Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 4, 2020
Date Accepted: Sep 19, 2020
Date Submitted to PubMed: Sep 22, 2020
Digital and Remote Care among 71,619 Individuals Seeking COVID-19 Health Information and Services: A Retrospective Cohort Study
ABSTRACT
Background:
Patient-facing digital-health tools have been promoted for managing COVID-19 related concerns, and for remote and self-care during the COVID-19 pandemic. It has also been suggested these tools may help further our understanding of the clinical characteristics of this new disease. However, there is limited information on the characteristics and patterns of use of these tools in practice.
Objective:
To describe the characteristics of people using digital-health tools for COVID-19, explore self-reported symptoms and characterize those associated with COVID-19, and characterize the recommendations provided by digital-health tools.
Methods:
This study used data from three digital health tools on the K-health app: a protocol based COVID-19 self-assessment, an AI-driven symptom checker, and communication with remote physicians. Deidentified data were extracted on demographic and clinical characteristics of adults seeking COVID-19 related health information between April 8th and June 20th, 2020. Analyses included exploring features associated with COVID-19 positivity, and features associated with the use of choosing to communicate with a remote physician.
Results:
During the period assessed, 71,619 individuals completed the COVID-19 self-assessment, 41,425 also used the AI-driven symptom checker, and 2,485 consulted with remote physicians. Individuals using the COVID-19 self-assessment were predominantly female (72.4%), with a mean age of 34.5 (±13.9) years. Testing for COVID-19 was reported by 2,901 users, of whom 433 (14.9%) reported testing positive. COVID-19 positive users were more likely to have reported loss of smell or taste (RR 6.66, 95% CI 5.53-7.94) and other established COVID-19 symptoms, as well as ocular symptoms. Users communicating with a remote physician were more likely to have been recommended to refer to immediate medical evaluation by the self-assessment due to the presence of severe symptoms (RR 1.19, 95% CI 1.02-1.32). Most consultations with remote physicians (76.9%) were resolved without need for referral to an in-person visit or to the emergency room.
Conclusions:
These results suggest that digital-health tools can help support remote- and self-management of COVID-19, and that self-reported symptoms from digital interactions can extend our understanding of symptoms associated with COVID-19.
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