Continuous monitoring in COVID-19 care; a retrospective study in time of crisis

de Ree, Roy; Willemsen, Jorn; te Grotenhuis, Gilbert; de Ree, Rick; Kolkert, Joé; Peppelman, Malou

BACKGROUND: A new monitoring system was implemented to support nursing staff and physicians on the COVID-19 ward. This system was designed to remotely monitor vital signs, to calculate an automated Early Warning Score (aEWS) and to help identify patients at risk of deterioration. METHODS: Hospitalized patients who tested positive for SARS-CoV-2 were connected to two wireless sensors measuring vital signs. Patients were divided into two groups based on the occurrence of adverse events during hospitalization. Heart and respiratory rate were monitored continuously and an automated EWS was calculated every 5 minutes. Data were compared between groups. RESULTS: Prior to the occurrence of adverse events, significantly higher median heart and respiration rate and significantly lower median SPO2 values were observed. Mean and median automated EWS were significantly higher in patients with an adverse event. CONCLUSION: Continuous monitoring systems might help to detect clinical deterioration in COVID-19 patients at an earlier stage. LAY SUMMARY: A new monitoring system was implemented to support nursing staff and physicians on the COVID-19 ward. This system was designed to remotely monitor vital signs, like respiratory rate, heart rate and the oxygen level in the blood. These parameters were used to calculate an automated early warning score which helps to identify patients at risk of deterioration. Hospitalized patients who tested positive for SARS-CoV-2 were connected to two wireless sensors. Heart and respiratory rate were monitored continuously and an automated EWS was calculated every 5 minutes. Data were compared between patients at the COVID-19 ward and patients who were transported to the ICU or died. COVID patients at the ICU or those who died had significantly higher median heart and respiration rate and significantly lower median oxygen levels. These findings showed that continuous monitoring systems might help to detect clinical deterioration in COVID-19 patients at an earlier stage.