Microscopie électronique d’une cellule infectée par le SARS-CoV-2 © Philippe Roingeard, Anne Bull-Maurer, Sonia Georgeault, unité Inserm U1259 MAVIVH & Université de Tours, France
Teams from AP-HP, Sorbonne University and Inserm at the Pierre Louis Institute of Epidemiology and Public Health, coordinated by Dr Youri Yordanov and Prof. Agnès Dechartres, assessed the clinical characteristics, fate and factors associated with hospitalization or death of ambulatory patients followed using the COVIDOM device.
This study, promoted by the AP-HP, and funded by the Fondation de France, the AP-HP Foundation, EIT-Health and a national PHRC (COVID 2020) was the subject of a publication on April 26, 2021 , in the journal Clinical Microbiology and Infection (CMI) .
COVIDOM is a home medical telemonitoring solution for patients with or suspected of Covid-19, co-built by AP-HP, Nouveal e-santé and URPS Ile-de-France, under the direction of Pr Patrick Jourdain (AP-HP, Université Paris-Saclay) medical director of COVIDOM.
Studies of COVID-19 infections have mainly focused on hospital patients or those with a severe form of the infection. To carry out the work that is currently the subject of a publication, researchers set up in March 2020 a prospective cohort of outpatients with mild or moderate COVID-19, monitored remotely using the solution of COVIDOM remote monitoring.
From March to August 2020, more than 43,000 patients were included in the cohort. The average age was 43; 93% of the patients were under 65 years of age and almost 62% were women. For almost 70% of patients, data on comorbidities and symptoms were available. The main comorbidities reported by the patients were asthma (13%), hypertension (12%) and diabetes (5%).
A small proportion (4%) of patients included in the COVIDOM cohort presented clinical worsening (hospitalization or death). The hospitalization rate was 4% and the death rate 0.1%. Factors associated with clinical worsening were: male gender, age, obesity and co-morbidities such as chronic renal failure or cancer under treatment. The likelihood of worsening was reduced with anosmia / ageusia.
The work carried out shows that clinical worsening was rare in ambulatory patients with a mild or moderate form of COVID-19, monitored remotely using the COVIDOM monitoring solution. Gender, age, and comorbidities such as chronic renal failure, active cancer, or obesity were independently associated with clinical worsening. However, more research is needed to confirm this assessment as it can be considered that this cohort included younger and healthier patients than in the general population.
Clinical characteristics and factors associated with hospital admission or death in 43,103 adult outpatients with COVID-19 managed with the Covidom telesurveillance solution : a prospective cohort study
Youri Yordanov, Aurélien Dinh, Alexandre Bleibtreu, Arthur Mensch, François-Xavier Lescure, Erwan Debuc, Patrick Jourdain, Luc Jaulmes, Agnes Dechartres – On behalf of the AP-HP/Universities/Inserm COVID-19 research collaboration.
Clinical Microbiology and Infection.