Telemedical management of symptomatic COVID-19 outpatients
| Autor: | Aenne S. von Falkenhausen, Scott Geipel, Antonia Gail, Clemens Scherer, Sven Stockhausen, Lauren E. Sams, Finn Becker, Philipp M. Doldi, Eric Lemmermöhle, Paul de Villèle, Michael Schleef, Marc Becker, Moritz Lauterbach, Steffen Massberg, Stefan Kääb, Moritz F. Sinner |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | ERJ Open Research, Vol 10, Iss 4 (2024) |
| Druh dokumentu: | article |
| ISSN: | 2312-0541 23120541 |
| DOI: | 10.1183/23120541.00277-2024 |
| Popis: | Background COVID-19 remains a challenge to individual health and healthcare resources worldwide. Telemedical surveillance might minimise hospitalisation and direct patient–physician contacts. Yet, randomised clinical trials evaluating telemedical management of COVID-19 patients are lacking. Methods COVID-SMART is a randomised, open-label, controlled clinical trial investigating whether telemedicine reduces the primary end-point of hospitalisation or any unscheduled utilisation of an emergency medical service within 30 days of follow-up. Key secondary end-points included mortality and primary end-point components. We enrolled acutely infected SARS-CoV-2 patients suitable for outpatient care. All presented with ≥1 risk factor for an adverse COVID-19 course. Patients were randomised 1:1 into a control group receiving standard of care and an intervention group receiving smartphone-based assessment of oxygen saturation, heart rate and electrocardiogram, and telemedical counselling via a 24/7 emergency hotline. Results Of 607 enrolled patients (mean±sd age 46.7±13.5 years), 304 were randomised into the intervention and 303 into the control group. The primary end-point occurred in 6.9% (n=21) of the intervention and in 9.6% (n=29) of the control group (hazard ratio (HR) 0.72, 95% confidence interval (CI) 0.41–1.26; p=0.24). No deaths occurred during follow-up. Fewer intervention group participants utilised outpatient-based emergency medical services (HR 0.43, 95% CI 0.20–0.90; p=0.03). Conclusions COVID-SMART is the first randomised clinical trial assessing the benefit of telemedicine in an acute respiratory infectious disease. Whereas telemedical management did not reduce the primary end-point of hospitalisation, fewer intervention group patients used outpatient-based emergency services, suggesting a potential benefit for less-acutely infected individuals. |
| Databáze: | Directory of Open Access Journals |
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