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Telemonitoring of Children with COVID-19: Experience Report of the First 100 Cases
Thales Araújo de Oliveira1, Ary Costa Ribeiro2, Felipe Monti Lora1
1Department of Emergency, Sabará Hospital Infantil, São Paulo, Brazil.
Insights
Telemonitoring effectively followed up on children with COVID-19 in Brazil, ensuring continuity of care and reducing unnecessary emergency visits. This approach proved valuable for pediatric COVID-19 management.
Area of Science:
- Pediatric infectious diseases
- Digital health and telemedicine
- Public health policy
Background:
- The first COVID-19 case in Brazil was diagnosed in February 2020, prompting regulatory measures for telemedicine.
- Telemedicine, including telemonitoring, was implemented to manage the pandemic's impact on healthcare services.
- Hospital Sabará initiated telemonitoring to manage pediatric COVID-19 cases not requiring hospitalization.
Purpose of the Study:
- To report the experience and evaluate the applicability of telemonitoring for children diagnosed with COVID-19.
- To assess the effectiveness of telemonitoring in the follow-up of pediatric COVID-19 patients discharged from the emergency department.
Main Methods:
- Retrospective analysis of care records for 100 pediatric COVID-19 patients.
- Initiation of telephone contact for families not completing the telemonitoring protocol.
- Evaluation of patient status, including symptoms and need for re-evaluation.
Main Results:
- The study included 100 children (54% male, average age 5.5 years), with 24% having comorbidities.
- 88% of infections originated from household contacts; initially, 44% were asymptomatic, rising to 81% by the second telemonitoring.
- 70% completed telemonitoring; 14 children returned to the emergency department, with 3 admitted directly due to telemedicine indications.
Conclusions:
- Telemonitoring is a clinically valuable tool for following pediatric COVID-19 patients.
- It ensures continuity of care and identifies patients needing further medical attention, including hospitalization.
- The study highlights telemonitoring's role in optimizing emergency department resource utilization.
Introduction:
The first case of coronavirus disease 2019 (COVID-19) in Brazil was diagnosed in February 2020. On March 20, the Ministry of Health issued Ordinance no. 467, regulating the use of telemedicine during the pandemic period. One of the various modalities of telemedicine is telemonitoring.
Objective:
To report our experience with telemonitoring and evaluate its applicability in the follow-up of the first 100 children who received the diagnosis of COVID-19 after visiting the emergency department of Sabará Hospital Infantil ("Hospital Sabará") and who had no indications for hospitalization.
Methods:
The care records of the children were retrospectively analyzed, and telephone contact with the families of patients who did not complete the proposed telemonitoring protocol was initiated.
Results:
The average age of the children was 5.5 years, and a slight male predominance (54/100) was observed. Comorbidities were present in 24/100. The source of infection was family members living in the same household in 88/100 and other sources in 12/100. In the first telemonitoring, 44% of the evaluated patients were asymptomatic. In the second telemonitoring, 81% of the patients were asymptomatic. Telemonitoring was completed by 70% of the children. A total of 14 children returned to the emergency department, 11 of whom spontaneously (2/11 were admitted) and 3 under the indication of telemedicine (3/3 were admitted).
Conclusions:
Telemonitoring proved to be a clinically valuable resource in the follow-up of children with COVID-19, as it allowed continuity of care and identified patients with indications to return to the emergency department of Hospital Sabará and for hospitalization, thus avoiding unnecessary emergency department visits.
