Background: Telemetry is widely used in hospitalized settings for the detection of cardiac arrhythmias. Our hospital uses an electronic telemetry to curb unnecessary telemetry use. The AHA has identified the utility of telemetry in non-cardiac conditions as an area of future research. We studied the telemetry ordering patterns of patients admitted with diagnosis of COVID-19 to our hospital during one of the peak periods of the pandemic.
Methods: All patients admitted to Emory University Hospital Midtown with telemetry ordered in July 2020 and a diagnosis of COVID-19 were included. Data was obtained from the Data Warehouse and chart reviews were performed.
Results: There were a total of 161 patient encounters included in the study. Average length of telemetry and hospital LOS were found to be 3.08 days and 9.96 days, respectively. Of the 36-hour indications, 30% had “COVID-19” written in by the provider as the reason for ordering telemetry. 46.4% had elevated troponin-I level (defined as >0.04 ng/ml). In 18% of cases, patients were transferred to ICU and of those, 86% of cases were due to respiratory failure. Telemetry monitoring was not mentioned in the majority of provider documentation. 6.2% rate of death was found during hospital stay.
Conclusions: Of the patients monitored on telemetry with COVID-19 diagnosis, the ones that required escalation of care, defined as transfer to ICU, were due to worsening respiratory failure. Reasons for telemetry monitoring in provider documentation was lacking in majority of cases. The detection of arrhythmia leading to escalation of care occurred in only 1 out of the 161 encounters (< 1%). This observational study suggests that patients admitted with COVID-19 diagnosis to the hospital that are thought to be high risk for clinical decompensation would benefit from continuous pulse oximetry monitoring rather than cardiac telemetry for the detection of arrhythmias.