ABSTRACT
Remdesivir has been widely used for the treatment of Coronavirus (COVID) in hospitalized patients, but its nephrotoxicity is still under investigation1. Given the paucity of knowledge regarding the mechanism and optimal treatment of the development of acute kidney injury (AKI) in the setting of COVID, we analyzed the role of remdesivir and built multifactorial causal models of COVID-AKI by applying causal discovery machine learning techniques. Risk factors of COVID-AKI and renal function measures were represented in a temporal sequence using longitudinal data from EHR. Our models successfully recreated known causal pathways to changes in renal function and interactions with each other and examined the consistency of high-level causal relationships over a 4-day course of remdesivir. Results indicated a need for assessment of renal function on day 2 and 3 use of remdesivir, while uncovering that remdesivir may pose less risk to AKI than existing conditions of chronic kidney disease.
ABSTRACT
OBJECTIVE: The study sought to evaluate early lessons from a remote patient monitoring engagement and education technology solution for patients with coronavirus disease 2019 (COVID-19) symptoms. MATERIALS AND METHODS: A COVID-19-specific remote patient monitoring solution (GetWell Loop) was offered to patients with COVID-19 symptoms. The program engaged patients and provided educational materials and the opportunity to share concerns. Alerts were resolved through a virtual care workforce of providers and medical students. RESULTS: Between March 18 and April 20, 2020, 2255 of 3701 (60.93%) patients with COVID-19 symptoms enrolled, resulting in over 2303 alerts, 4613 messages, 13 hospital admissions, and 91 emergency room visits. A satisfaction survey was given to 300 patient respondents, 74% of whom would be extremely likely to recommend their doctor. DISCUSSION: This program provided a safe and satisfying experience for patients while minimizing COVID-19 exposure and in-person healthcare utilization. CONCLUSIONS: Remote patient monitoring appears to be an effective approach for managing COVID-19 symptoms at home.