Home monitoring of coronavirus disease 2019 patients in different phases of disease

Abstract

Purpose of reviewVarious home monitoring programs have emerged through the COVID-19 pandemic in different phases of COVID-19 disease. Recent findingsThe prehospital monitoring of COVID-19-positive patients detects early deterioration. Hospital care at home provides early discharge with oxygen to empty hospital beds for other patients. Home monitoring during recovery can be used for rehabilitation and detection of potential relapses. General goals of home monitoring in COVID-19 are early detection of deterioration and prompt escalation of care such as emergency department presentation, medical advice, medication prescription and mental support. Due to the innovations of vaccination and treatment changes, such as dexamethasone and tocilizumab, the challenge for the healthcare system has shifted from large numbers of admitted COVID-19 patients to lower numbers of admitted patients with specific risk profiles (such as immunocompromised). This also changes the field of home monitoring in COVID-19. Efficacy and cost-effectiveness of home monitoring interventions depend on the costs of the intervention (use of devices, apps and medical staff) and the proposed patient group (depending on risk factors and disease severity).

Length of stay and economic sustainability of virtual ward care in a medium-sized hospital of the UK: a retrospective longitudinal study

“…As in other studies, patients admitted to the virtual ward had lower rates of comorbidity (see, eg, the review for the virtual ward COVID-19 by Majoor and Vorselaars 16 ). While recent literature reviews found a lower rate of readmission in older patients with COPD 3 and COVID-19 patients 17 after hospitalisation at home and virtual wards, the present study did not find any significant difference, as also reported in Creavin et al 5 However, readmission rates for all patients (hospital and virtual wards) increased if a patient was from a virtual ward, older and had COPD.…”

Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization

“…At the Mayo Clinic, the home monitoring system for high-risk patients showed comparable efficacy with a reduced hospitalization ratio (13.7 vs. 18%) and lower mortality (0.5 vs. 1.7%) [ 21 ]. A recent review is available on remote monitoring of COVID-19 patients [ 22 ]. Because the late management of patients with asymptomatic hypoxemia led to a very poor outcome [ 2 ], meticulous screening using home oximetry with virtual monitoring could prevent hospitalization, resuscitation, and/or death [ 3 , 23 ].…”