The Telecovid Study: Remote Monitoring of COVID-19 Positive High-Risk Patients in Domestic Isolation

Background: If a COVID-19 patient develops a so-called severe course, he or she must be taken to hospital as soon as possible. This proves difficult in domestic isolation, as patients are not continuously monitored. The aim of our study was to establish a telemonitoring system in this setting.  Methods: Oxygen saturation, respiratory rate, heart rate and temperature were measured every 15 minutes using an in-ear device. The data was transmitted to the Telecovid Centre via mobile network or internet and monitored 24/7 by a trained team. The data were supplemented by daily telephone calls. The patients´ individual risk was assessed using a modified National Early Warning Score. In case of a deterioration, a physician initiated the appropriate measures. Covid-19 Patients were included if they were older than 60 years or fulfilled at least one of the following conditions: pre-existing disease (cardiovascular, pulmonary, renal or hepatic), obesity (BMI >35), diabetes mellitus, hypertension, active malignancy, immunosuppressive medication, or pregnancy.  Findings: 153 patients (median age 59 years, 77 female) were included. Patients were monitored for 10 days (median, IQR 6 - 13 days) with a daily monitoring time of 13.3 hours (median, IQR 9.4 – 17.0 hours). 20 patients were referred to the clinic by the Telecovid team. 3 of these required intensive care without invasive ventilation, 4 with invasive ventilation, 1 of the latter died. All patients agreed that the device was easy to use. About 90% of hospitalised patients indicated that they would have delayed hospitalisation further if they had not been part of the study.   Interpretation: Our study demonstrates the successful implementation of a remote monitoring system in a pandemic situation. All clinically necessary information was obtained and adequate measures were derived from it without delay.  Funding Information: This work was supported by the TUM-Universitatsstiftung, by the Margarete-Ammon-Stiftung and by the Bayerisches Staatsministerium fur Wissenschaft und Kunst (U.7-H4001.1.7/35/3). Declaration of Interests: FK is an employee of cosinuss° GmbH. All other authors declare no competing interests. Ethics Approval Statement: The ethics committees of the Ludwig-Maximilians University and of the Technical University Munich approved the study protocol. The study was conducted in accordance with the principles of the Declaration of Helsinki. All patients gave written informed consent.