Abstract
BackgroundSARS-CoV-2 has ever-increasing attributed deaths. Vital sign trends are routinely used to monitor patients with changes in these parameters preceding an adverse event. Wearable sensors can measure vital signs continuously and remotely, outside of hospital facilities, recognising early clinical deterioration. We aim to determine the feasibility & acceptability of remote monitoring systems for quarantined individuals in a hotel suspected of COVID-19.MethodsA pilot, proof-of-concept, feasibility trial was conducted in engineered hotels near London airports (May–June 2020). Individuals arriving to London with mild suspected COVID-19 symptoms requiring quarantine, as recommended by Public Health England, or healthcare professionals with COVID-19 symptoms unable to isolate at home were eligible. The SensiumVitals™ patch, measuring temperature, heart & respiratory rates, was applied on arrival for the duration of their stay. Alerts were generated when pre-established thresholds were breeched; trained nursing staff could consequently intervene.ResultsFourteen individuals (M = 7, F = 7) were recruited; the mean age was 34.9 (SD 11) years. Mean length of stay was 3 (SD 1.8) days. In total, 10 vital alerts were generated across 4 participants, resulting in telephone contact, reassurance, or adjustment of the sensor. No individuals required hospitalisation or virtual general practitioner review.DiscussionThis proof-of-concept trial demonstrated the feasibility of a rapidly implemented model of healthcare delivery through remote monitoring during a pandemic at a hotel, acting as an extension to a healthcare trust. Benefits included reduced viral exposure to healthcare staff, with recognition of clinical deterioration through ambulatory, continuous, remote monitoring using a discrete wearable sensor.ConclusionRemote monitoring systems can be applied to hotels to deliver healthcare safely in individuals suspected of COVID-19. Further work is required to evaluate this model on a larger scale.Trial registrationClinical trials registration information: ClinicalTrials.gov Identifier: NCT04337489 (07/04/2020).
Highlights
Remote monitoring systems can be applied to hotels to deliver healthcare safely in individuals suspected of COVID-19
The rate of clinical deterioration for individuals suffering from COVID-19 remains unknown; given that widespread vaccine deployment remains imminently unforeseeable, novel strategies are required in approaching this pandemic
Returning travellers into London airports or healthcare staff who were suspected of having COVID-19 and were unable to isolate, were recruited into hotels for isolation, and eligible for the study
Summary
Vital sign trends are routinely used to monitor patients with changes in these parameters preceding an adverse event. Wearable sensors can measure vital signs continuously and remotely, outside of hospital facilities, recognising early clinical deterioration. The outbreak of SARS-CoV-2 (COVID-19), declared a pandemic by the World Health Organisation (WHO) and a growing global health problem, has stretched resources, creating pressures within the National Health Service (NHS) with implications for patient safety [1]. Vital signs trends (heart rate, respiratory rate, blood pressure, temperature, oxygen saturations) are routinely used for monitoring hospital patients [3]. Clinical deterioration may be recognised through changes in these parameters, with prodromal changes preceding an adverse event [4, 5].
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