December 11, 2020

Monitoring Covid-19 patients remotely

Doctors at Luigi Sacco University Hospital in Milan are testing a new system that monitors Covid-19 patients’ vital signs remotely using a chest belt initially developed at CSEM for space applications. The hope is that the system can help reduce the burden on hospitals and health-care professionals. The project is being led by Swiss startup Vexatec and includes EOS of Italy and CSEM.

COMO project: the chest belt.

Emergency rooms and intensive care units are under pressure once again as a result of the second wave of the Covid-19 pandemic. Beds are running short, the risk of cross-infection at hospitals is increasing, and capacity levels have reached a critical stage.

Under a project being carried out jointly by Vexatec (project lead), EOS(an Italian company specialized in system integration) and CSEM, engineers are working hard to ease the burden. They have developed a device consisting of light, comfortable sensors that Covid-19 patients can wear and allow doctors to track their vital signs. The sensors are incorporated into a CSEM-designed chest belt and take continual readings of a patient’s heartbeat, breathing rate and body movements. The system also includes wireless devices that periodically measure the patient’s blood oxygen-saturation levels (SpO2) and skin temperature.

The measurements are sent instantly to a central system through an app installed on the patient’s smartphone; doctors can then view the data and monitor the patient’s condition. If one of the patient’s readings falls out of a preset threshold range, the system can send a notification to the health-care team. With this system, patients can stay at home and receive personalized medical and psychological care as and when they need it.

Clinical trials under way in Milan

The system is currently undergoing clinical trials at Luigi Sacco University Hospital in Milan, under a protocol and program headed by Prof. Dr. Maurizio Viecca, the director of the departments of Cardiology. The platform was approved by the ethics committee, and Prof. Viecca notes

"I am very satisfied with the technological content in terms of reliability and precision, and happy for the patients who finally have access to a tool that is not an option, but a valid therapeutic tool.”

The project is called COMO – for COronavirus remote MOnitoring of outpatients – and is being run by an Italian-Swiss consortium with funding from both the European Space Agency (ESA) and the Italian Space Agency (ASI).

Equipping astronauts

COMO draws on technology that CSEM had initially developed for ESA to take measurements of physiological parameters during research expeditions at the Concordia research base in Antarctica. CSEM had also improved the sensing technology to make it compatible with conditions in the International Space Station, so that it can monitor astronauts. Now the technology is back in use, albeit in an updated version, through the R&D partnership with Vexatec.

"ESA’s programs aim to support the development and marketing of innovative products and services that draw on the knowledge and technology developed through our various space missions and research projects," say Elena Razzano and Arnaud Runge, who oversee the COMO project at ESA. "We would be delighted if our space-related research can be redeployed to help save lives" they add.

Dry-electrode sensors

The belt contains two sensors on each side that are placed directly on the patient’s skin. Each sensor contains all the electronics needed for signal processing. The data are sent to the patient’s smartphone via Bluetooth and subsequently to a cloud platform where the patient’s health-care team can view them. A smartphone app is also available for doctors.

“Our system can perform accurate electrocardiograms that cardiologists can work with directly,” says Pascal Heck, the project head at CSEM. Another advantage to COMO is that it employs dry-electrode sensors, which are more comfortable for patients to wear and easier to remove, such as when the patient wants to take a shower. “The electrodes usually used in ECGs are adhesive and can irritate the skin. We decided to use dry electrodes made of stainless steel and then develop the necessary electronics to achieve the same signal quality as doctors get in a clinic, but with less irritation for patients,” says Heck.

Vexatec plans to market the new system, based on the results of this development work.

“Our system has a lot of advantages for medical monitoring in general and for remote health care,” says Urs Ruggaber, CEO of Vexatec. “We are developing a new generation of sensors and aim to launch them next year.”

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