Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
JMIR Public Health Surveill. 2020 Jul 17;6(3):e21163. doi: 10.2196/21163.
The coronavirus disease (COVID-19) pandemic has caused an unprecedented worldwide public health crisis that requires new management approaches. COVIDApp is a mobile app that was adapted for the management of institutionalized individuals in long-term care facilities.
The aim of this paper is to report the implementation of this innovative tool for the management of long-term care facility residents as a high-risk population, specifically for early identification and self-isolation of suspected cases, remote monitoring of mild cases, and real-time monitoring of the progression of the infection.
COVIDApp was implemented in 196 care centers in collaboration with 64 primary care teams. The following parameters of COVID-19 were reported daily: signs/symptoms; diagnosis by reverse transcriptase-polymerase chain reaction; absence of symptoms for ≥14 days; total deaths; and number of health care workers isolated with suspected COVID-19. The number of at-risk centers was also described.
Data were recorded from 10,347 institutionalized individuals and up to 4000 health care workers between April 1 and 30, 2020. A rapid increase in suspected cases was seen until day 6 but decreased during the last two weeks (from 1084 to 282 cases). The number of confirmed cases increased from 419 (day 6) to 1293 (day 22) and remained stable during the last week. Of the 10,347 institutionalized individuals, 5,090 (49,2%) remained asymptomatic for ≥14 days. A total of 854/10,347 deaths (8.3%) were reported; 383 of these deaths (44.8%) were suspected/confirmed cases. The number of isolated health care workers remained high over the 30 days, while the number of suspected cases decreased during the last 2 weeks. The number of high-risk long-term care facilities decreased from 19/196 (9.5%) to 3/196 (1.5%).
COVIDApp can help clinicians rapidly detect and remotely monitor suspected and confirmed cases of COVID-19 among institutionalized individuals, thus limiting the risk of spreading the virus. The platform shows the progression of infection in real time and can aid in designing new monitoring strategies.
冠状病毒病（COVID-19）大流行造成了前所未有的全球公共卫生危机，需要采用新的管理方法。COVIDApp 是一款为长期护理机构的机构化个体管理而开发的移动应用程序。
本文旨在报告该创新工具在管理高风险人群（长期护理机构居民）中的应用，特别是用于早期识别和自我隔离疑似病例、远程监测轻症病例以及实时监测感染进展。
COVIDApp 与 64 个初级保健团队合作，在 196 个护理中心实施。每天报告以下 COVID-19 参数：症状/体征；逆转录酶聚合酶链反应诊断；无症状持续时间≥14 天；总死亡人数；疑似 COVID-19 隔离的卫生保健工作者人数。还描述了处于风险中的中心数量。
2020 年 4 月 1 日至 30 日期间，共记录了 10347 名机构化个体和最多 4000 名卫生保健工作者的数据。疑似病例数量迅速增加，直到第 6 天，但在最后两周有所减少（从 1084 例减少到 282 例）。确诊病例数从第 6 天的 419 例增加到第 22 天的 1293 例，并且在最后一周保持稳定。在 10347 名机构化个体中，5090 名（49.2%）无症状持续时间≥14 天。共报告 854/10347 例死亡（8.3%）；其中 383 例死亡（44.8%）为疑似/确诊病例。在 30 天内，隔离的卫生保健工作者人数居高不下，而疑似病例数量在最后两周减少。高风险长期护理机构的数量从 19/196（9.5%）减少到 3/196（1.5%）。
COVIDApp 可以帮助临床医生快速发现和远程监测机构化个体中疑似和确诊的 COVID-19 病例，从而限制病毒传播的风险。该平台实时显示感染进展情况，并有助于设计新的监测策略。
