An emergency system for monitoring pulse oximetry, peak expiratory flow, and body temperature of patients with COVID-19 at home: Development and preliminary application

  1. Leonardo Pereira Motta
  2. Pedro Paulo Ferreira da Silva
  3. Bruno Max Borguezan
  4. Jorge Luis Machado do Amaral
  5. Lucimar Gonçalves Milagres
  6. Márcio Neves Bóia
  7. Marcos Rochedo Ferraz
  8. Roberto Mogami
  9. Rodolfo Acatauassú Nunes
  10. Pedro Lopes de Melo

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Abstract

COVID-19 is characterized by a rapid change in the patient’s condition, with major changes occurring over a few days. We aimed to develop and evaluate an emergency system for monitoring patients with COVID-19, which may be useful in hospitals where more severe patients stay in their homes.

Methodology/Principal findings

The system consists of the home-based patient unit, which is set up around the patient and the hospital unit, which enables the medical staff to telemonitor the patient’s condition and help to send medical recommendations. The home unit allows the data transmission from the patient to the hospital, which is performed using a cell phone application. The hospital unit includes a virtual instrument developed in LabVIEW ® environment that can provide a real-time monitoring of the oxygen saturation (SpO 2 ), beats per minute (BPM), body temperature (BT), and peak expiratory flow (PEF). Abnormal events may be fast and automatically identified. After the design details are described, the system is validated by a 30-day home monitoring study in 12 controls and 12 patients with COVID-19 presenting asymptomatic to mild disease. Patients presented reduced SpO 2 (p<0.0001) and increased BPM values (p<0.0001). Three patients (25%) presented PEF values between 50 and 80% of the predicted. Three of the 12 monitored patients presented events of desaturation (SpO 2 <92%). The experimental results were in close agreement with the involved pathophysiology, providing clear evidence that the proposed system can be a useful tool for the remote monitoring of patients with COVID-19.

Conclusions

An emergency system for home monitoring of patients with COVID-19 was developed in the current study. The proposed system allowed us to quickly respond to early abnormalities in these patients. This system may contribute to conserving hospital resources for those most in need while simultaneously enabling early recognition of patients under acute deterioration, requiring urgent assessment.

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  1. Version published to 10.1371/journal.pone.0247635
  2. ScreenIT

    SciScore for 10.1101/2020.12.11.20247650: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The Research Ethics Committee of the Pedro Ernesto University Hospital (HUPE) approved the study that obeys the Declaration of Helsinki.
    Consent: The written post-informed consent of all volunteers was obtained before inclusion in the study.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Graphs were elaborated using MedCalc 13.1, and the results are present as the median and interquartile range.
    MedCalc
    suggested: (MedCalc, RRID:SCR_015044)

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Thus, it may be speculated that this reduction may introduce a limitation of the expiratory flow influencing the values obtained in peak-flow measurements. This processes would be similar to that observed in restrictive diseases in which the volumes exhaled are reduced [32]. These effects may explain, at least in part, the decrease in PEF presented in three of the studied patients, as well as the transient values below 50% of the predicted values observed in two patients, as described in Figure 9A. It is noteworthy that one of the patients who had EPF <50% also had desaturation <92%. There is general agreement in the literature that, given the severity of the ongoing global pandemic, the ability to remotely monitor patients who do not require hospitalization is essential for optimal utilization of health care resources [23]. To contribute in this direction, this study presents a low-cost open-architecture emergency system for remote monitoring of patients with COVID-19. There are currently no data to guide the use of home pulse oximetry in COVID-19 patients or its validity in identifying disease progression [23]. There is also a paucity of data on temperature management for COVID-19. No previous study has investigated the use of EFP in COVID-19. The system presented in this study may help to quickly accumulate data on SpO2, body temperature and EPF, contributing to the development of the guidelines for these clinical practices. Remote monitoring systems has been increasingly ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.12.11.20247650v1 on medRxiv