OBJECTIVES: Healthcare providers around the world have responded to COVID-19 by using remote vital signs’ monitoring to try reducing hospital admissions. Our aim was to investigate the effectiveness of virtual wards on health outcomes in patients with acute respiratory infection.

METHODS: We searched four electronic databases from 2000 to March 2021 for randomised controlled trials (RCTs) and systematic reviews (SRs). We included studies in people with acute respiratory illness (including Covid-19) or an acute exacerbation of a chronic respiratory illness; where a patient or carer measured vital signs (oximetry, blood pressure, pulse) for initial diagnosis and/or asynchronous monitoring; and people who were resident in a care home. We assessed risk of bias (RoB) using the Cochrane RoB tool and synthesised results using summary tables, and random effects meta-analysis for mortality.

RESULTS: We reviewed 6,372 abstracts followed by 148 full texts and judged eleven studies relevant for inclusion, of which two were SRs and nine were RCTs. We found no RCTs investigating Covid-19. In nine RCTs the sample size ranged from 37-389 (total=1627), with mean age between 61-77 years. We judged five trials to be at low RoB. Five RCTs had fewer hospital admissions in the intervention (monitoring) group compared to the control group, two studies had more admissions in the intervention group than control, and two studies had no difference between intervention and control groups. Most studies did not reach statistically significant findings, but two studies had fewer admissions in the intervention group, whereas one study had more admissions in the intervention group. In two studies, which were at low risk of bias, the pooled summary risk ratio for mortality was 0.90 (95% CI 0.55-1.48).

CONCLUSIONS: Remote monitoring of vital signs in acute respiratory illness shows promise in reducing hospitalisations. We demonstrate a need for studies investigating consistent patient-centric outcomes on healthcare utilisation.