilized for future epidemic outbreaks; also those with non-respiratory transmission; and is sufficiently flexible to adapt to natural catastrophes.

Telehealth-Based Services During the COVID-19 Pandemic: A Systematic Review of Features and Challenges

“…In telehealth solutions with treatment purpose, the aim was to provide necessary recommendations to symptomatic patients to reduce their symptoms. Most of the patients who received this type of services were confirmed cases (13,36,39,44,45,50,52,57,58,60,(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73).…”

Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era

“…The terms telehealth and telemedicine are usually employed interchangeably, but telehealth has developed to encapsulate a wider range of digital health care activities and services [25]. In fact, where telemedicine is specifically referred to as the practice of medicine by remote means, telehealth is an inclusive expression that includes all health care and health system components and activities that are conducted through telecommunications technology [26][27][28][29].…”

“…Zuccotti et al recently reported an Italian project about the implementation of active domiciliary monitoring (COD19) and a homecare hospital system (COD20) in COVID-19 patients, supported by the certified Amazon Web Services Serverless platform [25]. This monitoring system provides continuous assessment of critical medical status, detection of socially and clinically relevant issues, and the supply of necessary clinical services as a telemedicine service.…”

“…This monitoring system provides continuous assessment of critical medical status, detection of socially and clinically relevant issues, and the supply of necessary clinical services as a telemedicine service. COD20 is an interactive patient-to-physician video consultation system that enables an accurate evaluation of the clinical status and the potential need for any further visit, prioritizing outpatient in presence consultations or defining them as manageable through the new video consultation model [25]. This service was readily needed during COD19 in response to the identification of comorbidities in the monitored patients, but it also provides a significant management facility after the lockdown.…”

Long Term COVID-19 Complications in Inpatients and Outpatients: A One-Year Follow Up Cohort Study

“…For this reason, the Operations Center for Discharged Patients (Centrale Operativa Dimessi, COD19) was created as an active home surveillance system. 6 With the emerging evidence of long-term sequelae of COVID-19, COD19 started a oneyear follow-up of patients originally monitored during the first Italian phase of the pandemic. The purpose of this study is to report the clinical consequences in the population affected by COVID-19, both inpatients and outpatients, 12 months after the recovery from the acute illness.…”