Letter to the Editor: Virtual Care for Critically Ill Patients with COVID-19

Virtual Care for Critically Ill Patients with COVID-19

In a recent article, Omboni et al. suggested that during the COVID-19 epidemic, Italy was unprepared to manage lockdown patients with chronic diseases due to a limited availability of telemedicine solutions.¹ However, the widespread of infection is associated with a demand to provide adequate care for thousands of hospitalized SARS-CoV-2–infected patients.

SARS-CoV-2 impacted Russia later than Italy and many other countries. The government had time to adopt appropriate measures to mitigate the impact of the emerging outbreak of infection, (i.e., mass testing, contact tracing, mask wearing, self-isolation, and finally a lockdown of the country). Efforts to avoid the worst-case scenario included reprofiling of thousands of hospital beds and rapid construction of new medical facilities for infected patients. More than 110,000 physicians of different specialties and young interns, including those who lacked expertise in treating progressive respiratory failure, joined the battle against COVID-19.

To address a potential lack of skills necessary for effective management of critically ill patients with COVID-19, the Russian Ministry of Health made an investment in telemedicine and set up a Federal Center at the Sechenov University (Moscow) to provide 24/7 virtual support for intensive care unit (ICU) physicians across the country. According to the government’s decision, all local COVID-19 hospitals were proposed to submit medical records of critically ill patients through secure network to the Federal Center giving urgent advice on the antiviral therapy and critical care management. The center is operated by a team of faculty members including 5 senior consultants in critical care, pulmonology, infectious diseases, or internal medicine, 8 critical care physicians, 14 pulmonologists, and 4 medical registrars who provide expert assistance (face-to-face if required) to the local physicians at no cost. Since the beginning of the outbreak, we were performing up to 100–150 remote consultations per day, and their total number has now reached 4,500 (Fig. 1). Medical records were received from the hospitals located in 78 geographic regions of the Russian Federation. Preliminary analysis showed that among the first 987 ICU patients with SARS-CoV-2–induced severe pneumonia, 646 (65.6%) died and 341 (34.5%) recovered.