Rajanna Avinash H, Bellary Vaibhav S, Puranic Sohani Kashi, C Nayana, Nagaraj Jatin Raaghava, A Eshanye D, K Preethi
General Medicine, Employees' State Insurance Corporation and Medical College (ESIC-MC) and Post Graduate Institute of Medical Science and Research (PGIMSR) Model Hospital, Rajajinagar, Bangalore, IND.
Cureus. 2023 Sep 1;15(9):e44528. doi: 10.7759/cureus.44528. eCollection 2023 Sep.
Background COVID-19 steadily built up the pressure on healthcare systems worldwide, creating the need for novel methods to alleviate the burden. Continuous remote monitoring of vital parameters reduces morbidity and mortality in hospitals by providing real-time disease data that can be analyzed through web portals. It enables healthcare workers to identify which patients require prompt administration of healthcare. Patients remain under the purview of their doctors and can be notified early if there are any deteriorations in the parameters being monitored. Aims To evaluate the use of remote monitoring in moderate and severe COVID-19 patients and to correlate the Dozee Early Warning Score (DEWS) with severity and outcome in moderate and severe COVID-19 patients. Materials and methods We conducted a prospective study on adult (>18 years old) moderate and severe COVID-19 patients during the second wave of COVID-19. The vitals of the subjects were continuously monitored using Dozee, a contactless remote patient monitoring system enabled with DEWS that reflects the overall patient condition based on respiratory rate (RR), heart rate (HR), and oxygen saturation (SpO). We assessed the correlation of DEWS with patients' clinical outcomes: deteriorated or recovered. Results Thirty-nine COVID-19 patients were recruited for the study, of whom 29 were discharged after recovery and 10 deteriorated and died. Respiratory rate trend, respiratory rate DEWS, SpO DEWS, and total DEWS showed a significant reduction in recovered patients, while the same parameters showed a significant increase followed by consistently high scores in patients who deteriorated and died due to the disease. Total DEWS was proportional to the risk of mortality in a patient. Conclusion We concluded that continuous vitals monitoring and the resulting DEWS in moderate and severe COVID-19 patients were indicators of their improvement or deterioration. DEWS uses continuous remote monitoring of routinely collected vitals (HR, RR, and SpO) to serve as a predictor of patient outcome.
新型冠状病毒肺炎（COVID-19）持续给全球医疗系统带来压力，因此需要新方法来减轻负担。通过网络门户对重要参数进行持续远程监测，可提供实时疾病数据，从而降低医院内的发病率和死亡率。这使医护人员能够确定哪些患者需要及时给予医疗护理。患者仍在医生的监护之下，如果监测参数出现任何恶化情况，可尽早得到通知。目的：评估远程监测在中度和重度COVID-19患者中的应用，并将多泽早期预警评分（DEWS）与中度和重度COVID-19患者的病情严重程度及预后相关联。材料和方法：在COVID-19第二波疫情期间，我们对成年（>18岁）中度和重度COVID-19患者进行了一项前瞻性研究。使用多泽对受试者的生命体征进行持续监测，多泽是一种非接触式远程患者监测系统，具备DEWS，可根据呼吸频率（RR）、心率（HR）和血氧饱和度（SpO）反映患者的整体状况。我们评估了DEWS与患者临床结局（病情恶化或康复）之间的相关性。结果：39例COVID-19患者被纳入研究，其中29例康复后出院，10例病情恶化并死亡。康复患者的呼吸频率趋势、呼吸频率DEWS、SpO DEWS和总DEWS均显著降低，而对于因该疾病病情恶化并死亡的患者，相同参数则显著升高，随后分数持续较高。总DEWS与患者的死亡风险成正比。结论：我们得出结论，对中度和重度COVID-19患者进行持续生命体征监测以及由此得出的DEWS是其病情改善或恶化的指标。DEWS通过对常规收集的生命体征（HR、RR和SpO）进行持续远程监测，作为患者预后的预测指标。
