Telemonitoring and Care Program for Left Ventricular Assist Device Patients during COVID-19 Outbreak: Results from a European Experience.

Mariani, Silvia; Schöde, Alexandra; Homann, Katharina; Feueriegel, Silke; Nöth, Sandra; Warnke, Katharina; Bounader, Karl; Andreeva, Alexandra; Li, Tong; Dogan, Günes; Haverich, Axel; Schmitto, Jan D

Coronavirus disease 2019 (COVID-19) radically modified the organization of healthcare systems with shut-down of routine activities and outpatient clinics. Herein, we report our institutional experience with a Telemonitoring and Care Program (TC-Program) to monitor and support LVAD patients during COVID-19 outbreak. This single-arm cohort study analysed 156 patients who entered the TC-Program at our institution between April and August 2020. The TC-Program was based on routine phone calls to patients and a 24/7 emergency line. In November 2020, patients were asked for feedback on the TC-Program and checked for survival, transplant or explant. The primary endpoint was the rate of TC-Program-driven interventions. Patients (males: 82.8%) were 61 years old (IQR:53.0-67.5) and on LVAD support for 1266 days (IQR:475-2211). Patients were included in the TC-Program for a median time of 99 days (min:15, max:120) and received a median number of 6 phone calls (min:1, max:14). 23 patients (14.7%) were referred for clinical evaluation after phone contact. Two patients (1.27%) were diagnosed with COVID-19: one of them died after intensive care, and one remained paucisymptomatic and recovered. Three patients asked to exit the program considering it not useful while the others gave high rates in terms of usefulness (median: 9, IQR: 8-10), information (median: 9, IQR: 8-10), good medical care (median: 9, IQR: 8-10) and psychological support (median: 8, IQR: 7-10). A TC-Program based on the four ICSA principles (Inform, Care, Support, and Adapt) is feasible in LVAD patients and can be rapidly implemented during the COVID-19 pandemic.