A remote care model for patients at high risk of hospital admission due to COVID-19 deterioration : who makes it at home? - a multicenter follow-up case from Slovenia

Mihevc, Matic (avtor), Podgoršek, Diana (avtor), Gajšek, Jakob (avtor), Mikuletič, Samanta (avtor), Homar, Vesna (avtor), Kolšek, Marko (avtor), Petek Šter, Marija (avtor)

Aim: To assess the feasibility of a remote care model for high-risk COVID-19 patients, identify risk factors for hospital admission, and propose modifications to the tested model. Methods: We conducted a multicenter observational study of 225 patients (55.1% male) treated at three primary care centers between October 2020 and February 2022. Patients were enrolled into a telemonitoring program if they had a mild-moderate course of COVID-19 confirmed by polymerase chain reaction testing and were classified as high-risk for COVID-19 deterioration. Patients measured their vital signs three times daily, consulted their primary care physician every other day, and were followed up for 14 days. At inclusion, data were collected with a semi-structured questionnaire, and blood was drawn for laboratory analysis. A multivariable Cox regression model was used to determine predictors of hospital admission. Results: The median age was 62 years (range 24-94). The hospital admission rate was 24.4%, and the mean time from inclusion to hospital admission was 2.7±2.9 days. A total of 90.9% of patients were hospitalized within the first five days. A Cox regression model, adjusted for age, sex, and the presence of hypertension, revealed that the main predictors of hospital admission were type-2 diabetes (hazard ratio [HR] 2.38, 95% confidence interval [CI] 1.19-4.77, P=0.015) and thrombocytopenia (HR 2.46, 95% CI 1.33-4.53, P=0.004). Conclusion: Telemonitoring of vital signs is a feasible method of remote care that helps identify patients requiring immediate hospital admission. For further scale-up, we suggest shortening call intervals in the first five days, when the risk of hospital admission is highest, and giving special attention to patients with type-2 diabetes and thrombocytopenia at inclusion.

• Jezik: Angleški jezik
• Ključne besede: COVID-19, epidemiology, follow-up studies
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2023
• Št. strani: Str. 170-178
• Številčenje: Vol. 64, iss. 3
• PID: 20.500.12556/RUL-183066
• UDK: 614
• ISSN pri članku: 0353-9504
• DOI: 10.3325/cmj.2023.64.170
• COBISS.SI-ID: 157562371
• Datum objave v RUL: 03.06.2026

Gradivo je del revije

• Naslov: Croatian medical journal
• Skrajšan naslov: Croat. med. j.
• Založnik: University of Zagreb Medical School
• ISSN: 0353-9504
• COBISS.SI-ID: 33135360

Licence

• Licenca: CC BY-NC-ND 4.0, Creative Commons Priznanje avtorstva-Nekomercialno-Brez predelav 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by-nc-nd/4.0/deed.sl
• Opis: Najbolj omejujoča licenca Creative Commons. Uporabniki lahko prenesejo in delijo delo v nekomercialne namene in ga ne smejo uporabiti za nobene druge namene.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: COVID-19, epidemiologija, nadaljnje študije