COVIDApp as an Innovative Strategy for the Management and Follow-Up of COVID-19 Cases in Long-Term Care Facilities in Catalonia: Implementation Study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

The coronavirus disease (COVID-19) pandemic has caused an unprecedented worldwide public health crisis that requires new management approaches. COVIDApp is a mobile app that was adapted for the management of institutionalized individuals in long-term care facilities.

Objective

The aim of this paper is to report the implementation of this innovative tool for the management of long-term care facility residents as a high-risk population, specifically for early identification and self-isolation of suspected cases, remote monitoring of mild cases, and real-time monitoring of the progression of the infection.

Methods

COVIDApp was implemented in 196 care centers in collaboration with 64 primary care teams. The following parameters of COVID-19 were reported daily: signs/symptoms; diagnosis by reverse transcriptase–polymerase chain reaction; absence of symptoms for ≥14 days; total deaths; and number of health care workers isolated with suspected COVID-19. The number of at-risk centers was also described.

Results

Data were recorded from 10,347 institutionalized individuals and up to 4000 health care workers between April 1 and 30, 2020. A rapid increase in suspected cases was seen until day 6 but decreased during the last two weeks (from 1084 to 282 cases). The number of confirmed cases increased from 419 (day 6) to 1293 (day 22) and remained stable during the last week. Of the 10,347 institutionalized individuals, 5,090 (49,2%) remained asymptomatic for ≥14 days. A total of 854/10,347 deaths (8.3%) were reported; 383 of these deaths (44.8%) were suspected/confirmed cases. The number of isolated health care workers remained high over the 30 days, while the number of suspected cases decreased during the last 2 weeks. The number of high-risk long-term care facilities decreased from 19/196 (9.5%) to 3/196 (1.5%).

Conclusions

COVIDApp can help clinicians rapidly detect and remotely monitor suspected and confirmed cases of COVID-19 among institutionalized individuals, thus limiting the risk of spreading the virus. The platform shows the progression of infection in real time and can aid in designing new monitoring strategies.

Related collections

Most cited references 19

Record: found
Abstract: found
Article: found

Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy

Graziano Onder, Giovanni Rezza, Silvio Brusaferro (2020)

0 comments Cited 2019 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle

Hongzhou Lu, Charles W. Stratton, Yi-Wei Tang (2020)

Since December 2019, a total of 41 cases of pneumonia of unknown etiology have been confirmed in Wuhan city, Hubei Province, China. Wuhan city is a major transportation hub with a population of more than 11 million people. Most of the patients visited a local fish and wild animal market last month. At a national press conference held today, Dr Jianguo Xu, an academician of the Chinese Academy of Engineering, who led a scientific team announced that a new‐type coronavirus, tentatively named by World Health Organization as the 2019‐new coronavirus (2019‐nCoV), had caused this outbreak. 1 The 2019‐nCoV has a different coronavirus‐specific nucleic acid sequence from known human coronavirus species, which are similar to some of the beta coronaviruses identified in bats. 2 , 3 The virus‐specific nucleic acid sequences were detected in lung fluid, blood and throat swab samples in 15 patients and the virus that was isolated showed a typical coronavirus appearance under electron microscopy. Further research will be conducted to better understand the new coronavirus to develop antiviral agents and vaccines. 4 We applauded the excellent job that has been done so far. The infection was first described in December. Within 9 days, a special team consisted of physicians, scientists and epidemiologists who ruled out several extremely contagious pathogens including SARS, which killed hundreds of people more than a decade ago, and MERS. This has surely alleviated environmental concerns as Hong Kong authorities had quickly stepped up the disinfection of trains and airplanes and checks of passengers due to this outbreak. Most of the patients visited the fish and wild animal market last month in Wuhan. This fish and wild animal market also sold live animals such as poultry, bats, marmots, and snakes. All patients received prompt supportive treatment in quarantine. Among them, seven patients were in serious condition and one patient died. All of the 42 patients so far confirmed were from China except one Thailand patient who was a traveler from Wuhan. Eight patients have been cured of the disease and were discharged from the hospital last week. The 2019‐nCoV now have been isolated from multiple patients and appears to be the culprit. But the mystery has not been completely solved yet. Until there is a formal published scientific manuscript, the facts can be argued, particularly regarding causality despite these facts having been officially announced. The data collected so far is not enough to confirm the causal relationship between the new‐type coronavirus and the respiratory disease based on classical Koch's postulates or modified ones as suggested by Fredricks and Relman. 5 The viral‐specific nucleic acids were only discovered in 15 patients, and successful virus culture was extremely limited to only a few patients. There remains considerable work to be done to differentiate between colonization, shedding, and infection. Additional strains of the 2019‐nCoV need to be isolated to study their homologies. It is expected that antigens and monoclonal antibodies will be developed so serology can be used to confirm previous and acute infection status. The episode demonstrates further the need for rapid and accurate detection and identification methods that can be used in the local hospitals and clinics bearing the burden of identifying and treating patients. Recently, the Clinical Laboratory Improvement Amendments (CLIA) of 1988 has waived highly sensitive and specific molecular devices known as CLIA‐waived devices so that these devices are gradually becoming available for point of care testing. Finally, the epidemiological similarity between this outbreak and that of SARS in 2002‐2003 6 is striking. SARS was then traced to animal markets 7 and eventually to palm civets. 8 Later bats were identified as animal reservoirs. 9 Could this novel coronavirus be originated from wild animals? The family Coronaviridae includes two subfamilies. 10 One, the subfamily Coronavirinae, contains a substantial number of pathogens of mammals that individually cause a remarkable variety of diseases, including pneumonia. In humans, coronaviruses are among the spectrum of viruses that cause the common cold as well as more severe respiratory disease—specifically SARS and MERS, which are both zoonoses. The second subfamily, Torovirinae, contains pathogens of both terrestrial and aquatic animals. The genus Torovirus includes the type species, equine torovirus (Berne virus), which was first isolated from a horse with diarrhea, and the Breda virus, which was first isolated from neonatal calves with diarrhea. White bream virus from fish is the type species of the genus Bafinivirus. However, there is no evidence so far that the seafood from the fish and animal market caused 2019‐nCoV‐associated pneumonia. This epidemiologic similarity clearly provides a starting point for the further investigation of this outbreak. In the meantime, this fish and animal market has been closed until the epidemiological work determines the animal host of this novel coronavirus. Only then will the miracle be complete.

0 comments Cited 1386 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Virtually Perfect? Telemedicine for Covid-19

Judd Hollander, Brendan Carr (2020)

0 comments Cited 1330 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Patricia Echeverría: On behalf of : COVIDApp Group

ORCID: https://orcid.org/0000-0003-2755-3695

Infectious Diseases DepartmentHospital Universitari Germans Trias i PujolCarretera de Canyet s/nBadalonaSpain34 934978887 ext 3417pecheverria@flsida.org

Journal

Journal ID (nlm-ta): JMIR Public Health Surveill

Journal ID (iso-abbrev): JMIR Public Health Surveill

Journal ID (publisher-id): JPH

Title: JMIR Public Health and Surveillance

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2369-2960

Publication date Collection: Jul-Sep 2020

Publication date (Electronic): 17 July 2020

Publication date PMC-release: 17 July 2020

Volume: 6

Issue: 3

Electronic Location Identifier: e21163

Affiliations

[1 ] Infectious Diseases Department Hospital Universitari Germans Trias i Pujol Badalona Spain

[2 ] Lluita contra la Sida Foundation Hospital Universitari Germans Trias i Pujol Badalona Spain

[3 ] Direcció Clínica Territorial Metropolitana Nord Institut Català de la Salut Barcelona Spain

[4 ] Servei d'Atenció Primària Vallès Occidental Direcció Atenció Primària Metropolitana Nord Institut Català de la Salut Barcelona Spain

[5 ] Servei d'Atenció Primària Barcelonès Nord Maresme Direcció Atenció Primària Metropolitana Nord Institut Català de la Salut Barcelona Spain

[6 ] Servei d'Atenció Primària Vallès Oriental Direcció Atenció Primària Metropolitana Nord Institut Català de la Salut Barcelona Spain

[7 ] Direcció Atenció Primària Metropolitana Nord Institut Català de la Salut Barcelona Spain

[8 ] Lluita contra la Sida Foundation Digital Health Department Doole Health S.L. Badalona Spain

[9 ] AIDS Research Institute-IRSICAIXA Hospital Universitari Germans Trias i Pujol Universitat Autònoma de Barcelona Barcelona Spain

[10 ] Centre for Health and Social Care Research (CESS) Faculty of Medicine University of Vic - Central University of Catalonia Barcelona Spain

Author notes

Corresponding Author: Patricia Echeverría pecheverria@ 123456flsida.org

Author information

Patricia Echeverría https://orcid.org/0000-0003-2755-3695

Miquel Angel Mas Bergas https://orcid.org/0000-0003-3232-7182

Jordi Puig https://orcid.org/0000-0002-4075-0346

Mar Isnard https://orcid.org/0000-0001-6297-8520

Mireia Massot https://orcid.org/0000-0003-3649-5167

Cristina Vedia https://orcid.org/0000-0003-4192-3779

Ricardo Peiró https://orcid.org/0000-0003-1429-7805

Yolanda Ordorica https://orcid.org/0000-0003-0916-4629

Sara Pablo https://orcid.org/0000-0002-2001-6670

María Ulldemolins https://orcid.org/0000-0002-6623-6302

Mercé Iruela https://orcid.org/0000-0003-3758-9464

Dolors Balart https://orcid.org/0000-0003-4852-827X

José María Ruiz https://orcid.org/0000-0002-6550-5785

Jordi Herms https://orcid.org/0000-0002-5261-187X

Bonaventura Clotet Sala https://orcid.org/0000-0003-3232-4598

Eugenia Negredo https://orcid.org/0000-0001-5298-1734

Article

Publisher ID: v6i3e21163

DOI: 10.2196/21163

PMC ID: 7373378

PubMed ID: 32629425

SO-VID: 51d9958e-53ab-452c-ba38-755c93f2b9e9

Copyright © ©Patricia Echeverría, Miquel Angel Mas Bergas, Jordi Puig, Mar Isnard, Mireia Massot, Cristina Vedia, Ricardo Peiró, Yolanda Ordorica, Sara Pablo, María Ulldemolins, Mercé Iruela, Dolors Balart, José María Ruiz, Jordi Herms, Bonaventura Clotet Sala, Eugenia Negredo. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 17.07.2020.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license information must be included.

History

Date received : 7 June 2020

Date revision requested : 15 June 2020

Date revision received : 26 June 2020

Date accepted : 6 July 2020

Comments

Comment on this article

scite_

Cited by 20

See all cited by

Most referenced authors 278

See all reference authors

Submit your digital health research with an established publisher
- celebrating 25 years of open access