Clinical learnings from a virtual primary care program monitoring mild to moderate COVID-19 patients at home. (19th December 2020)

• Record Type: Journal Article
• Authors: Pimlott, Nicholas; Agarwal, Payal; McCarthy, Lisa M; Luke, Miles J; Hum, Susan; Gill, Sumeet; Heisey, Ruth
• Is Part Of: Family practice. Volume 38:Number 5(2021)
• Page Start: 549
• Page End: 555
• Publication Date: 2020-12-19
• Subjects: COVID-19 -- family practice -- multidisciplinary care -- primary health care -- SARS-CoV-2 -- telemedicine; Primary care (Medicine) -- Periodicals; Clinical medicine -- Periodicals; 616.005
• DOI: 10.1093/fampra/cmaa130
• Languages: English
• ISSNs: 0263-2136

Abstract

Abstract: Background: Virtual consults have replaced in-person visits for many home-isolated patients with COVID-19 disease. Objectives: To describe the natural history, clinical management and outcomes of community-dwelling patients with COVID-19, who received support from a family medicine-led, virtual CovidCare@Home program in Toronto, Ontario, Canada. Methods: Observational, descriptive study conducted by retrospective chart review of 98 patients enrolled during the first 5 weeks of program implementation (8 April–11 May 2020); 73 patients with laboratory-confirmed COVID-19, with symptom onset ≤ 14 days before initial consult were included for analysis. Patients were classified as mild, moderate or severe based on WHO Criteria. Results: All patients in the program experienced mild (88%) or moderate (12.3%) disease. No patients were hospitalized or died. Patients were mainly female (70%); with mean age of 43.3 years. Most patients (82.2%) worked in higher risk, healthcare settings. Almost 40% had no medical co-morbidities. Common symptoms were cough (65.8%), fatigue (60.3%), headache (42.5%) and myalgia (39.7%), followed by fever (32.9%), sore throat (21.9%), nasal congestion (21.9%) and rhinorrhea (20.5%). Headache (51%) and anosmia (45.1%) were common among females; fever and breathlessness among males (40.9%). Nine patients (12.3%) experienced worsening of symptoms (mainly respiratory) or exacerbation of co-morbidities, which required care outside the virtual service. Conclusion: Patients with mild to moderate COVID-19 disease can be managed safely and effectively in a family medicine-led virtual program. Some sex differences in symptoms were observed. Future work should focus on long-term follow up in view of the existence of so-called 'long-haulers'.