COVIDApp as an Innovative Strategy for the Management and Follow-Up of COVID-19 Cases in Long-Term Care Facilities in Catalonia: Implementation Study.

Patricia Echeverría,José María Ruiz,María Ulldemolins,Jordi Puig,Ricardo Peiró,Sara Pablo,Jordi Herms,Yolanda Ordorica,Bonaventura Clotet Sala,Mercé Iruela,Miquel Angel Mas Bergas,Dolors Balart,Mar Isnard,Eugenia Negredo,Mireia Massot,Cristina Vedia

doi:10.2196/21163

Abstract

BackgroundThe coronavirus disease (COVID-19) pandemic has caused an unprecedented worldwide public health crisis that requires new management approaches. COVIDApp is a mobile app that was adapted for the management of institutionalized individuals in long-term care facilities.ObjectiveThe aim of this paper is to report the implementation of this innovative tool for the management of long-term care facility residents as a high-risk population, specifically for early identification and self-isolation of suspected cases, remote monitoring of mild cases, and real-time monitoring of the progression of the infection.MethodsCOVIDApp was implemented in 196 care centers in collaboration with 64 primary care teams. The following parameters of COVID-19 were reported daily: signs/symptoms; diagnosis by reverse transcriptase–polymerase chain reaction; absence of symptoms for ≥14 days; total deaths; and number of health care workers isolated with suspected COVID-19. The number of at-risk centers was also described.ResultsData were recorded from 10,347 institutionalized individuals and up to 4000 health care workers between April 1 and 30, 2020. A rapid increase in suspected cases was seen until day 6 but decreased during the last two weeks (from 1084 to 282 cases). The number of confirmed cases increased from 419 (day 6) to 1293 (day 22) and remained stable during the last week. Of the 10,347 institutionalized individuals, 5,090 (49,2%) remained asymptomatic for ≥14 days. A total of 854/10,347 deaths (8.3%) were reported; 383 of these deaths (44.8%) were suspected/confirmed cases. The number of isolated health care workers remained high over the 30 days, while the number of suspected cases decreased during the last 2 weeks. The number of high-risk long-term care facilities decreased from 19/196 (9.5%) to 3/196 (1.5%).ConclusionsCOVIDApp can help clinicians rapidly detect and remotely monitor suspected and confirmed cases of COVID-19 among institutionalized individuals, thus limiting the risk of spreading the virus. The platform shows the progression of infection in real time and can aid in designing new monitoring strategies.

Highlights

The disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), called coronavirus disease (COVID-19), was initially identified in December 2019 as a case of pneumonia in Wuhan, China [1,2]
The objective of this paper is to report the use of this innovative tool for the management of long-term care facility residents as a high-risk population, for early identification and self-isolation of suspected cases, remote monitoring of mild cases, and real-time monitoring of the progression of the infection
We describe the implementation of a mobile app (COVIDApp) for the management of COVID-19 in institutionalized persons in long-term care facilities

Summary

Introduction

The disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), called coronavirus disease (COVID-19), was initially identified in December 2019 as a case of pneumonia in Wuhan, China [1,2]. COVID-19 has since become a global pandemic that is affecting more than 200 countries worldwide, with more than 3.5 million people infected globally and more than 240,000 related deaths as of April 30, 2020 [3]. The World Health Organization declared COVID-19 a pandemic on March 11, 2020, and called for coordinated mechanisms to provide a response to the infection across various health sectors [4]. The rapid spread of the infection and its severity in a considerable percentage of patients has necessitated unprecedented public health measures. Health professionals require methods to detect, treat, and monitor patients with COVID-19 effectively and efficiently and to prevent further transmission of the disease. The coronavirus disease (COVID-19) pandemic has caused an unprecedented worldwide public health crisis that requires new management approaches. COVIDApp is a mobile app that was adapted for the management of institutionalized individuals in long-term care facilities

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Conclusion