Metro North Hospital and Health Service, Brisbane, Australia.
J Med Internet Res. 2021 Feb 10;23(2):e25518. doi: 10.2196/25518.
COVID-19 has necessitated the implementation of innovative health care models in preparation for an influx of patients. A virtual ward model delivers clinical care remotely to patients in isolation. We report on an Australian cohort of patients with COVID-19 treated in a virtual ward.
The aim of this study was to describe and evaluate the safety and efficacy of a virtual ward model of care for an Australian cohort of patients with COVID-19.
Retrospective clinical assessment was performed for 223 patients with confirmed COVID-19 treated in a virtual ward in Brisbane, Australia, from March 25 to May 15, 2020. Statistical analysis was performed for variables associated with the length of stay and hospitalization.
Of 223 patients, 205 (92%) recovered without the need for escalation to hospital care. The median length of stay in the virtual ward was 8 days (range 1-44 days). In total, 18 (8%) patients were referred to hospital, of which 6 (33.3%) were discharged after assessment at the emergency department. Furthermore, 12 (5.4%) patients were admitted to hospital, of which 4 (33.3%) required supplemental oxygen and 2 (16.7%) required mechanical ventilation. No deaths were recorded. Factors associated with escalation to hospital care were the following: hypertension (odds ratio [OR] 3.6, 95% CI 1.28-9.87; P=.01), sputum production (OR 5.2, 95% CI 1.74-15.49; P=.001), and arthralgia (OR 3.8, 95% CI 1.21-11.71; P=.02) at illness onset and a polymerase chain reaction cycle threshold of ≤20 on a diagnostic nasopharyngeal swab (OR 5.0, 95% CI 1.25-19.63; P=.02).
Our results suggest that a virtual ward model of care to treat patients with COVID-19 is safe and efficacious, and only a small number of patients would potentially require escalation to hospital care. Further studies are required to validate this model of care.
为应对大量患者涌入，新冠疫情需要采用创新的医疗模式。虚拟病房通过远程为隔离患者提供临床护理。我们报告了在澳大利亚接受新冠病毒虚拟病房治疗的患者队列情况。
本研究旨在描述和评估澳大利亚新冠患者虚拟病房护理模式的安全性和疗效。
对 2020 年 3 月 25 日至 5 月 15 日期间在澳大利亚布里斯班虚拟病房接受治疗的 223 例确诊新冠患者进行回顾性临床评估。对与住院时间和住院相关的变量进行统计分析。
223 例患者中，205 例（92%）无需升级治疗即可康复。虚拟病房的中位住院时间为 8 天（范围 1-44 天）。共有 18 例（8%）患者被转至医院，其中 6 例（33.3%）在急诊科评估后出院。此外，12 例（5.4%）患者住院，其中 4 例（33.3%）需要补充氧气，2 例（16.7%）需要机械通气。无死亡病例。与升级到医院治疗相关的因素如下：发病时患有高血压（优势比[OR] 3.6，95%置信区间 [CI] 1.28-9.87；P=.01）、咳痰（OR 5.2，95% CI 1.74-15.49；P=.001）和关节炎（OR 3.8，95% CI 1.21-11.71；P=.02），以及诊断性鼻咽拭子的聚合酶链反应循环阈值≤20（OR 5.0，95% CI 1.25-19.63；P=.02）。
我们的结果表明，治疗新冠患者的虚拟病房护理模式是安全有效的，只有少数患者可能需要升级到医院治疗。需要进一步研究来验证这种护理模式。
