PhD Scientific Days 2021

Budapest, 7-8 July 2021

CL_IV_L: Clinical Medicine IV. Lectures

Peripheral Pulse Wave Changes in a COVID-19 Patient by an Innovative Remote Daily Monitoring System - a Case Study

Flóra Antali 1,2, Dániel Kulin 1,2 , Zsuzsanna Miklós 1, Sándor Kulin 2 , Ildikó J. Dobrán 3
1. Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Tűzoltó u. 37–47., Hungary - the main affiliation address
2. E-Med4All Europe Ltd., 1036 Budapest, Bécsi út 85/B, Hungary
3. Rehabilitation Centre, 81739 Munich, Carl-Wery-Str. 26., Germany

Text of the abstract

Introduction
In the COVID-19 pandemic, it is desirable to remotely screen a wide population, especially the high-risk groups in order to control the vital parameters of the infected patients in the acute phase and during rehabilitation. SARS-CoV-2 infection has been shown to affect various organs including the cardiovascular (CV) system. Regular monitoring of CV functions may supplement the arterial oxygen saturation measurements of the infected patients.
Aims
The aim of this case presentation is twofold. One is to introduce an innovative methodology with which the peripheral pulsewave signal of any given patient can be collected easily from the patient’s home. The other is to provide deeper insight into the cardiovascular changes recorded by the given telemedicine system.
Method
The patient was monitored with SCN4ALL system on a daily basis before, during and after SARS-CoV-2 infection. The SCN4ALL telemedicine system detects the digital volume pulse with a transmission pulse oximeter, which communicates with a mobile application. The app transmits the data to a cloud-based automated algorithm that calculates various pulse contour and PRV parameters and displays them on a medical website.
We analyzed the changes of different pulsewave and pulse rate variability (PRV) parameters before and over the course of the infection.
Results
During the acute phase of the infection the mean heart rate increased. Among the pulse contour parameters, arterial stiffness index increased, whereas the corrected ventricular ejection time values decreased. However, SpO2 values ​​remained in the normal range, so there was no systemic hypoxia. Concerning the PRV parameters, a substantial decrease could be observed in „Total Power”, in „rMSSD”, „HF” and in „LF” values. All of the parameters returned to their baseline averages after the acute phase of the infection.

Conclusion
This case shows that parameters derived from the PPG signal with a remote patient monitor system might be useful indicators of the disease progression of SARS-CoV-2 infection, as it is a simple and non-invasive method for studying and monitoring changes in the peripheral pulse-wave morphology.
Funding
This case report was funded by E-Med4All Europe Ltd.
Dr. F. Antali and Dr. D. Kulin received support from the EFOP-3.6.3-VEKOP-16-2017-00009 project during their current semester within their PhD studies.

University and Doctoral School

Semmelweis University, Doctoral School of Theoretical and Translational Medicine