Early Identification of COVID-19 using Remote Cardiorespiratory Monitoring: Three Case Reports (Preprint)

BACKGROUND The adoption of remote patient monitoring (RPM) into routine medical care requires an increased understanding of how the physiologic changes accompanying disease development and what proactive interventions will improve outcomes. OBJECTIVE We present three case reports which highlight the capability of RPM to allow for early identification of viral infection with COVID-19 in chronic respiratory disease patients. METHODS Patients at a large pulmonary practice were identified who were enrolled in a respiratory RPM program and who had contracted COVID-19. The physiologic data was retrospectively reviewed and three instances were identified where the RPM system had notified clinicians of physiologic deviation due to the viral infection. RESULTS Physiologic deviations from respective patient baselines occurred during infection onset and, despite the infection manifesting differently in each case, had been identified by the RPM system. In one case, the patient was symptomatic, in another the patient was pre-symptomatic, and in the final the patient varied from asymptomatic to mildly symptomatic. CONCLUSIONS RPM systems meant for long-term use and which utilize patient-specific baselines can highlight physiologic changes early in the course of acute disease, such as COVID-19 infection. The cases demonstrate opportunities for earlier diagnosis, treatment, and isolation. This supports the need for further research into how RPM can be effectively integrated into clinical practice. CLINICALTRIAL