Wearable devices for remote monitoring of hospitalized patients with COVID-19 in Vietnam

Châu, Nguyễn Văn Vĩnh; Trung, Truong Ngoc; Khanh, Phan Nguyen Quoc; Nhat, Phung Tran Huy; Van, Hoang Minh Tu; Hai, Ho Bich; Thuy, Duong Bich; Tung, Nguyen Le Nhu; Khoa, Dao Bach; Vien, Tran Thi Dong; Hảo, Nguyễn Văn; Oanh, Pham Kieu Ngyuyet; Khoa, Tran Dang; Phong, Nguyễn Thanh; Nguyen, Nguyen Thanh; Huynh, Julie; Walker, Timothy M; Nuil, Jennifer Ilo Van; An, Luu Phuoc; McKnight, Jacob; Toan, Le Mau; Tan, Le Van; Dung, Nguyen Thanh; Truong, Nguyen Thanh; Thwaites, Louise

doi:10.12688/wellcomeopenres.18026.1

“…The pulse oximeters were connected via Bluetooth to a bedside tablet where data could be visualised, and also transmitted to cloud server for remote visualisation and downloading of data. (20). Accelerometers were attached to the patient's infraclavicular fossa to infer prone vs non prone.…”

Section: Methodsmentioning

confidence: 99%

Awake prone positioning effectiveness in moderate to severe COVID-19 a randomized controlled trial

Phong,

Duc,

Hai

et al. 2024

Preprint

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ObjectivesWe evaluated the efficacy and acceptability of awake-prone positioning (APP) in a randomised controlled trial, using a dedicated APP implementation team and wearable continuous-monitoring devices to monitor position and oximetry.MethodsThe trial was performed at a tertiary level hospital in Ho Chi Minh City, Vietnam, recruiting adults (≥18 years) hospitalised with moderate or severe COVID-19 and receiving supplemental oxygen therapy via nasal/facemask systems or high-flow nasal canulae. Participants were randomized (1:1) to standard care or APP. The primary outcome was escalation of respiratory support within 28 days of randomisation.ResultsNinety-three patients were enrolled between March 2022 and March 2023; 80 (86%) had received ≥2 doses of SARS-CoV2 vaccine. Significantly greater mean daily APP times were achieved in those allocated to APP, although most did not achieve the target 8 hours/day. We did not detect significant differences in the primary outcome (RR 0.85, 95% CI 0.40-1.78, p=0.67) or secondary outcomes, including intubation rate and 28-day mortality. Particpants reported prone positioning was comfortable, although almost all preferred supine positioning. No adverse events associated with the intervention were reported.ConclusionsAPP was not associated with benefit, but was safe. Continuous monitoring with wearable devices was feasible and acceptable to patients.Clinical Trials RegistrationNCT05083130FundingWellcome Trust Grant 089276/B/09/7, 217650/Z/19/Z and FDCO/Wellcome Trust 225437/Z/22/Z

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Awake prone positioning effectiveness in moderate to severe COVID-19 a randomized controlled trial.

Phong,

Duc,

Hai

et al. 2024

Wellcome Open Res

0

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Background Awake prone positioning (APP) may be beneficial in patients with respiratory failure who are not receiving mechanical ventilation. Randomized controlled trials of APP have been performed during peak COVID-19 periods in unvaccinated populations, with limited data on compliance or patient acceptability. We aimed to evaluate the efficacy and acceptability of APP in a lower-middle income country in an open-label randomized controlled trial using a dedicated APP implementation team and wearable continuous-monitoring devices. Methods The trial was performed at a tertiary level hospital in Ho Chi Minh City, Vietnam, recruiting adults (≥18 years) hospitalized with moderate or severe COVID-19 and receiving supplemental oxygen therapy via nasal/facemask systems or high-flow nasal cannula (HFNC). Patients were allocated by a computer-generated random number sequence in a 1:1 ratio to standard care or APP, where a dedicated team provided bedside support. Wearable devices continuously recorded pulse oximetry and body position continuously. Our primary outcome was escalation of respiratory support within 28 days of randomization. Results Ninety-three patients were enrolled in this study between March 2022 and March 2023. Eighty (86%) patients had received ≥2 doses of SARS-CoV2 vaccine. The study was terminated early because of a reduction in the number of eligible patients. Data from 46 patients allocated to APP and 47 to standard care were available for analysis. At baseline, 19/47 (40%) patients allocated to the standard care group and 14/46 (30%) patients allocated to the APP group received HFNC. Continuous monitoring data were available for all patients monitored with wearable devices. Significantly greater mean daily APP times were achieved in those allocated to APP, however, most achieved less than the target 8 h/day. We did not detect clear differences in the primary outcome (relative risk,RR, 0.85, 95% CI 0.40-1.78, p=0.67) or secondary outcomes, including intubation rate and 28-day mortality. Patients reported prone positioning was comfortable, although almost all patients preferred supine positioning. No adverse events associated with the intervention were observed. Conclusions APP was not associated with benefit, but there was no sign of harm. Continuous monitoring with wearable devices is both feasible and acceptable for patients. In our population, achieving prolonged APP time was challenging despite a dedicated support team, and patients preferred supine positioning. Clinical Trials Registration NCT05083130.

show abstract

Awake prone positioning effectiveness in moderate to severe COVID-19 a randomized controlled trial.

Phong,

Duc,

Hai

et al. 2024

Wellcome Open Res

0

View full text Add to dashboard Cite

Background Awake prone positioning (APP) may be beneficial in patients with respiratory failure who are not receiving mechanical ventilation. Randomized controlled trials of APP have been performed during peak COVID-19 periods in unvaccinated populations, with limited data on compliance or patient acceptability. We aimed to evaluate the efficacy and acceptability of APP in a lower-middle income country in an open-label randomized controlled trial using a dedicated APP implementation team and wearable continuous-monitoring devices. Methods The trial was performed at a tertiary level hospital in Ho Chi Minh City, Vietnam, recruiting adults (≥18 years) hospitalized with moderate or severe COVID-19 and receiving supplemental oxygen therapy via nasal/facemask systems or high-flow nasal cannula (HFNC). Patients were allocated by a computer-generated random number sequence in a 1:1 ratio to standard care or APP, where a dedicated team provided bedside support. Wearable devices continuously recorded pulse oximetry and body position continuously. Our primary outcome was escalation of respiratory support within 28 days of randomization. Results Ninety-three patients were enrolled in this study between March 2022 and March 2023. Eighty (86%) patients had received ≥2 doses of SARS-CoV2 vaccine. The study was terminated early because of a reduction in the number of eligible patients. Data from 46 patients allocated to APP and 47 to standard care were available for analysis. At baseline, 19/47 (40%) patients allocated to the standard care group and 14/46 (30%) patients allocated to the APP group received HFNC. Continuous monitoring data were available for all patients monitored with wearable devices. Significantly greater mean daily APP times were achieved in those allocated to APP, however, most achieved less than the target 8 h/day. We did not detect clear differences in the primary outcome (relative risk,RR, 0.85, 95% CI 0.40-1.78, p=0.67) or secondary outcomes, including intubation rate and 28-day mortality. Patients reported prone positioning was comfortable, although almost all patients preferred supine positioning. No adverse events associated with the intervention were observed. Conclusions APP was not associated with benefit, but there was no sign of harm. Continuous monitoring with wearable devices is both feasible and acceptable for patients. In our population, achieving prolonged APP time was challenging despite a dedicated support team, and patients preferred supine positioning. Clinical Trials Registration NCT05083130.

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Wearable devices for remote monitoring of hospitalized patients with COVID-19 in Vietnam

Cited by 3 publications

References 13 publications

Awake prone positioning effectiveness in moderate to severe COVID-19 a randomized controlled trial

Awake prone positioning effectiveness in moderate to severe COVID-19 a randomized controlled trial

Awake prone positioning effectiveness in moderate to severe COVID-19 a randomized controlled trial.

Awake prone positioning effectiveness in moderate to severe COVID-19 a randomized controlled trial.

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