2 ED Doctors Use App to Track COVID-19 Symptoms, Recovery in Wuhan

An online multidisciplinary management model may aid in the quarantine and recovery of patients with coronavirus disease 2019 (COVID-19), according to a paper published in Telemedicine and e-Health.

Investigators from Wuhan, China studied the usefulness of the online multidisciplinary quarantine observation tool for 2 patients with COVID-19.

The investigators sought to track the recovery of these patients in order to provide a practical management model for quarantine, epidemic prevention, and control. The tool was developed by a team of medical experts from the fields of rehabilitation, psychology, and nursing.

Wuhan was the original center of the coronavirus outbreak and is only recently attempting a return to normalcy.

The study authors described their first case: a 32-year-old male physician in an emergency department without any underlying medical conditions. He had been in contact with patients with confirmed COVID-19 cases and presented with cough and runny nose on January 15^th.

By January 19^th, the patient developed dyspnea, soreness, lack of strength, and fever. He was quarantined at home and ordered to rest and was treated with oral oseltamivir, arbidol, and avelox. On February 20^th and 21^st, the patient’s throat swabs tested negative for COVID-19.

The second patient was a 31-year-old male physician who did not have any underlying medical conditions. Like the first patient, he had been in contact with patients with COVID-19. He developed a fever on January 5^th and a CT scan showed blurry, patchy shadows in the lower right lobe of his lung.

Subsequently, the patient developed chest tightness and dyspnea, and was quarantined in the emergency department for observation. He was admitted to the respiratory department on January 10^th.

By January 14^th, CT scans showed pathological changes which resulted in treatment with mechanical ventilation. On January 16^th, he tested positive for COVID-19 and on the following day was transferred to the intensive care unit.

The patient was eventually transferred to the general quarantine ward after his symptoms began to improve (25 days after onset) and his throat swabs tested negative and he presented no fever for 17 days.

While quarantined, both patients followed strict guidelines from the nursing staff, including ventilating the room at least twice a day, having only a few simple items and a garbage can with a lid in the room, cleaning surfaces with disinfectant at least once daily, washing hands frequently, using separate sets of utensils for eating, washing, and sterilizing, and sterilizing clothes at a high temperature and then washing them separately with laundry detergent, followed by complete drying.

The patients were also told to rest, avoid excessive work, and do pulmonary rehabilitation exercises when they felt able. By measuring their heart rates, the patients were told when they needed to stop doing the exercises in real time, the study authors explained.

The first patient lived by himself. The second patient lived with his family, and had to undergo single-room quarantine.

The patients were also asked to use the online quarantine observation form on their phones daily, where they could “truthfully record” their current symptoms and severity. Their actual conditions, as determined by their medical teams, were also recorded.

“Care for patients [with COVID-19] should be enhanced during quarantine,” the study authors wrote.

The study authors also noted how important a patient’s mentality is for overcoming a disease. The first patient lived alone, but was able to express any negative emotions he may have been feeling by talking by phone or video calls with his family.

Overall, the study authors noted suggested patients with COVID-19 could monitor their conditions closely through their tool under the guidance of their medical observation teams. Their tool “has potential application in our specific quarantine sites and treatment facilities as well as in other countries with severe epidemic,” they concluded.