COVID-19 home monitoring program: Healthcare innovation in developing, maintaining, and impacting the outcome of SARS-CoV-2 infected patients

Jaffar A Al-Tawfiq,Hatim Kheir,Talal Al-Dakheel,Saeed Al-Qahtani,Hussain Alkhadra,Ahlam Sarhan,Maryam Bu Halaiga,Rana Ibrahim

doi:10.1016/j.tmaid.2021.102089

Abstract

IntroductionThe Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) had caused an increased burden on healthcare organizations. Thus, a new strategy is needed to ensure all COVID-19 positive cases appropriately followed up , to receive the proper medical and psychological support, and to comply with the isolation guidelines. Here, we describe the characteristics and outcome of COVID-19 patients who were managed at home. In addition, we describe the differences between asymptomatic and those with mild symptoms. Materials and methodsThis is descriptive study of all COVID-19 positive cases who were monitored utilizing the home care concept. ResultsDuring the study period from June 8 to October 18, 2020, there was a total of 5368 COVID-19 patients who were referred to the home isolation/monitoring program. Of those, 2397 (45%) were female and 2971 (55%) were male. Of the total cases, 295 (5%) required hospital admission, 45 (1%) were admitted to zone 2 (an intermediate care facility), and the majority 5028 (94%) were continued in the home monitoring program till recovery. Of the total cases, 3137 (59%) were asymptomatic and the remaining 41% were symptomatic. Asymptomatic patients in comparison to symptomatic patients showed significant differences in relation to mean age (+ SD) of 31.5 (+ 18.6) and 46.45 (+ 17.1), respectively (P < 0.001)), gender, being healthcare workers, and the presence of significant medical conditions. However, a logistic regression analysis showed that only age and the presence of diabetes mellitus were associated with the presence of symptoms. The mean age (±SD) of those who required hospital admission was higher than those who were continued in home monitoring or cared for in zone 2. ConclusionThe utilization of home monitoring program was effective and safe in patients who were either asymptomatic or had mild symptoms.

Highlights

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) had caused an increased burden on healthcare organizations
COVID-19 had resulted in a great disparity in the outcome as it relates to gender and minorities [7] in addition to the unique characteristics of COVID-19 patients in rural and urban communities [8]
There is a need for a new strategy to manage those patients and to ensures all COVID-19 cases are followed up appropriately, receive proper medical and psychological support, and comply with the isolation guidelines in order to prevent the spread of the infection

Summary

Introduction

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused the current pandemic since its emergence in December 2019 in Wuhan city, China [1,2]. Home monitoring program was considered for all COVID-19 positive patients who were asymptomatic or had mild symptoms and deemed at low-risk of complications. Results: During the study period from June 8 to October 18, 2020, there was a total of 5368 COVID-19 positive cases who were referred to the home isolation/monitoring program. Patients were required to be in a facility if they had been asymptomatic or had mild symptoms This was changed to home isolation monitoring. The current study showed that 59% of the patients included in the home monitoring program were asymptomatic. In KSA, all SARS-COV-2 positive patients were initially required by the Saudi Ministry of Health to be hospitalized including asymptomatic [4]. In a meta-analysis of 28 studies, asymptomatic SARS-CoV-2 infection was 1.4% to 78.3% of 6,071 COVID-19 cases [32].

Suitable home environment for home isolation

Heart failure

Findings

No change in home environment suitability