AUTHOR=Dinh Aurélien , Mercier Jean-Christophe , Jaulmes Luc , Artigou Jean-Yves , Juillière Yves , Yordanov Youri , Jourdain Patrick , The AP-HP/Universities/INSERM COVID-19 Research Collaboration , Aurélien Dinh , Jean-Christophe Mercier , Jean-Yves Artigou , Yves Juillière , Luc Jaulmes , Youri Yordanov , Patrick Jourdain , Caroline Apra , Luc Jaulmes , Arthur Mensch , Amélie Aime-Eusebi , Caroline Apra , Alexandre Bleibtreu , Erwan Debuc , Agnes Dechartres , Laurene Deconinck , Aurelien Dinh , Patrick Jourdain , Christine Katlama , Josselin Lebel , François-Xavier Lescure , Youri Yordanov , Yves Artigou , Amelie Banzet , Elodie Boucheron , Christiane Boudier , Edouard Buzenac , Marie-Claire Chapron , Dalhia Chekaoui , Laurent De Bastard , Erwan Debuc , Aurelien Dinh , Alexandre Grenier , Pierre-Etienne Haas , Julien Hody , Michele Jarraya , Patrick Jourdain , Louis Lacaille , Guern Aurelie Le , Jeremy Leclert , Fanny Male , Jerome Marchand-Arvier , Emmanuel Martin-Blondet , Apolinne Nassour , Oussama Ourahou , Thomas Penn , Ambre Ribardiere , Nicolas Robin , Camille Rouge , Nicolas Schmidt , Pascaline Villie
TITLE=Safe Discharge Home With Telemedicine of Patients Requiring Nasal Oxygen Therapy After COVID-19
JOURNAL=Frontiers in Medicine
VOLUME=8
YEAR=2021
URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.703017
DOI=10.3389/fmed.2021.703017
ISSN=2296-858X
ABSTRACT=Introduction: The COVID-19 pandemic created challenges to healthcare systems worldwide. To allow overwhelmed hospitals to focus on the most fragile and severely ill patients, new types of management had to be set up. During the pandemic, patients with COVID-19 from greater Paris area were monitored at home using a web-based remote system called COVIDOM™, using self-administered questionnaires, which triggered alerts to a regional control center. To ease hospital discharge and to prevent hospital from being overwhelmed, patients still requiring low-flow oxygen therapy discharged home were also included in this telemedicine solution. We aim to evaluate the safety of this original management.
Methods: We conducted a retrospective multicenter cohort of patients discharged home from hospital after COVID-19 and still requiring nasal oxygen therapy, who were monitored by questionnaire and trained physicians using COVIDOM. During late follow-up, the status of the patients using a Euro-Qol (EQ-5D-5L) questionnaire, and the Medical Research Council (MRC) Dyspnea scale was collected.
Results: From March 21st to June 21st 2020, 73 COVID-19 patients still receiving nasal oxygen at hospital discharge were included. Median [Inter-Quartile Range (IQR)] age was 62.0 [52.5–69.0] years, 64.4% were male. Altogether, risk factors were observed in 49/73 (67%) patients, mainly hypertension (35.6%), diabetes mellitus (15.1%) and active neoplasia (11.0%). Among the cohort, 26% of patients were previously managed in ICU. Oxygen therapy was required for a median [IQR] of 20 [16–31] days. No death or urgent unplanned hospitalization were observed during the COVIDOM telemonitoring. During the late follow-up evaluation (6 months after inclusion), the mean EQ-5D-5L questionnaire score was 7.0 ± 1.6, and the mean MRC dyspnea scale was 0.8 ± 1.0, indicating absence of dyspnea. Five patients have died from non-COVID causes.
Conclusions: In this preliminary study, early discharge home of patients with severe COVID-19 disease who still required low-oxygen therapy seems to be safe.