A single-center experience in home management of mild and moderate COVID-19 cases

INTRODUCTION: The use of telemedicine for treatment of coronavirus disease 2019 (COVID-19) infection has been effective in lowering the risk of infection and relieving strain on the healthcare system. This study aimed to describe the clinical characteristics of COVID-19 cases, their follow-up, risk factors of disease severity, and predictors of hospital admission while using telemedicine. METHODOLOGY: The study included 611 Egyptian patients with mild and moderate COVID-19 disease. The patients were isolated at home and monitored daily. RESULTS: Based on the World Health Organization classification, 79% of studied patients had mild illness while 20.5% had moderate illness. The initial symptoms included cough (51.7%), fever (50.8%), fatigue (45.9%), sore throat (41.1%), dyspnea (35.2%), and headache (34%); 25.2% patients had prolonged symptoms (≥ 21 days). Dyspnea was the most frequent (15.5%) long-term symptom. Age, co-existing diabetes, and COVID-19 infection with moderate severity, were associated with the need for hospitalization. We compared patients with COVID-19 infection who required hospital admission (n = 37) versus patients who continued in home isolation (n = 574). High neutrophil/lymphocyte ratio, transaminases, and ferritin significantly correlated with the need for hospitalization. 18.9% of the patients who required hospital admission had diabetes. Multivariate analysis described age and diabetes as independent predictors of disease severity. Age and high neutrophil/lymphocyte ratio were independent predictors of hospital admission. CONCLUSIONS: Telemedicine is effective in-home management of mild/moderate COVID-19 patients, which may ease the pressure on the healthcare system, even beyond the pandemic.