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Research

A virtual care program for outpatients diagnosed with COVID-19: a feasibility study

Philip W. Lam, Prateek Sehgal, Nisha Andany, Samira Mubareka, Andrew E. Simor, Omar Ozaldin, Jerome A. Leis, Nick Daneman and Adrienne K. Chan
May 23, 2020 8 (2) E407-E413; DOI: https://doi.org/10.9778/cmajo.20200069
Philip W. Lam
Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont
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Prateek Sehgal
Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont
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Nisha Andany
Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont
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Samira Mubareka
Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont
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Andrew E. Simor
Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont
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Omar Ozaldin
Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont
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Jerome A. Leis
Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont
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Nick Daneman
Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont
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Adrienne K. Chan
Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont
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  • Figure 1:
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    Figure 1:

    Coronavirus disease 2019 (COVID-19) Expansion to Outpatients program process map for the management of new cases of COVID-19 in outpatients who are in self-isolation.

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    Figure 2:

    Case count for the 50 outpatients diagnosed with coronavirus disease 2019 (COVID-19) assessed through the COVID-19 Expansion to Outpatients program, stratified by travel history.

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    Figure 3:

    Care trajectory for the 50 outpatients diagnosed with coronavirus disease 2019 (COVID-19) assessed through the COVID-19 Expansion to Outpatients (COVIDEO) program up until Apr. 2, 2020. Dark blue bars that extend to Apr. 1 reflect patients who were still being followed actively by the COVIDEO program at the time of data collection. One patient (row 10) was admitted to hospital during the initial presentation and then discharged home before the diagnosis of COVID-19 was confirmed. Note: day of final COVIDEO assessment = discontinuation of further follow-up.

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    Table 1:

    Characteristics of the first 50 outpatients diagnosed with COVID-19 managed with the COVID-19 Expansion to Outpatients virtual care program

    CharacteristicNo. (%) of patients*
    Demographic
    Age, yr, median (IQR)44 (30.5–59.5)
    Male sex33 (66)
    Days from symptom onset to health care assessment, median (IQR)3 (1.5–5.0)
    Travel within 14 d of symptom onset†26 (52)
    Austria3
    Canada (within country)2
    Cayman Islands1
    Colombia1
    Dominican Republic1
    Egypt2
    England1
    Germany1
    Iran3
    Japan1
    Peru2
    Switzerland1
    United Arab Emirates2
    United States10
    Health care worker17 (34)
    Community acquisition9
    Travel within 14 d of symptom onset8
    Comorbidities
    Asthma3 (6)
    Cardiac disease1 (2)
    Chronic hematologic disease2 (4)
    Chronic kidney disease2 (4)
    Chronic lung disease1 (2)
    Chronic neurologic disease1 (2)
    Diabetes3 (6)
    HIV infection0 (0)
    Hypertension11 (22)
    Malignant disease5 (10)
    Malnutrition0 (0)
    Moderate to severe liver disease0 (0)
    Obesity1 (2)
    Rheumatic disorder1 (2)
    Smoking5 (10)
    Presenting symptoms
    Abdominal pain8 (16)
    Adenopathy0 (0)
    Anorexia21 (42)
    Arthralgia5 (10)
    Chest pain7 (14)
    Chills/rigors18 (36)
    Confusion1 (2)
    Conjunctivitis3 (6)
    Cough34 (68)
    Depression and anxiety9 (18)
    Diarrhea15 (30)
    Dyspnea10 (20)
    Fatigue/malaise32 (64)
    Fever19 (38)
    Headache22 (44)
    Hemoptysis0 (0)
    Insomnia13 (26)
    Myalgia21 (42)
    Nausea and vomiting10 (20)
    Otalgia5 (10)
    Pharyngitis19 (38)
    Rash0 (0)
    Rhinorrhea13 (26)
    Sputum production16 (32)
    Wheezing2 (4)
    Investigations
    Complete blood count13 (26)
     Leukocyte count × 109/L, median4.9
     Lymphocyte count × 109/L, median0.9
    Chest radiography15 (30)
     Abnormal findings11
     Bilateral infiltrates7
    • Note: COVID-19 = coronavirus disease 2019, IQR = interquartile range.

    • ↵* Except where noted otherwise.

    • ↵† Some patients had travelled to more than 1 country.

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CMAJ Open: 8 (2)
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A virtual care program for outpatients diagnosed with COVID-19: a feasibility study
Philip W. Lam, Prateek Sehgal, Nisha Andany, Samira Mubareka, Andrew E. Simor, Omar Ozaldin, Jerome A. Leis, Nick Daneman, Adrienne K. Chan
Apr 2020, 8 (2) E407-E413; DOI: 10.9778/cmajo.20200069

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A virtual care program for outpatients diagnosed with COVID-19: a feasibility study
Philip W. Lam, Prateek Sehgal, Nisha Andany, Samira Mubareka, Andrew E. Simor, Omar Ozaldin, Jerome A. Leis, Nick Daneman, Adrienne K. Chan
Apr 2020, 8 (2) E407-E413; DOI: 10.9778/cmajo.20200069
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