Abstract
Monitoring and treatment of severely ill COVID-19 patients in the ICU poses many challenges. The effort to understand the pathophysiology and progress of the disease requires high-quality annotated multi-parameter databases. We present CoCross, a platform that enables the monitoring and fusion of clinical information from in-ICU COVID-19 patients into an annotated database. CoCross consists of three components: (1) The CoCross4Pros native android application, a modular application, managing the interaction with portable medical devices, (2) the cloud-based data management services built-upon HL7 FHIR and ontologies, (3) the web-based application for intensivists, providing real-time review and analytics of the acquired measurements and auscultations. The platform has been successfully deployed since June 2020 in two ICUs in Greece resulting in a dynamic unified annotated database integrating clinical information with chest sounds and diagnostic imaging. Until today multisource data from 176 ICU patients were acquired and imported in the CoCross database, corresponding to a five-day average monitoring period including a dataset with 3477 distinct auscultations. The platform is well accepted and positively rated by the users regarding the overall experience.
Highlights
In the media briefing on March 11, 2020, the World Health Organization (WHO) declared a state of a pandemic for COVID-19
Intensive care physicians are required to resort to alternative testing methods that lack the immediacy and practicality of listening with the stethoscope and cannot substitute the information gained from the auscultation method
In this paper we have presented CoCross, a platform that enables monitoring, recording and fusion of clinical information with chest sounds and imaging of COVID-19 intensive care unit (ICU)
Summary
In the media briefing on March 11, 2020, the World Health Organization (WHO) declared a state of a pandemic for COVID-19. Ill patients with a COVID-19 infection show frequent alternations between different clinical and radiological patterns [6], as well as frequent complications of the disease and applied mechanical ventilation (such as atelectasis, pneumothorax, pulmonary embolism, etc.). The auscultation technique has remained critical in the comprehensive diagnosis and management of the COVID-19 disease, despite the practical issues related to the personal protective equipment [7], since this method is easy to apply multiple times a day, reliable, and intensivists are highly familiar with it. Modern digital auscultation modalities have been reported to change the landscape of diagnosis and treatment of many heart and lung conditions in a favorable way for the patients [8]. CT scans are often impossible to have, in the most severe cases of ARDS patients (acute respiratory distress syndrome) who are unable to be transported safely to the CT scanner and back
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