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An Outpatient Management Strategy Using a Coronataxi Digital Early Warning System Reduces Coronavirus Disease 2019
Adeline Lim1, Theresa Hippchen1, Inga Unger1
1Department of Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany.
Insights
The Coronataxi digital early warning (CDEW) system significantly lowered COVID-19 mortality by 3- to 4-fold. This digital health tool also reduced hospitalization duration, proving effective for managing future pandemics.
Area of Science:
- Digital Health
- Epidemiology
- Public Health
Background:
- The COVID-19 pandemic severely strained healthcare systems globally.
- Effective outpatient management strategies are crucial for saving lives and optimizing resource allocation.
- Preparing for future pandemics necessitates robust healthcare infrastructure and innovative management approaches.
Purpose of the Study:
- To evaluate the effectiveness of the Coronataxi digital early warning (CDEW) system in managing COVID-19 patients in home quarantine.
- To compare mortality and hospitalization rates between patients managed with and without the CDEW system.
- To assess the impact of the CDEW system on hospitalization duration, intensive care, and mechanical ventilation rates.
Main Methods:
- A single-center cohort study was conducted in Rhein-Neckar County and Heidelberg, Germany.
- The CDEW system involved remote digital monitoring via a mobile app and a doctor dashboard for COVID-19 patients in home quarantine.
- Outcomes including mortality, hospitalization, and intensive care utilization were compared between the CDEW cohort (459 patients) and a control group.
Main Results:
- The CDEW cohort exhibited a 3- to 4-fold lower mortality rate (0.65%) compared to the control group (2.16%-2.82%).
- Hospitalization rates were significantly higher in the CDEW cohort (14.81%) versus the control group (6.15%-7.22%), P < .001.
- The median hospitalization duration was significantly lower in the CDEW cohort (6 days) compared to a national sentinel cohort (10 days), P = .002.
Conclusions:
- The CDEW system demonstrated a significant reduction in COVID-19 mortality.
- The digital early warning system effectively decreased the duration of hospitalization for COVID-19 patients.
- The CDEW system shows promise for managing future pandemics and improving outpatient care.
Background:
The coronavirus disease 2019 (COVID-19) pandemic has caused sudden, severe strain to healthcare systems. Better outpatient management is required to save lives, manage resources effectively, and prepare for future pandemics.
Methods:
The Coronataxi digital early warning (CDEW) system deployed in Rhein-Neckar County and Heidelberg, Germany is an outpatient care system consisting of remote digital monitoring via a mobile application, a medical doctor dashboard, and medical care delivery to COVID-19 patients in home quarantine when indicated. Patients reported their symptoms, temperature, breathing rate, oxygen saturation, and pulse via the app. This single-center cohort study compared outcomes of the population with and without using the CDEW system. The primary outcome was mortality; the secondary outcomes were hospitalization, duration of hospitalization, intensive care therapy, and mechanical ventilation.
Results:
Mortality rate was 3- to 4-fold lower and hospitalization rate was higher in the CDEW cohort (459 patients) compared with the cohort without CDEW in the same test area and other regions (Mannheim, Karlsruhe town, Karlsruhe district, and Germany), (mortality rate: 0.65% [95% confidence interval {CI}, .13%-1.90%] versus 2.16%, 2.32%, 2.48%, 2.82% and 2.76%, respectively, P < .05 for all; hospitalization rate: 14.81% [95% CI, 11.69%-18.40%] versus 6.89%, 6.93%, 6.59%, 6.15%, and 7.22%, respectively, P < .001 for all). The median duration of hospitalization in the CDEW cohort was significantly lower compared with a national sentinel cohort (6 days [interquartile range {IQR}, 4-9.75 days] versus 10 days [IQR, 5-19 days]; Z = -3.156; P = .002). A total of 1.96% patients needed intensive care and 1.09% were mechanically ventilated.
Conclusions:
The CDEW system significantly reduced COVID-19 mortality and duration of hospitalization and can be applied to the management of future pandemics.
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