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远程 COVID 试验的初步试验:远程监测在疑似 COVID-19(SARS-CoV-2)病例中的应用。

The pilot, proof of concept REMOTE-COVID trial: remote monitoring use in suspected cases of COVID-19 (SARS-CoV 2).

机构信息

Division of Surgery & Cancer, 10th Floor Queen Elizabeth the Queen Mother Wing (QEQM) St Mary's Campus, London, W2 1NY, UK.

West Middlesex University Hospital, Twickenham Road, London, TW7 6AF, UK.

出版信息

BMC Public Health. 2021 Apr 1;21(1):638. doi: 10.1186/s12889-021-10660-9.

Abstract

BACKGROUND

SARS-CoV-2 has ever-increasing attributed deaths. Vital sign trends are routinely used to monitor patients with changes in these parameters preceding an adverse event. Wearable sensors can measure vital signs continuously and remotely, outside of hospital facilities, recognising early clinical deterioration. We aim to determine the feasibility & acceptability of remote monitoring systems for quarantined individuals in a hotel suspected of COVID-19.

METHODS

A pilot, proof-of-concept, feasibility trial was conducted in engineered hotels near London airports (May-June 2020). Individuals arriving to London with mild suspected COVID-19 symptoms requiring quarantine, as recommended by Public Health England, or healthcare professionals with COVID-19 symptoms unable to isolate at home were eligible. The SensiumVitals™ patch, measuring temperature, heart & respiratory rates, was applied on arrival for the duration of their stay. Alerts were generated when pre-established thresholds were breeched; trained nursing staff could consequently intervene.

RESULTS

Fourteen individuals (M = 7, F = 7) were recruited; the mean age was 34.9 (SD 11) years. Mean length of stay was 3 (SD 1.8) days. In total, 10 vital alerts were generated across 4 participants, resulting in telephone contact, reassurance, or adjustment of the sensor. No individuals required hospitalisation or virtual general practitioner review.

DISCUSSION

This proof-of-concept trial demonstrated the feasibility of a rapidly implemented model of healthcare delivery through remote monitoring during a pandemic at a hotel, acting as an extension to a healthcare trust. Benefits included reduced viral exposure to healthcare staff, with recognition of clinical deterioration through ambulatory, continuous, remote monitoring using a discrete wearable sensor.

CONCLUSION

Remote monitoring systems can be applied to hotels to deliver healthcare safely in individuals suspected of COVID-19. Further work is required to evaluate this model on a larger scale.

TRIAL REGISTRATION

Clinical trials registration information: ClinicalTrials.gov Identifier: NCT04337489 (07/04/2020).

摘要

背景

SARS-CoV-2 造成的死亡人数不断增加。生命体征趋势通常用于监测这些参数变化的患者,这些参数的变化先于不良事件发生。可穿戴传感器可以连续、远程测量生命体征,在医院设施外,识别早期临床恶化。我们旨在确定在伦敦机场附近的酒店中对疑似 COVID-19 的隔离个体进行远程监测系统的可行性和可接受性。

方法

2020 年 5 月至 6 月,在伦敦机场附近的工程酒店进行了一项试点、概念验证、可行性试验。符合以下条件的个体有资格参与研究:抵达伦敦时出现轻微疑似 COVID-19 症状需要隔离的个体,或出现 COVID-19 症状无法在家隔离的卫生保健专业人员。抵达时,将 SensiumVitals™贴片贴在身上,持续监测体温、心率和呼吸频率。当达到预先设定的阈值时,会生成警报;经过培训的护理人员可以进行干预。

结果

共招募了 14 名个体(男性 7 名,女性 7 名);平均年龄为 34.9(SD 11)岁。平均入住时间为 3(SD 1.8)天。总共有 10 名参与者共发生 10 次生命体征警报,结果是通过电话联系、提供安慰或调整传感器。没有个体需要住院治疗或虚拟全科医生就诊。

讨论

这项概念验证试验证明了在酒店通过远程监测在大流行期间迅速实施医疗保健的模型的可行性,该模型是医疗保健信托的延伸。好处包括减少了医疗保健人员的病毒暴露,并通过使用离散的可穿戴传感器进行动态、连续、远程监测,识别临床恶化。

结论

远程监测系统可应用于酒店,为疑似 COVID-19 的个体提供安全的医疗服务。需要进一步的工作来评估该模型的更大规模。

试验注册

临床试验注册信息:ClinicalTrials.gov 标识符:NCT04337489(2020 年 7 月 4 日)。

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